5 Geriatric Care Management Tips for the Sandwich Generation

The Sandwich Generation refers to a generation of people who are caring for their aging parents while supporting their own children. If you’re a caregiver in this generation you might liken the associated financial and emotional stress with the feeling of being “sandwiched” between the two responsibilities that are taking up most of your time.

Sandwich generation providers can create a care management sandwich that meets their needs and the needs of their aging parent(s) through effective planning, support, and advocacy.

5 crucial ingredients for a balanced care management sandwich:

  • Emotional well-being
  • Financial Planning
  • Healthcare
  • Career
  • Family

1. Emotional Well-being

For those taking on the greatest time commitment for providing care for an aging parent or parents and also trying to fulfill their own parenting obligations, finding time for self is an important part of maintaining balance in life. Caregiver burnout can seriously impact your quality of life and your ability to continue caring for your loved ones. It is essential that you carve out some time for yourself every day to do something for yourself. It might be a session at the gym, coffee with a friend, reading a book, or any activity that recharges your emotional batteries.

2. Financial Planning

Perhaps one of the biggest contributors to sandwich generation caregiver stress is managing the costs associated with raising children and maintaining the health of aging parents.

To help ease the financial burden talk to your family members and involve them in the financial planning process. Assess all of your financial resources and create separate accounts with allocated budgets for long-term care management and day-to-day expenses for the whole family. If this task seems too overwhelming, seek the help of a Certified Financial Planner that deals with long term care planning. Contact us to help find a specialist that meets your needs.

3. Healthcare

As your parents age, medical issues are likely to arise. Advance planning for possible physical and mental healthcare issues is key to effectively managing them. It is helpful for caregivers to visit and evaluate several long-term care facilities well ahead of the need for placement. Understand that institutionalization may be a normal progression in the process. Encourage the completion of a Durable Power of Attorney for Health Care form or an Advance Health Directive for Dementia in the event of your aging parent(s) being unable to make healthcare decisions for themselves at a later stage. Also see: Practical Advice on Caring For a Parent with Dementia5-step Geriatric Care Management Plan for Dementia Patients and the Families Caring for Them

Part of your planning should also include ways of keeping your aging parent(s) active. Involve them, as far as possible, in the day-to-day chores in the household and plan simple mental and physical activities like reading to the children, doing a crossword, going for a walk, joining a senior activity group etc.

4. Family

Multiple generations living together in one household can be stressful. There are so many voices that need to be heard, and often not enough time for everyone to have their say. Open, honest family communication is so very important for maintaining household balance. Try and set aside a time, perhaps around the dinner table, for each family member to talk about their day or share a personal experience. Plan a monthly family outing, even it’s in the back yard with a ball. Laugh together as often as you can and learn to sweat the small stuff.

5. Career

Juggling work-life balance is an art that requires a lot of planning and support – from your family and your employers. Don’t be afraid to ask your family members and colleagues for help if you need it, and you probably will. A geriatric care manager can also help you find the care management support and resources you need.

5-Step Geriatric Care Management Plan for Dementia Patients and The Families Caring For Them

Caring for a loved one with dementia comes with a unique set of challenges that often require professional support to effectively manage long-term care. Because dementia is a deteriorating condition, a physician/caregiver/patient relationship is the recommended approach for meeting the needs of elderly patients with dementia.

Follow these 5 steps to plan ahead and find the Geriatric Care Management support you need:

  1. Making sure physicians who are overseeing medical care for your loved one understand your needs as a family caregiver and the challenges you face are essential aspects of caring for the person with dementia. The physician can help caregivers anticipate changes, plan for role transitions, and arrange for education and support that is needed to provide care.
  2. In the earliest stages of the disease, it is helpful for caregivers to identify a health care proxy for the person with dementia. Encourage the completion of a Durable Power of Attorney for Health Care form (your physician should have copies available in their office.) The copy of completed forms becomes part of the patient’s record. (See What is a Health Directive for Dementia? for a downloadable dementia-specific health care form.)
  3. Caregivers need to maintain their personal health and vitality to provide continuing care for the demented patient. Taking the time for self-care will help reduce the chances of Caregiver Burnout (Also see Dementia and Caregiving Challenges).
  4. Caregivers should become familiar early in the illness with adult day-care services and in-home or in-facility respite services.
  5. It is helpful for caregivers to visit and evaluate several long-term care facilities well ahead of the need for placement. Understand that institutionalization may be a normal progression in the process.

