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Guardianship?

Any comments on the pro's and con's of state appointed guardianship?

An update: my mom accused us of all kinds of horrid things on 1 Dec, told us to never call or come over again, etc. Called us twice more during the month to accuse us again. We did call her doctor to let them know and contacted a neighbor to watch over her. Mom is unable to drive, cook much, understand her bills, etc. without help.

The Adult Protective Services called us, they had visited with my mom and determined that she is not able to live alone without aid, has clear signs of dementia and paranoia but at this stage she's not a danger to herself. Considering her hatred of us, the APS figured it might be difficult for us to enact the POA and take care of her. They recommended that we consider a state appointed guardian. Sounds good but it also sounds very expensive.

I want my mom to be safe but the emotions involved are pretty bad. What do you think?
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State regulations vary, but in my area once adult protective services "suggests" a guardianship it is an inevitability. A hearing is set up in surrogate court and the court appoints both an attorney for the patient and an investigator. It pays for as relative to visit surrogate court and ask to see the pro se (free) attorney for advice. At this point they will ask if you have an attorney. If you say yes they will refuse advice. Always say NO.  Adult protective services then shows up with a form for a relative to sign covering certain costs. They hint that without such a signature the care might be less than optimal. They fib. Every guardianship is different, and there can be a co-guardianship, although the court appointed guardians will fight this. Usually the "guardian" is only required to interface with the patient twice a year. All the patient's assets, bank accounts, house, etc. will be used to pay the attorney, investigator and for nursing care. Thus if there is a joint bank account it pays to get everything out. When the patient's assets go below $1,500 the state takes over payment to the guardian. The procedure is "sequestered" but a relative has "standing" and may attend. Proceedings are informal. At the time a relative may make one or more "motions" to the judge. A motion is a "simple one line request for the judge to do something asked". A motion should be made for at least one relative to be permitted to access all medical records, specifically psychiatric records, and for a nursing home to interface with this person insofar as treatment, rehab and care. At this time a motion may be made for the patient to be remanded to a specific nursing home or one within a certain geographic area. Like in the marriage vows this is a time to "speak now or forever hold your peace". Many of the guardians get kickbacks or have a financial interests in a specific nursing home. Surprise!
You bypass the guardian by making a motion to the judge for a specific home. Furthermore, many homes will not accept a patient with certain psychiatric disabilities. The reality is, when they get such a patient they are sedated. It's called a "chemical straightjacket". Zombie city. I have probably been in over 200 nursing homes over the decades in three states.  Some are magnificent. Others reek with the stench of urine and feces. Most states publish a list of violations of every home you may access before making a decision. When in a nursing home the patient's family physician is not allowed to treat or be involved. I get around this by having a physician visit as a "friend" and then conduct an examination. I have obtained independent psychiatric evaluations in this manner, and when these are submitted to the court the nursing home and that guardians generally go nuts.
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My opinion of state appointed "guardians" is that the community should consider what the French did to their soldiers during the first world war. That is shoot-every-other one to "encourage the others". This is a VERY complex situation and it revolves around the fact there may be a conservatorship and a guardianship, which are different animals, and the both them may be "shared" by two people. I have been involved with several of them and not one has been worth the high explosives to send them to the moon. It's a big racket. They set up "non-profit" guardianships and through political connections get appointments. There are several law books out concerning guardianships and you need to buy one. I have been involved with seven guardianships (rescuing helpless elderly women from their clutches) and the idea that these court appointed guardians are altruistic angels of mercy is a fantasy. (Remember that line: "we're from the government - we're here to help you") One I am dealing with has a class sixty siren and (illegal) red light on his car, a hip-knife, flare-gun, a shoulder-knife, a stun-gun, gun-permit, sixteen patches certifying he is an underwater rescue expert and CPR instructor,  and a fire and police buff with deep-seeded psychiatric problems. Oh yeah. A masters in social work he got by sending in box-tops. He bills $150 an hour. Taken from the life-savings of the person under guardianship. He was appointed because of his religious affiliations and political connections and founded a "non-profit" guardianship. Mental cases seem to be attracted to guardianships like flies on cow poo. In another case with another woman, the court appointed a conservator. The conservator runs interference because the woman has issues revolving around her daughter (hates her), and takes care of seeing the woman gets medical and psychiatric care, but the daughter retains all control over the finances and selection of a nursing facility if she need go there. This conservator bills $50 an hour. One big problem with the state guardianships is that they will only approve care through a state certified care provider. The guardian then fired the excellent part-time caregivers (charging $10 an hour) I had set up for the woman to enable her to live at home and insisted that only those from visiting nurse or a licensed care provider could be used ($40 per hour), allegedly because "I'll be liable for insurance purposes if anything happens". This caused he woman to be placed in a nursing home. The "guardian" then threatened to have an order of protection issued against ANYONE who spoke in the nursing home about getting the woman out. Meanwhile he threw out her personel belongings and thousand of pages of her writings (he said they had bedbugs).
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LOL  I don't know whether to laugh or cry while reading your post. I love how you explain it all but then I'm discouraged thinking I'll be forced into the position of caring for an abusive, elderly parent.

