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Guardianship

  • Nery A. DiazEmail author
  • Reema D. Mehta
Chapter

Abstract

When older adults are thought to no longer be able to make decisions for themselves, physicians may be asked to determine decisional capacity and assist in the application for guardianship. Guardianship can be a long, expensive, and confusing process. This chapter explores in detail the process of assessing decisional capacity, application for guardianship, and the disadvantages/limitations of guardianships. In addition, this chapter also highlights alternatives to guardianship.

Keywords

Guardianship Guardian Conservator Capacity Older adults Ward 

References

  1. 1.
    National Guardianship Association. What is guardianship? Available from: https://www.guardianship.org/what-is-guardianship/.
  2. 2.
    Cohen AB, Wright MS, Cooney L Jr, Fried T. Guardianship and end-of-life decision making. JAMA Intern Med. 2015;175(10):1687–91.CrossRefGoogle Scholar
  3. 3.
    Moye J, Naik AD. Preserving rights for individuals facing guardianship. JAMA. 2011;305(9):936–7.CrossRefGoogle Scholar
  4. 4.
    Appelbaum PS, Grisso T. Assessing patients’ capacities to consent to treatment. N Engl J Med. 1988;319(25):1635–8.CrossRefGoogle Scholar
  5. 5.
    PRACTICAL Tool for Lawyers: steps in supporting decision-making. 2016. Available from: https://www.americanbar.org/content/dam/aba/administrative/law_aging/PRACTICALGuide.pdf.
  6. 6.
    Tueth MJ. Exposing financial exploitation of impaired elderly persons. Am J Geriatr Psychiatry. 2000;8(2):104–11.CrossRefGoogle Scholar
  7. 7.
    Marson DC, Martin RC, Wadley V, Griffith HR, Snyder S, Goode PS, et al. Clinical interview assessment of financial capacity in older adults with mild cognitive impairment and Alzheimer’s disease. J Am Geriatr Soc. 2009;57(5):806–14.CrossRefGoogle Scholar
  8. 8.
    Pfeffer RI, Kurosaki TT, Harrah CH Jr, Chance JM, Filos S. Measurement of functional activities in older adults in the community. J Gerontol. 1982;37(3):323–9.CrossRefGoogle Scholar
  9. 9.
    Wilkins JM. More than capacity: alternatives for sexual decision making for individuals with dementia. Gerontologist. 2015;55(5):716–23.CrossRefGoogle Scholar
  10. 10.
    Mahieu L, Gastmans C. Sexuality in institutionalized elderly persons: a systematic review of argument-based ethics literature. Int Psychogeriatr. 2012;24(3):346–57.CrossRefGoogle Scholar
  11. 11.
  12. 12.
    NAPSA. NAPSA Adult Protective Services Abuse Registry National Report. 2018.Google Scholar
  13. 13.
    Types of abuse [cited 2018]. Available from: https://ncea.acl.gov/faq/abusetypes.html - self.
  14. 14.
    Naik AD, Lai JM, Kunik ME, Dyer CB. Assessing capacity in suspected cases of self-neglect. Geriatrics. 2008;63(2):24–31.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Gill TM. Elder self-neglect: medical emergency or marker of extreme vulnerability? JAMA. 2009;302(5):570–1.CrossRefGoogle Scholar
  16. 16.
    Mittal V, Muralee S, Williamson D, McEnerney N, Thomas J, Cash M, et al. Review: delirium in the elderly: a comprehensive review. Am J Alzheimers Dis Other Demen. 2011;26(2):97–109.CrossRefGoogle Scholar
  17. 17.
    Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2014;383(9920):911–22.CrossRefGoogle Scholar
  18. 18.
    Yueh B, Shapiro N, MacLean CH, Shekelle PG. Screening and management of adult hearing loss in primary care: scientific review. JAMA. 2003;289(15):1976–85.CrossRefGoogle Scholar
  19. 19.