Contact us if you need helping finding Geriatric Care Management support and resources.

Dementia and Guardianship

Dementia

1 in 3 seniors die with Alzheimer’s or some form of dementia. Of the 5.4 million Americans with Alzheimer’s, an estimated 5.2 million people are age 65 and older, and approximately 200,000 individuals are under age 65 (younger-onset Alzheimer’s). One in nine people age 65 and older has Alzheimer’s disease. By mid-century, someone in the United States will develop the disease every 33 seconds. Guardianship of adults suffering from Dementia can become necessary when the adult becomes incapable of making decisions for themselves and they don’t have a Power of Attorney in place. See What is the Difference between Guardianship and Power of Attorney?

Caring for a loved one with dementia comes with a unique set of challenges, including issues such as harm to self. For example, an individual might set a fire while cooking or become a wander risk or begin to think someone is going to harm them or is breaking into their home. See Practical Advice on Caring for a Parent with Dementia

Typically, as the disease progresses, it becomes more emotionally and physically draining for the caregiver who often reaches a breaking point. When focusing on the negative, it can become exhausting and overwhelming. See Recognizing the Signs of Caregiver Burnout

It’s important to find supportive services such as those offered by Living Life with Dignity before this point is reached. The volatility of the disease can make situations dangerous and upsetting. Depending on the progression or type of dementia, needs can change rapidly. For many, it is a full time commitment. See Dementia and Caregiving Challenges and What is a Health Directive for Dementia?

Case Study

Living Life with Dignity was appointed Guardian of and Advocate for an 83-year-old female suffering from Dementia.

Background

She was a retired nurse living alone, estranged from her adopted son and raising her deceased daughter’s son. The female, having lived in her current home for 60 years, had her neighbors all rally to help. Her phonecalls to the neighbors started to become erratic and she became acutely paranoid that someone was trying to break into her home. She refused having a caregiver and expressed her desire to fire her attorney and Power of Attorney. Upon contacting a new attorney, it became obvious to the attorney that the client needed intervention and guardianship.

Services

Living Life with Dignity was called in and we provided the following services for the client:

Also see: This Job Sucks! Choosing the right Power of Attorney is imperative

What is a Health Directive for Dementia?

People with advancing dementia lose the ability to make decisions for themselves. Their families need to make medical decisions for them. Giving family members guidance about what kind of care you’d want if you were to develop worsening dementia can ease the burden of their decision making and make you feel more secure that you’ll receive the care that you would want.

Following our articles on Late Life Depression, Late-onset Depression and Dementia, and Practical Advice on Caring for an Adult with Dementia, here is a Dementia-specific Advance Directive download that allows you to map out your care and medical intervention plan should you or a loved one become ill with dementia in the future.

Practical Advice on Caring For a Parent with Dementia

Mental Health CareWhen a diagnosis of dementia is made, the physician is pivotal in providing the knowledge and resources that are needed to care for the patient. Because family members provide the majority of care for persons with dementia, they are an essential resource for the patient and the health care system. Making sure physicians who are overseeing medical care for your loved one understand your needs as a family caregiver and the challenges you face are essential aspects of caring for the person with dementia. A physician/caregiver/patient relationship is the recommended approach for meeting the needs of both you and your loved one.

Dementia Caregiving and the Health Care System

Physicians can provide a proactive approach to support by providing you with information about dealing with your loved one’s dementia symptoms, and linking you with resources (e.g., the Alzheimer’s Association). This can improve your capabilities as a caregiver and lead to more successful and enduring caregiving.

Make sure your loved ones’ physician:

  • Works collaboratively with their other physicians, nurses and/or social workers who are knowledgeable about symptom and behavioral management strategies;
  • Understands that you are physically, emotionally, and financially vulnerable;
  • Understands that to be an effective and knowledgeable caregiver, you often rely on physicians to provide information about dementia symptom management and the availability of support services.