After my Dad died she did get a new will and the lawyer set up a POA where I would be taking care of things if she was incapacitated. My mom took the will and lost it, hid it, shredded it - I don't know but I kept the POA. There's no doubt that she would be declared unable to care for herself. Between her doctor and the Adult Protective Service lady, they agree that she is showing clear signs of paranoia and dementia. The APS lady said a court would have no problem setting a guardianship in place.

Now I'm back to POA. Hubby had the same feeling as you about guardianship only his explanation wasn't quite as colorful. He knows the state is mainly interested in the cash flow, not the well being of the patient. Whereas we would pinch every penny to make sure she got the best care without being ripped off.

We also have to deal with the neighbor who ripped her off last year and has  now weaseled her way back into my mom's life and "taking care" of her. At what cost? I don't know.
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144586_tn?1284669764
State regulations vary, but in my area once adult protective services "suggests" a guardianship it is an inevitability. A hearing is set up in surrogate court and the court appoints both an attorney for the patient and an investigator. It pays for as relative to visit surrogate court and ask to see the pro se (free) attorney for advice. At this point they will ask if you have an attorney. If you say yes they will refuse advice. Always say NO.  Adult protective services then shows up with a form for a relative to sign covering certain costs. They hint that without such a signature the care might be less than optimal. They fib. Every guardianship is different, and there can be a co-guardianship, although the court appointed guardians will fight this. Usually the "guardian" is only required to interface with the patient twice a year. All the patient's assets, bank accounts, house, etc. will be used to pay the attorney, investigator and for nursing care. Thus if there is a joint bank account it pays to get everything out. When the patient's assets go below $1,500 the state takes over payment to the guardian. The procedure is "sequestered" but a relative has "standing" and may attend. Proceedings are informal. At the time a relative may make one or more "motions" to the judge. A motion is a "simple one line request for the judge to do something asked". A motion should be made for at least one relative to be permitted to access all medical records, specifically psychiatric records, and for a nursing home to interface with this person insofar as treatment, rehab and care. At this time a motion may be made for the patient to be remanded to a specific nursing home or one within a certain geographic area. Like in the marriage vows this is a time to "speak now or forever hold your peace". Many of the guardians get kickbacks or have a financial interests in a specific nursing home. Surprise!
You bypass the guardian by making a motion to the judge for a specific home. Furthermore, many homes will not accept a patient with certain psychiatric disabilities. The reality is, when they get such a patient they are sedated. It's called a "chemical straightjacket". Zombie city. I have probably been in over 200 nursing homes over the decades in three states.  Some are magnificent. Others reek with the stench of urine and feces. Most states publish a list of violations of every home you may access before making a decision. When in a nursing home the patient's family physician is not allowed to treat or be involved. I get around this by having a physician visit as a "friend" and then conduct an examination. I have obtained independent psychiatric evaluations in this manner, and when these are submitted to the court the nursing home and that guardians generally go nuts.
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144586_tn?1284669764
I see on the internet there are a few sites providing information about guardianships. Some of the information does not apply in all states. For example, in many states all proceedings are sequestered. If you do not have standing you cannot even learn the name of the guardian. Nor access the proceedings. If there is a house, property and valuables involved they will be disposed of by the guardian. If the patient goes to a nursing home the guardian will not pay for storage of the clothing, furniture or personnel goods, even if there is plenty of money in the patient's bank. If there are family heirlooms in the house an affidavit should be prepared itemizing those objects to be removed. A guardian is directed to pay all debts of the patient. They don't make any (or a feeble) attempt to determine if the debts are justified. Let's say a neighbor has been providing shopping care. They pop out of the woodwork at the hearing and demand "x" number of dollars owed for their services. If the amount is reasonable they will get this. At the time of the hearing, if an interested party with standing wants to make any special requests for medical care this is the time, or forever hold your peace. As an example, under Obamacare, there are only 24 physical rehab sessions permitted per year. If the patient's friends desire him/her to have an additional expenditure or spend time in a specific rehab facility not covered by insurance this is the time to make that request. Once the assets dip below $1,500 the patient will have all social security and benefits sent to the nursing home and be allowed $50 per month. At the guardianship hearing a motion may be made to set aside some of the savings towards the purchase of make-up or hair-dressing over the next few years. Before this procedure you can have the patient visit any doctor you want. Afterwards you are constrained. You can make a motion to request an "assisted living" facility rather than a nursing home. The judge will then direct the guardian to make an attempt to find such a facility. The term to remember is "res judicata". Once these court proceedings are over you can't go back and rehash things. The court orders become, more or less, set in stone. There are no specific requirements for being a guardian, except in some jurisdictions they must attend a short course.
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Just to provide a concrete example of guardianship problems. A patient I was involved with had (has) a length housing court proceeding. As is usual, a landlord requests legal fees. Since these proceedings went on over a number of years these fees amounted to over fifteen thousand dollars. Because the patient was in a nursing home, the guardian did not involve himself in fighting the awarding of fees for the landlord's attorneys, which were outrageous. Whatever the housing court judge rules, will not be appealed. The amount simply paid from the patient's assets by the Guardian.
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That is a lot of information to process and is quite discouraging. When the APS person spoke to me last week she mentioned that they can't initiate a guardianship; we have to do it. I hope she's right because I don't want my mom railroaded into a crappy situation. She may be a mean person but no elderly person deserves to be jerked around like that.

