Guardianship of Adults: Guardianship Process - #87
Take QuizElderly patients in inpatient or outpatient settings with potential neurocognitive impairment.
" ["format"]=> string(9) "full_html" ["safe_value"]=> string(102) "Elderly patients in inpatient or outpatient settings with potential neurocognitive impairment.
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" ["format"]=> string(9) "full_html" ["safe_value"]=> string(64) "Understand the general process of assigning guardianship
" } } } ["field_definition"]=> array(1) { ["und"]=> array(1) { [0]=> array(3) { ["value"]=> string(963) "Guardianship is the court’s appointment of legal authority over the person and property of another individual, called the ward. In assigning guardianship, the court makes a ruling as to the competence of an individual. Guardianship allows for:
- the making of decisions for a person who is unable to make them for him/herself
- the exercising of rights that the person cannot exercise for him/herself
- protecting and advocating for the individual’s best interests
- protecting the individual from abuse, neglect, exploitation, and violation of legal rights
This authority is assigned through the judicial system, distinguishing it from a designated “Power of Attorney” (POA). In designating a POA, an individual cedes rights or responsibilities, under specific circumstances, to a person of their choosing while they are capable of making such a decision.
" ["format"]=> string(9) "full_html" ["safe_value"]=> string(932) "Guardianship is the court’s appointment of legal authority over the person and property of another individual, called the ward. In assigning guardianship, the court makes a ruling as to the competence of an individual. Guardianship allows for:
- the making of decisions for a person who is unable to make them for him/herself
- the exercising of rights that the person cannot exercise for him/herself
- protecting and advocating for the individual’s best interests
- protecting the individual from abuse, neglect, exploitation, and violation of legal rights
This authority is assigned through the judicial system, distinguishing it from a designated “Power of Attorney” (POA). In designating a POA, an individual cedes rights or responsibilities, under specific circumstances, to a person of their choosing while they are capable of making such a decision.
" } } } ["field_incidence"]=> array(1) { ["und"]=> array(1) { [0]=> array(3) { ["value"]=> string(269) "While the number of guardianship cases per year is not available, the aging population’s increasing incidence of dementia is anticipated to create an increase in cases. Careful attention to completion of advance directives is essential to mitigate this rise.
" ["format"]=> string(9) "full_html" ["safe_value"]=> string(268) "While the number of guardianship cases per year is not available, the aging population’s increasing incidence of dementia is anticipated to create an increase in cases. Careful attention to completion of advance directives is essential to mitigate this rise.
" } } } ["field_underlying_sciences"]=> array(1) { ["und"]=> array(1) { [0]=> array(3) { ["value"]=> string(59) "Behavioral and Social Sciences Including Bioethics
" ["format"]=> string(9) "full_html" ["safe_value"]=> string(58) "Behavioral and Social Sciences Including Bioethics
" } } } ["field_background"]=> array(0) { } ["field_etiologies"]=> array(0) { } ["field_guideline"]=> array(0) { } ["field_objectives"]=> array(1) { ["und"]=> array(1) { [0]=> array(3) { ["value"]=> string(165) "1. Define purpose and types of guardianship
2. Explain the standards for incompetence
3. List the steps in the guardianship process
" ["format"]=> string(9) "full_html" ["safe_value"]=> string(154) "1. Define purpose and types of guardianship
2. Explain the standards for incompetence
3. List the steps in the guardianship process
" } } } ["field_references"]=> array(1) { ["und"]=> array(1) { [0]=> array(3) { ["value"]=> string(154) "Guardianship of Adults. Department of Health Services, State of Wisconsin. Division of Long Term Care. P-20460 (06/2011).
" ["format"]=> string(9) "full_html" ["safe_value"]=> string(137) "Guardianship of Adults. Department of Health Services, State of Wisconsin. Division of Long Term Care. P-20460 (06/2011).
" } } } ["field_authors"]=> array(1) { ["und"]=> array(1) { [0]=> array(3) { ["value"]=> string(89) "Steven Denson, MD, Associate Professor of Medicine, Medical College of Wisconsin
" ["format"]=> string(9) "full_html" ["safe_value"]=> string(88) "Steven Denson, MD, Associate Professor of Medicine, Medical College of Wisconsin
" } } } ["field_copyright"]=> array(0) { } ["field_assessment"]=> array(1) { ["und"]=> array(1) { [0]=> array(3) { ["value"]=> string(3454) "Types of guardianship include:
- Guardian of the person
- The estate (property and finances)
- Temporary guardianship
- Standby guardian (a backup to a primary guardian)
Guardianship laws vary by state, and attorneys familiar with guardianship processes for the specific area should be consulted. Several general concepts hold true, however:
- Guardianship is predicated on an individual being considered incompetent relative to other adults within that community.