    Rubin GS, Roche KB, Prasada-Rao P, Fried LP. Visual impairment and disability in older adults. Optom Vis Sci. 1994;71(12):750–60.CrossRefGoogle Scholar
  20. 20.
    Ancelin ML, Artero S, Portet F, Dupuy AM, Touchon J, Ritchie K. Non-degenerative mild cognitive impairment in elderly people and use of anticholinergic drugs: longitudinal cohort study. BMJ. 2006;332(7539):455–9.CrossRefGoogle Scholar
  21. 21.
    Mintzer J, Burns A. Anticholinergic side-effects of drugs in elderly people. J R Soc Med. 2000;93(9):457–62.CrossRefGoogle Scholar
  22. 22.
    Fick DM, Semla TP, Beizer J, et al. American Geriatrics Society 2015 updated beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015;63(11):2227–46.CrossRefGoogle Scholar
  23. 23.
    Kasl-Godley J, Gatz M. Psychosocial interventions for individuals with dementia: an integration of theory, therapy, and a clinical understanding of dementia. Clin Psychol Rev. 2000;20(6):755–82.CrossRefGoogle Scholar
  24. 24.
    Block SD. Perspectives on care at the close of life. Psychological considerations, growth, and transcendence at the end of life: the art of the possible. JAMA. 2001;285(22):2898–905.CrossRefGoogle Scholar
  25. 25.
    Levy BR, Slade MD, Murphy TE, Gill TM. Association between positive age stereotypes and recovery from disability in older persons. JAMA. 2012;308(19):1972–3.CrossRefGoogle Scholar
  26. 26.
    Ganzini L, Volicer L, Nelson WA, Fox E, Derse AR. Ten myths about decision-making capacity. J Am Med Dir Assoc. 2005;6(3 Suppl):S100–4.CrossRefGoogle Scholar
  27. 27.
    Bandy RJ, Helft PR, Bandy RW, Torke AM. Medical decision-making during the guardianship process for incapacitated, hospitalized adults: a descriptive cohort study. J Gen Intern Med. 2010;25(10):1003–8.CrossRefGoogle Scholar
  28. 28.
    Ricotta DN, Parris JJ, Parris RS, Sontag DN, Mukamal KJ. The burden of guardianship: amatched cohort study. J Hosp Med. 2018;13:595–601.PubMedGoogle Scholar
  29. 29.
    ABA Commission on Law and Aging. Capacity definition &initiation of guardianship proceedings American Bar Association. 2016. Available from: https://www.americanbar.org/content/dam/aba/administrative/law_aging/chartcapacityandinitiation.authcheckdam.pdf.
  30. 30.
    Guardianship Health Care Decision-Making Authority and Statutory Restrictions American Bar Association. 2014. Available from: https://www.americanbar.org/content/dam/aba/administrative/law_aging/2014_HealthCareDecisionMakingAuthorityofGuardiansChart.authcheckdam.pdf.
  31. 31.
    Wright JL. Guardianship for your own good: improving the well-being of respondents and wards in the USA. Int J Law Psychiatry. 2010;33(5–6):350–68.CrossRefGoogle Scholar
  32. 32.
    Aviv R. How the elderly lose their rights. The New Yorker; 2017. https://www.newyorker.com/magazine/2017/10/09/how-the-elderly-lose-their-rights.
  33. 33.
    Edlich RF. Guardian ad litem, a potentially expensive invitation to either the mismanagement or management of patients with cognitive disorders. Clin Interv Aging. 2010;5:369–72.CrossRefGoogle Scholar
  34. 34.
    Rabiner DJ, O’Keeffe J, Brown D. Financial exploitation of older persons: challenges and opportunities to identify, prevent, and address it in the United States. J Aging Soc Policy. 2006;18(2):47–68.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Columbia University Irving Medical CenterNew YorkUSA
  2. 2.New York State Psychiatric InstituteNew YorkUSA
  3. 3.Jacobi Medical CenterBronxUSA
  4. 4.Albert Einstein College of MedicineBronxUSA

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