I'm not particularly stupid so I'll get through this mess but I'm so thankful that my husband is willing to take on any battles. Emotionally my mom has drained me for years and this is pretty hard on me. He's more objective about it all.
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Had a phone conference with APS today and it was very informative. We have a few options now concerning my mom. She is not in imminent danger to herself so going to assisted living is not an option. And that's fine since we know how important it is to her to stay in her own house.

But we can start the POA or do a guardianship (I'm named in the legal form that she made out 4 years ago) or do a shared guardianship where we would manage her finances and the other person would take care of personal needs like shopping, doctor visits etc., all those items where my mom will refuse to have direct contact with us. We choose the co-guardian, not the court.

We have to think about this a bit more, get some legal advice and then make a decision. It's such a hard thing to want to help her and keep her safe from the vultures that prey on the elderly but also to hear her accuse us and hate us. I can't seem to wrap my mind around that.
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I'm pleased things seem to be going in the right direction with respect for your mom, Ireno.

My two cents regarding Guardians is that whomever the Guardian is there will eventually be resentment and friction between the patient and Guardian. It's the "nature of the beast". Issues come up when the Guardian has to make a decision in the patient's best interest that the patient may not like.
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I had to laugh a bit. You're so diplomatic. "There may be some friction between the patient and the guardian."  We haven't even started the process and my mom is very annoyed. The APS person had a talk with her, explained that she needs help around the home and so she needs a "guardian" to be appointed. That did not go over well. But she's not going to last long being completely isolated as she is.

We do meet with the lawyer on Monday. She's the same one who wrote up my mom's will and is willing to consult with us for free (I assume free for the first visit only). I may end up with some peace of mind eventually. :-)
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In some jurisdictions an attorney is appointed to look after the interests of the person for whom the guardianship is sought, as well as an investigator. Their fees (attorney and investigator) are paid by the surrogate court. In some cases a fee may be deducted from the patient's assets.   If you consult with an attorney outside of this situation you can probably expect a fee. The person(s) assuming the guardianship is required to take a short course within a certain number of months for which there is a small fee. The course isn't too difficult. At every courthouse there is a free "pro-se" attorney. Surrogate court is no different. Do not tell them (the pro-se attorney) you are or have been consulting an outside attorney, because then they cannot legally give you advice.
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Thanks. We were told that my mom would be appointed some kind of attorney when we had to see a judge about the guardianship. First she has to be seen by 2 doctors and have a full evaluation (mental I suppose) before anything moves forward. The APS person seemed to feel that would be no problem at all since she felt my mom shows clear signs of dementia and paranoia.

I wonder if she's gotten worse in the past couple of months since we've seen her. She was pretty angry and confused about basic things before. If a stranger can see this in a visit or two, it concerns me. All of her sisters developed dementia or Alzheimers. Most died in their late 70's or early 80's. My mom's time is running out if she follows in their footsteps. She's not a very nice person but I don't want to see her hurt.
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