- Lack of evaluative capacity is defined as the inability to take in, evaluate, and communicate information for decisions. It is not a function of being old, having an unrelated disability, or making “bad” but otherwise informed decisions.
- Individuals must be at least 17 years and 9 months old at the time of guardianship (i.e. transitioning from “minor” status to adult)
- Individuals must have a court-determined impairment including:
- a developmental disability or serious or persistent mental illness
- a degenerative brain disorder, or “other like incapacities”.
- note: a physical disability, unless it affects communication, is not a criterion.
- Individuals must lack evaluative capacity, putting them at risk of harm to either their person or estate and less restrictive alternatives (e.g., limited capacity to assign a power of attorney) are not available.
Individual’s rights are protected through state and federal constitutions. These include the right to:
- Communicate with court or government officials
- Petition the court for a review of guardianship, protective services, and placement
- Representation (attorney) and the right to communicate privately with advocacy agencies
- Protest placement in a facility
- Withhold consent and to refuse certain treatments (e.g., mental illness treatment).
However, certain rights (e.g., right to vote, execute a will, serve on a jury, consent to marriage, apply for licenses, consent to organ donation) cannot be delegated to a guardian.
The Guardianship Process is based on legal due process.
- Step 1: An individual is deemed to lack decisional capacity, and to lack the limited capacity to assign a less restrictive representative (i.e. a Power of Attorney). This is decided by two physicians, or a physician and a psychologist.
- Step 2: A petition is filed with the state if the person meets the standards for guardianship.
- Step 3: Notice must be provided to the individual, proposed guardian, and any “interested persons” (family or friends who have a relationship with the individual, and who wish to have a say in the proceedings).
- Step 4: A guardian ad litem is assigned. This is not a temporary guardian, but rather someone who makes certain that the individual’s rights are not violated and represents the best interests of the proposed ward during the guardianship process.
- Step 5: A court hearing is held in the jurisdiction where the individual resides.
Types of guardianship include:
- Guardian of the person
- The estate (property and finances)
- Temporary guardianship
- Standby guardian (a backup to a primary guardian)
Guardianship laws vary by state, and attorneys familiar with guardianship processes for the specific area should be consulted. Several general concepts hold true, however:
- Guardianship is predicated on an individual being considered incompetent relative to other adults within that community.
- Lack of evaluative capacity is defined as the inability to take in, evaluate, and communicate information for decisions. It is not a function of being old, having an unrelated disability, or making “bad” but otherwise informed decisions.
- Individuals must be at least 17 years and 9 months old at the time of guardianship (i.e. transitioning from “minor” status to adult)
- Individuals must have a court-determined impairment including:
- a developmental disability or serious or persistent mental illness
- a degenerative brain disorder, or “other like incapacities”.
- note: a physical disability, unless it affects communication, is not a criterion.
- Individuals must lack evaluative capacity, putting them at risk of harm to either their person or estate and less restrictive alternatives (e.g., limited capacity to assign a power of attorney) are not available.
Individual’s rights are protected through state and federal constitutions. These include the right to:
- Communicate with court or government officials
- Petition the court for a review of guardianship, protective services, and placement
- Representation (attorney) and the right to communicate privately with advocacy agencies
- Protest placement in a facility
- Withhold consent and to refuse certain treatments (e.g., mental illness treatment).
However, certain rights (e.g., right to vote, execute a will, serve on a jury, consent to marriage, apply for licenses, consent to organ donation) cannot be delegated to a guardian.
The Guardianship Process is based on legal due process.
- Step 1: An individual is deemed to lack decisional capacity, and to lack the limited capacity to assign a less restrictive representative (i.e. a Power of Attorney). This is decided by two physicians, or a physician and a psychologist.
- Step 2: A petition is filed with the state if the person meets the standards for guardianship.
- Step 3: Notice must be provided to the individual, proposed guardian, and any “interested persons” (family or friends who have a relationship with the individual, and who wish to have a say in the proceedings).
- Step 4: A guardian ad litem is assigned. This is not a temporary guardian, but rather someone who makes certain that the individual’s rights are not violated and represents the best interests of the proposed ward during the guardianship process.