5 Steps Caregivers can take to Prepare for Dementia Care Problems

Dementia and the Health Care System

Because dementia is a deteriorating condition that develops over an extended period of time, care problems can be anticipated and planned for well in advance. Use these tips to get started:

  1. The physician can help family members anticipate changes, plan for role transitions, and arrange for education and support that is needed to provide care.
  2. In the earliest stages of the disease, it is helpful for caregivers to identify a health care proxy for the person with dementia. Encourage the completion of a Durable Power of Attorney for Health Care form (your physician should have copies available in their office.) The copy of completed forms becomes part of patient’s record. (See What is a Health Directive for Dementia? for a downloadable dementia-specific health care form.)
  3. Caregivers need to maintain their personal health and vitality to provide continuing care for the demented patient. (see Recognizing Caregiver Burnout and Dementia and Caregiving Challenges).
  4. Caregivers should become familiar early in the illness with adult day-care services and in-home or in-facility respite services.
  5. It is helpful for caregivers to visit and evaluate several long-term care facilities well ahead of the need for placement. Understand that institutionalization may be a normal progression in the process.

Information for this blog was cited from the Alzheimer’s Association and the American Medical Association.

Written by Author and Keynote Speaker Sue Salach-Cutler. Sue has a Master’s degree in Gerontology and has worked in the healthcare field for over 25 years.  She is the Author of “Along Comes Grandpa”, a caregiving resource guide, and the novel “If I Walked in Her Shoes”. Her programs and books provide the vital resources needed to help family caregivers as they maneuver through the caregiving journey. Find out more about her books and programs here: CaregiverLife.com.  Adapted from: https://theworkingcaregiver.org

Ask Yourself These Proactive Caregiving Questions Today to Prepare for the “What ifs?” in Life

“I wish I had met you a few months ago.” I hear some variation of this phrase weekly from people I meet through both networking and personal events.  The comment comes from people who have experienced family caregiving in some form and had no idea what resources were available to assist them or the person they were caring for.

At some point in our lives we have either been, will be or know someone who is the caregiver of an elderly relative. Depending on our life expectancy, we will also become the elderly person in need of resources.  What happens when caregivers have to make decisions with no per-conceived notion of the available resources or when they have to make decisions in reaction to a crisis?

All decisions made from the point of the “incident”, the “fall”, “hospitalization”…you fill in the blank, are done in reaction to the situation.  These very important, potentially life altering decisions are based primarily on an emotional response to the event or the direction given by a medical professional.  Regrettably, reactionary caregiving decisions may not be the best option and may contradict the person’s wishes.

Now I realize that in our busy world, if something isn’t happening immediately, we don’t really have the need to know about resources available for the “what if’s” in life. Unfortunately, neglected “what if” planning can lead to reactionary caregiving decision-making when a crisis strikes.

The good news is it doesn’t have to be that way.  There are caregiving preparations that can be made TODAY for the “what ifs” in life.

Ask yourself and those you love these proactive “what if” questions and begin preparing for potential crisis:

  • What if I cannot make decisions for myself?
  • What if I needed long-term nursing care?
    • Would I want that in home or in a facility?
    • What would be my personal guidelines to determine where the care was given?
  • What if I need short-term rehabilitation?
    • Where would I want to go for that care?
  • What if I could no longer manage my finances?
    • Who would I trust to manage them for me?
  • What do I need to have in place to make sure that if one of my “what if’s” happened, my family would know what I wanted done?
  • What if (Fill in the Blank)

I know that asking these questions can be awkward; however, if and when the crisis strikes, you’ll be glad you did.

For more resources visit – AlongComesGrandpa.com

Written by Author and Keynote Speaker Sue Salach-Cutler. Sue has a Master’s degree in Gerontology and has worked in the healthcare field for over 25 years.  She is the Author of “Along Comes Grandpa”, a caregiving resource guide, and the novel “If I Walked in Her Shoes”. Her programs and books provide the vital resources needed to help family caregivers as they maneuver through the caregiving journey. Find out more about her books and programs here: CaregiverLife.com.  Adapted from: https://theworkingcaregiver.org

This Job Sucks! Choosing the right Power of Attorney is imperative

Sibling Power of AttorneyWhile visiting with a friend who just lost his sister, he shared how difficult it was for him because his sister had chosen him (above her parents, children and other siblings) to be her Power of Attorney (POA). His sister was in the final stages of cancer when he had to make some very difficult decisions about her care at the end. Having spoken with her at length about what she did and did not want done to prolong her life, he followed her wishes and made decisions accordingly, which meant not approving a procedure that would have been very painful and would have done little to change the outcome of her prognosis.

