The Fundamentals of Guardianship: What Every Guardian Should Know, Second Edition

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.

Table of Contents:
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

About the Author :
Sally Hurme is an elder law attorney and author. While with AARP for 23 years she worked on a wide variety of issues including advance care planning, surrogate decision making, consumer fraud, elder abuse, and financial security. Ms. Hurme was an advisor to the Uniform Law Commission in the drafting of the uniform guardianship jurisdiction act and Uniform Guardianship, Conservatorship and other Protective Arrangements Act. She also was a member of the U.S. State Department delegation that drafted the Hague Convention on the International Protection of Adults. She has authored 20 law review articles and book chapters on various elder law issues and taught elder law at George Washington University Law School. She is author of the ABA/AARP Checklist series: Checklist for My Family, Checklist for Family Survivors, Checklist for Family Caregivers, Get the Most Out of Retirement, and Wise Moves. She received her law degree from the Washington College of Law at American University, Washington, D.C., and her bachelor's degree from Newcomb College, Tulane University in New Orleans. Sally currently lives in Bridgewater, VA.