North Shore Elder Services’ (NSES) employees Karyn Smith and Kelly Briggs are now our Guardianship Case Workers. Our official contract for this program began in July 2017. We are the first Aging Services Access Point (ASAP) to offer guardianship services and it comes at a time of great need in the state.
Guardianship is a “delegated judicial function that entails a high responsibility to achieve stability or improve the life of a vulnerable adult” (National Guardianship Association). The person or entity acting as guardian has the legal and moral responsibility to act in the best interest of the person. Guardians were designed to protect the interests of incapacitated adults and elders in particular.
Although many states have guardianship programs, Massachusetts does not have a public guardianship program “for the most isolated and indigent of those in need”.
Karyn and Kelly’s goal as caseworkers is to build a relationship with the person under guardianship. “We try as much as possible to make decisions with the person – to include them. We want to find out as much history as we can about someone in order to make decisions regarding what this person would want. When appropriate and possible, we consult with family members and friends. Guardianship is about least restrictive so if there is a way to meet the individual’s needs that is less than full guardianship, we will seek that. That is why limited guardianship is good.”
The program includes meeting with each individual at least once per month. However, Karyn and Kelly find that there may be more contact, particularly in the beginning of someone being referred to the program.
“Unlike in Home Care, we are able as case workers to do whatever someone needs to have done, short of personal care. It might be buying groceries, going to the bank, clothes shopping, purchasing durable equipment, or going for a walk while visiting. We become “professional family.” We can make lives better for those who may not have anyone to act on their behalf.”
Part of the planning is working on short and long term goals with the client that will enhance the quality of life for the client. If there is no Comfort Care/Do Not Resuscitate (CC/DNR), or Health Care Proxy, Karyn and Kelly will help get those in order.
Guardianship certainly underlines the importance of protecting yourself with designating someone to make decisions in the event of being incapacitated. We can avoid risk by completing the appropriate documents like Durable power of Attorney, Health Care Advance Directives, and Medical Orders for Life Sustaining Treatment (Molst). To read more about these important decisions you can refer to https://www.honoringchoicesmass.com/ and to our blog on the importance of health care proxies at https://nselder.org/blog/healthcare-proxies-are-vital-to-making-sure-your-healthcare-treatment-choices-are-followed/
The unfortunate but very real increase in cognitive disabilities will produce an increasing demand to seek guardianship. Our aging population will lead to greater demand for services for people who are unable to care for themselves. Guardianship is a necessary tool for the protection of vulnerable adults.
North Shore Elder Services’ guardianship program strives to protect people from harm while respecting their self-autonomy. If you would like to learn more about the state guardianship program, check https://www.mass.gov/how-to/file-for-guardianship-of-an-incapacitated-person
NSES is currently hiring another Case Manager for the Guardianship program. If interested, please check out https://nselder.org/get-involved/employment-opportunities/ for more information