guardianship

A legal relationship, created by a state court (in most states in the probate division), between a patient declared incompetent (ward) & a guardian, appointed by the court as a surrogate decison maker. The appointing court maintains oversight jurisdiction as long as the guardianship is in effect. Not standard terminology (state-specific). Judicial appointment of a guardian means that the ward no longer retains the power to exercise decisional rights that have been assigned to the guardian. Courts have the authority to allow the ward to make certain types of decisions, but not others which are assigned to the guardian. A guardian may also be appointed on a temporary basis, if it is expected that the ward may regain capacity to make decisions in the foreseeable future. Most states require periodic review of guardianship orders. Guardianship may be sought for several reasons: 1) helping professions, social agenices or friends &/or relatives may seek an effective legal mechanism for assuming necessary control over personal or financial affairs of a cognitively or emotionally impaired person 2) a health care professional or organization may seek to establish a party who is responsible to payment of services & who is legally impowered to provide binding informed consent 3) guardianship petitions may result from mandated provider compliance with state elder abuse & neglect reporting requirements As a temporary measure, adult protective serivices can provide a surrogate decision maker.

References

Kapp M & Finucane T. Decision Making, In: Comprehensive Geriatric Assessment, Osterweil et al eds, McGraw-Hill, New York, pg 605