Co-sponsored by the National Guardianship Association
Serving as guardian is never simple or easy. Having the responsibility to make major life decisions for another is much more difficult than making decisions for oneself. Recent studies by the National Center for State Courts estimate that between one to two million adults are under court-supervised guardianship. The Administrative Conference of the United States estimates that approximately 75 percent of guardians are family members or friends. A constant refrain in multiple national studies and legislative reports is that once guardians are appointed they receive little instruction on how to carry out their responsibilities and have few resources to guide them.
The new edition of Fundamentals of Guardianship is the much-needed, basic manual for new guardians that explains those roles and responsibilities. The court orders guardians to make decisions; Fundamentals of Guardianship explains how to make those decisions. It guides the new guardian step-by-step through the process of how to make responsible and ethical decisions, prudently manage another's resources, avoid conflicts of interest, and involve the person under guardianship in the decision process. Fundamentals of Guardianship is the authoritative resource written by guardians with decades of experience and members of the National Guardianship Association.
This book will appeal to all who have been appointed as guardian or conservator, whether lawyer, family member, friend, volunteer, or public or private entity, as well as all those who serve vulnerable adults. Included on this list are judges, court administrators, law enforcement officials, adult protective services, social workers, health care providers, case managers, residential care administrators, long-term care ombudsmen, financial institutions, and financial advisors.
CONTENTS
Introduction vi
Acknowledgments viii
Ways to Avoid the Need for Guardians 1
Advance Directives 1
Durable Powers of Attorney 2
Health Care Directives 2
Living Wills 3
Health Care Powers of Attorney 4
Health Care Surrogate Acts 4
Guardianship Initiation 5
Petitioning 5
Prehearing Process 6
Hearing Process 6
Guardian Qualifications 7
Authority to Act 8
Due Process Rights 8
Guardians Make Decisions 10
Guardian as Surrogate Decision-Maker 10
Decision-Making Process 11
Informed Consent 12
Decision-Making Standards 13
Person-Centered Decision-Making and Planning 13
Substituted Judgment 14
Best Interest 14
Least Restrictive Alternatives 15
Guardians Are Fiduciaries 16
Fiduciary Relationships 19
Guardians’ Relationships with Family and Friends 19
Guardians’ Relationships with Other Professionals and Service Providers 20
Guardians’ Relationships with the Court 20
Guardians of the Person 22
Assess Needs 23
Assess Functional Abilities 23
Give Informed Consent 24
Promote the Person’s Well-Being 25
Advocate for the Person 25
Know the Person 26
Create Care Plans 27
Monitor Care and Treatment 28
Develop Communication Skills 28
Use Available Community Resources 29
Assist with Finances 29
Determine Residence 30
Address Behavioral Problems 31
Monitor Medical Status 32
Make Medical Treatment Decisions 33
Invasive Medical Procedures 35
Withholding and Withdrawing Medical Treatment 36
Physician Orders 36
Final Arrangements 37
Guardians of the Estate 38
Center on the Person 39
Marshal the Estate 40
Inventory the Estate 41
Maintain the Estate 42
Invest with Prudence 43
Know the Guardian’s Limits 44
Develop Communication Skills 45
Guardians Respect Rights 46
Rights Retained 46
Rights Restricted 48
Rights Delegated 48
Guardians Seek Modification 49
Right to Restoration 49
Termination Process 50
Changes in the Person’s Status 50
Death of the Person 51
Minor Coming of Age 52
Interstate Recognition and Transfer 52
Removal or Resignation of the Guardian 52
Successor Guardians 53
Guardians Report Abuse 54
Signs of Physical Abuse 54
Signs of Emotional Abuse in Behaviors 55
Signs of Sexual Abuse 55
Signs of Neglect 55
Signs of Self-Neglect 55
Signs of Exploitation 56
Signs of Abandonment 56
Signs of Environmental Abuse 56
Signs of Caregiver Abuse 56
Signs of Improper Residential/Group Setting Care 56
Guardians Avoid Conflicts of Interest 58
Staying Out of Trouble 58
National Guardianship Association Resources 60
Education Products 60
Professional Development 60
NGA Brochures 61
National Certified Guardian Study Guide 61
Finance Certificate Study Guide 61
Checklists and Forms 62
Appendix A: National Guardianship Association Ethical Principles 109
Appendix B: National Guardianship Association Standards of Practice 110
Appendix C: Practice Checklist 141
Appendix D: Websites 151
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