Those who have never had to make potentially life/death decisions cannot imagine the strength it takes to make these types of choices, even if it is following the directions of your loved one to the letter.

As I have shared in my speaking and blogging, choosing a POA (and making sure it is the right person for the job) is imperative. (See What is a Power of Attorney?). However, being named as the “chosen one” has its burdens as well.

Here are just a few:

  • You may question why you were picked and wonder if you are the best choice;
  • Others may question why you were picked, thinking they would have been a better choice;
  • Knowing the right time/situation to step in to help someone in making difficult health-care decisions isn’t easy;
  • You need the strength to make difficult decisions IN SPITE OF your emotions and/or the emotions of other family members; and
  • You need the courage to make difficult decisions IN SPITE OF the criticism of those around you.

Sounds daunting but have heart; there is hope.

Family WishesHere are some steps you can take to encourage the person who has chosen you as the Power of Attorney, and to make the job a lot easier for yourself:

  • Have a very direct and serious conversation about what they want/don’t want in certain situations. Use these Proactive Questions as a starting point.
  • Ask them to write down in DETAIL what they would or would not want if certain situations were to arise (helpful tool – 5 wishes)
  • Ask them to share their decision to choose you with other family members (family conflict can arise when someone else thinks they are in charge, only to realize they were not the “chosen one”),
  • Respect your family members’ wishes by asking them to write them down in detail so you can follow their instructions and include them in the caregiving process.
  • Make sure that everyone in the family understands that this was their decision and that this is not about “favorites”, it is about who THEY FEEL is able to manage the care in the fashion requested by the assignee.

Important point!!

**Just because someone asks you to be his or her power-of-attorney does not mean you have to say “yes”.

You must be willing and able to follow their wishes IN SPITE OF your own thoughts, feelings or emotional connection and have thick skin and an unwavering spirit to face the potential hostile response/criticism that may come from other family members. If you do not think you can do that, you should be honest with them and graciously decline and share the reasons.

Written by Author and Keynote Speaker Sue Salach-Cutler. Sue has a Master’s degree in Gerontology and has worked in the healthcare field for over 25 years.  She is the Author of “Along Comes Grandpa”, a caregiving resource guide, and the novel “If I Walked in Her Shoes”. Her programs and books provide the vital resources needed to help family caregivers as they maneuver through the caregiving journey. Find out more about her books and programs here: CaregiverLife.com.  Adapted from: https://theworkingcaregiver.org

What is a Power of Attorney?

Power of AttorneyMedical Power of Attorney (POA) is something each of us, no matter our age, should have. Frequently, people grant POA to their spouse, children or siblings. POA goes into effect only if you are not able to make competent decisions. Not when the POA doesn’t like or agree with the decisions you are making.

*It is crucial to choose someone you trust and discuss what you do and don’t want done in certain circumstances (i.e. removing life support).  Confirm they are willing to following YOUR wishes in spite of their feelings at the time the decisions have to be made. When someone has been granted the POA for another, they have an ethical responsibility to act in good faith on behalf of the person. (Read This Job Sucks! Choosing the right Power of Attorney is imperative

What is a Medical POA?

It is a document, signed by a competent adult, i.e., “principal,” designating a person that the principal trusts to make health care decisions on the principal’s behalf should the principal be unable to make such decisions. The individual chosen to act on the principal’s behalf is referred to as an “agent.”

What happens if I do not have a Durable Power of Attorney for Health Care?

If you do not have a Durable Power of Attorney for Health Care and are physically or mentally unable to tell your doctors what you want, the following people, in order of priority, are legally authorized to make your health care decisions for you:

  1. Your court-appointed guardian or conservator (Read What is the Difference between Guardianship and Power of Attorney?);
  2. Your spouse or domestic partner;
  3. Your adult child;
  4. Your adult sibling;
  5. A close friend; or
  6. Your nearest living relative.

When does the POA have the right to make health care decisions on my behalf?

A POA can make health care decisions for you only if your attending physician certifies in writing that you are incompetent, some states may require 2 physician certifications. The physician must file the certification in your medical record. Usually the POA authority will take over in situations where you suffer from advanced dementia, permanent disability or experience a dramatic mental decline.

The process to appoint your POA should be done before competency is questionable. As long as you can make decisions for yourself, there is no need for a power of attorney.

