A Waverly man charged in the Nov. 2006 killings of his cousin and her husband is no longer competent to face trial, his attorneys argued Monday in county court.

The condition of John Joseph DeSisti, 76, has significantly worsened since the court last evaluated his fitness to stand trial in Oct. 2012, according to testimony at Monday's hearing from experts for the defense as well as DeSisti's wife and son. The hearing will resume at 9 a.m. today.

DeSisti was arrested in Dec. 2010 and charged with two counts of murder and one count of burglary in the shooting deaths of David and Carol Keeffe at their Athens Township home. A jury trial is scheduled for July 8, but DeSisti's attorney, Arthur T. Donato Jr. of Media, Pa., filed a motion in April asking the court to re-assess DeSisti's competency based upon intervening factors.

DeSisti's dementia, which experts said Monday appears to be the result of Alzheimer's and possibly Parkinson's disease, has worsened since the October hearing, Donato said in his opening statement to senior judge David Grine.

Donato argued that DeSisti's deteriorating condition no longer makes him able to participate in his defense or understand the proceedings against him. DeSisti no longer communicates, despite frequent urging from his counsel and from family members visiting him at the state correctional institution at Waymart, Donato said.

His physical condition has also worsened, experts argued. DeSisti was transported to and from the courthouse by ambulance Monday, was wheeled into the building on a stretcher and sat in a wheelchair during the proceedings. He often exhibited hand and head tremors typical of Parkinson's disease during the course of Monday's hearing.

Forensic psychologist Dr. Elliot Atkins and psychiatrist Dr. Richard Fischbein, who argued for DeSisti's incompetence in October, performed further evaluations of DeSisti in Nov. 2012 and May 2013. The two were joined in May by Dr. Mario Cornacchione, an expert in geriatric medicine and Alzheimer's disease.

The prosecution's expert, psychiatrist John S. O'Brien II, also examined DeSisti in May and is expected to testify today.

In his May 20 report, Atkins stated that DeSisti can no longer take care of himself or interact with others. During his evaluation, DeSisti could not name his attorneys or answer questions about the proceedings, Atkins stated.

The report, Atkins said, reaffirmed his earlier opinion that DeSisti was not competent to stand trial.

DeSisti's mental and physical condition was "absolutely" worse at the November evaluation than in April 2012, when his counsel first expressed concerns about his competency, Fischbein said. DeSisti was originally scheduled to face trial April 23, 2012, but the trial was stayed pending investigation into his mental state.

According to Atkins and Fischbein, Waymart staff stated that DeSisti is incontinent, needs to be fed or reminded to eat and requires frequent repositioning to avoid bed sores. "He could not survive on his own," Fischbein said.

Experts also stated Monday that they did not think DeSisti could be restored to competency. "This is a non-reversible disease process," Fischbein stated.

Cornacchione explained that DeSisti provided no verbal responses during his evaluation, but a physical examination revealed brain damage, widespread muscle wasting and signs of Parkinson's such as extreme rigidity.

According to the Functional Assessment Staging Tool, a scale used to determine the progression of Alzheimer's disease, DeSisti is approaching the severe final stage of dementia, Cornacchione testified. Patients in the final stage generally have an average life expectancy of six months to a year due to a marked loss of function, he stated.

The prosecution, led by attorney Joseph McGettigan, continued to assert Monday that DeSisti has feigned his symptoms for secondary gain - an argument former president judge Jeffrey Smith upheld in his February opinion that DeSisti was able to stand trial.

Smith stated in his written opinion that DeSisti's counsel failed to make a distinction between whether DeSisti lacked the ability cooperate with his counsel or whether he simply chose not to cooperate.

However, Cornacchione stated Monday that it would be difficult to impossible to mimic the tremors and behaviors symptomatic of DeSisti's severe dementia. "That's not volition," he said of DeSisti's symptoms.

In his condition, DeSisti "cannot have a rational understanding of his legal situation," Cornacchione said.

In their testimony, Nancy DeSisti, the defendant's wife of 52 years, and son John A. DeSisti both stated that DeSisti fails to react during family members' weekly visits to Waymart. DeSisti sits passively and quietly with his eyes closed during the visits, family members testified.

"We would prompt him over and over with questions," John A. DeSisti testified. "I got the impression that he just didn't understand."

The younger DeSisti estimated Monday that his father "has probably lost 50 pounds" since his incarceration and can no longer feed or take care of himself, a marked change from a man the family described as "vigorous."

"I think my father would be mortified if he understood what the hell was happening to him right now," he said.

DeSisti also remained silent during two recent telephone calls with his wife, including one in which she told him he'd recently become a great-grandfather, Nancy DeSisti said.

"That's not my husband," she told the court, her eyes welling up with tears. "He's gone."

Amanda Renko can be reached at (570) 888-9652; or email: arenko@thedailyreview.com.