![]() ![]() The thrust of limited guardianship is to foster autonomy and maintain opportunity to make independent choices, which is critical in promoting mental health ( Quinn, 2004). National organizations and UGPPA recommend that orders be linked to retained abilities (“limited guardianship”) that less restrictive alternatives to guardianship be fully explored before its use and that the allegedly incapacitated person attend the hearing unless excused by court for good cause. The UGPPA is consistent with reforms recommended by national organizations concerned with guardianship, including the use of clinical evaluation to sensitively assess functional strengths and weaknesses by “a physician, psychologist, or other individual appointed by the court who is qualified to evaluate the respondent’s alleged impairment” (§5–306). Some states have made minor revisions other states major revisions and still others have replaced their guardianship statutes entirely, frequently based on the Uniform Guardianship and Protective Proceedings Act (UGPPA National Conference of Commissioners on Uniform State Laws, 1997). State statutes for guardianship have undergone significant reform over the past 20 years to enhance due-process protections and match statutory definitions of decision-making capacity to more contemporary understandings of brain and behavior. In comparison with other older adults, those at risk for guardianship are older, more likely to suffer dementia, to have physical or emotional limitations, and to have limited social supports ( Reynolds, 2002 Reynolds & Wilber, 1997). A later study ( Lisi, Burns, & Lussenden, 1994) involving the observation of hearings and an examination of court files found that hearings were extremely brief, did not rely upon medical testimony, and often resulted in plenary orders (that is, orders transferring all rights and powers to guardians). ![]() In early studies ( Alexander & Lewin, 1972 Blenkner, Bloom, Nielson, & Weber, 1974), concerns were raised that guardianship, although usually well meaning, often benefited the guardian more than the ward and could hasten institutionalization for the protected person. There is limited empirical study of adult guardianship. Our goal, with this preliminary project, is to examine the quality of clinical evaluations present in guardianship cases in three states that vary in terms of statutory reform.Ĭoncerns about guardianship have been raised since the 1970s, including limited due process, lack of protection of rights, poor interface between medical providers and the court, and overly paternalistic interventions ( Horstman, 1975 Mitchell, 1978). Unfortunately, the existing research on clinical evaluations for adult guardianship suggests that these evaluations may not provide such data. Ideally, clinicians provide documentation of both cognitive and functional abilities in order to allow the courts evidence that may be used to craft effective guardianship orders. In the eyes of the law, the guardian essentially stands for the protected person and is empowered to make all life decisions-including those of a most personal nature. Although guardianship is intended to be protective, it results in substantial losses of individual autonomy and rights. Clinical evaluations of capacity are often the primary evidence supplied to the courts in guardianship hearings for older adults.
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