- Step 5: A court hearing is held in the jurisdiction where the individual resides.
There are 3 multiple choice questions in this quiz.
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Listen to Geriatric Fast Cast #87 & #88 here: https://geriatricfastcasts.libsyn.com/guardianship-geriatric-fast-facts-87-and-88
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Listen to Geriatric Fast Cast #87 & #88 here: https://geriatricfastcasts.libsyn.com/guardianship-geriatric-fast-facts-...
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Listen to Geriatric Fast Cast #87 & #88 here: https://geriatricfastcasts.libsyn.com/guardianship-geriatric-fast-facts-87-and-88
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Listen to Geriatric Fast Cast #87 & #88 here: https://geriatricfastcasts.libsyn.com/guardianship-geriatric-fast-facts-...
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- Guardian of the person
- The estate (property and finances)
- Temporary guardianship
- Standby guardian (a backup to a primary guardian)
Guardianship laws vary by state, and attorneys familiar with guardianship processes for the specific area should be consulted. Several general concepts hold true, however:
- Guardianship is predicated on an individual being considered incompetent relative to other adults within that community.
- Lack of evaluative capacity is defined as the inability to take in, evaluate, and communicate information for decisions. It is not a function of being old, having an unrelated disability, or making “bad” but otherwise informed decisions.
- Individuals must be at least 17 years and 9 months old at the time of guardianship (i.e. transitioning from “minor” status to adult)
- Individuals must have a court-determined impairment including:
- a developmental disability or serious or persistent mental illness
- a degenerative brain disorder, or “other like incapacities”.
- note: a physical disability, unless it affects communication, is not a criterion.
- Individuals must lack evaluative capacity, putting them at risk of harm to either their person or estate and less restrictive alternatives (e.g., limited capacity to assign a power of attorney) are not available.
Individual’s rights are protected through state and federal constitutions. These include the right to:
- Communicate with court or government officials
- Petition the court for a review of guardianship, protective services, and placement
- Representation (attorney) and the right to communicate privately with advocacy agencies
- Protest placement in a facility
- Withhold consent and to refuse certain treatments (e.g., mental illness treatment).
However, certain rights (e.g., right to vote, execute a will, serve on a jury, consent to marriage, apply for licenses, consent to organ donation) cannot be delegated to a guardian.
The Guardianship Process is based on legal due process.
- Step 1: An individual is deemed to lack decisional capacity, and to lack the limited capacity to assign a less restrictive representative (i.e. a Power of Attorney). This is decided by two physicians, or a physician and a psychologist.
- Step 2: A petition is filed with the state if the person meets the standards for guardianship.
- Step 3: Notice must be provided to the individual, proposed guardian, and any “interested persons” (family or friends who have a relationship with the individual, and who wish to have a say in the proceedings).
- Step 4: A guardian ad litem is assigned. This is not a temporary guardian, but rather someone who makes certain that the individual’s rights are not violated and represents the best interests of the proposed ward during the guardianship process.
- Step 5: A court hearing is held in the jurisdiction where the individual resides.
Elderly patients in inpatient or outpatient settings with potential neurocognitive impairment.
Understand the general process of assigning guardianship
Guardianship is the court’s appointment of legal authority over the person and property of another individual, called the ward. In assigning guardianship, the court makes a ruling as to the competence of an individual. Guardianship allows for:
- the making of decisions for a person who is unable to make them for him/herself
- the exercising of rights that the person cannot exercise for him/herself
- protecting and advocating for the individual’s best interests
- protecting the individual from abuse, neglect, exploitation, and violation of legal rights
This authority is assigned through the judicial system, distinguishing it from a designated “Power of Attorney” (POA). In designating a POA, an individual cedes rights or responsibilities, under specific circumstances, to a person of their choosing while they are capable of making such a decision.
While the number of guardianship cases per year is not available, the aging population’s increasing incidence of dementia is anticipated to create an increase in cases. Careful attention to completion of advance directives is essential to mitigate this rise.
Behavioral and Social Sciences Including Bioethics
Science Principles
1. Define purpose and types of guardianship
2. Explain the standards for incompetence
3. List the steps in the guardianship process
Review of Systems (ROS)
Geriatric Topics
ACGME Compentencies
Science Principles
Guardianship of Adults. Department of Health Services, State of Wisconsin. Division of Long Term Care. P-20460 (06/2011).
Steven Denson, MD, Associate Professor of Medicine, Medical College of Wisconsin