Can the agent make a health care decision if I object?

No. Treatment may not be given to or withheld from you if you object. This is true whether or not you are deemed incompetent.

What health care decision-making power does the POA grant to an agent?

The POA can make arrangements for doctor visits, treatments, medications, tests and surgeries if needed. It also gives the agent the power to make decisions about life support.

However, an agent cannot consent to:

  • Commitment to a mental institution
  • Convulsive treatment
  • Psychosurgery,
  • Abortion, and
  • Neglect of comfort care.

In the POA document itself, you may limit the agent’s decision-making authority. The POA agent can be changed at any time by simply tearing up the old form and filling out a new one. Many states do not require a lawyer or notary to update the forms so check what the requirements are in your state.

**This post is meant to share basic information about POA laws in order to get you to think pro-actively about potential future care needs and those whom you would want in charge of your care.  Laws vary from state to state, so it is important that you consult with an attorney near you on the scope and range that a medical power of attorney contract has for you.

References: Texas Medical Association & AgingCare.com

Written by Author and Keynote Speaker Sue Salach-Cutler. Sue has a Master’s degree in Gerontology and has worked in the healthcare field for over 25 years.  She is the Author of “Along Comes Grandpa”, a caregiving resource guide, and the novel “If I Walked in Her Shoes” Her programs and books provide the vital resources needed to help family caregivers as they maneuver through the caregiving journey. Find out more about her books and programs here: CaregiverLife.com.  Adapted from:https://theworkingcaregiver.org

What is the difference between Guardianship and Power of Attorney?

Healthcare Power of Attorney, Living Will, Estate Plan

Often times when I have to call a corporation for a custodial account, I am asked, “Are you the Power of Attorney.” My response is, “no, I am the Guardian.” To which they reply, “I am sorry I cannot divulge any information unless you are the Power of Attorney.” Then I have to go into an explanation as to why they can give me information. Then they will say, “Oh, so you are the Power of Attorney then.” Oy vey.

On paper they look somewhat the same; you are basically making the decisions for someone who is not capable of making decisions for themselves. However, they are not interchangeable.

Here are a few points to understand the difference.

Power of Attorney (POA)

  • A proactive decision made by an individual when they are of sound mind.
  • A designation of someone known and trusted to carry directives.
  • Can be for Healthcare or of the Property.
  • Two types of POA: one that is effective immediately and the other that requires proof of capacity.
  • A Power of Attorney for healthcare can be revoked at any time.
  • A Mental Health Directive is separate from the Power of Attorney and is needed in cases where the health issue is behavioral vs. clinical (IE: Bi-polar disorder).
  • Is not a judicial order.
  • No oversight for a Power of Attorney.
  • Cost effective.

Also see What is a Power of Attorney?

Guardianship

  • A judicial decision made when an individual has not designated a POA.
  • It is a request by someone other than the individual it is for.
  • Can be of the Person or of the Estate.
  • Can be Temporary, Limited or Plenary.
  • Is only revocable when an individual can produce proof that they have regain capacity.
  • The Mental Health Directive is included in the Guardianship.
  • It is a judicial order.
  • Judicial oversight and guidelines for Guardianship.
  • Expensive.

It is always better to be proactive than reactive. Planning for your future needs can keep you independent longer and be more cost effective. If you put a Power of Attorney in place with someone you trust and you provide them with a detailed account of what you want (or don’t want), you are more likely to be cared for the way that you want and your money will go further. Our Life with Dignity service offering can help you plan your future the way you envision it should be.

If you don’t have a Power of Attorney or a Mental Health Directive and you become incapacitated then anyone who has a vested interest in your welfare, whether family or friend, can petition the court for Guardianship. This gives you less choice of care givers and puts you at higher risk of not having your choices honored, potentially jeopardizing your independence and financial well-being. In many cases, when someone gets Guardianship, the wishes of the individual cannot be determined, and the ward is subject to what the guardian feels is in the individual’s best interest. Guardianship proceedings in themselves can be very costly. A contested Guardianship is even more costly.

When referring to Power of Attorney for the Person or of the Property vs the different types of Guardianship, you are basically referring to managing an individual personally and financially. So let’s look at the differences:

Difference between Power of Attorney for Healthcare and Plenary, Limited & Temporary Guardianship

In a POA for Healthcare your designee can make any decision for you without a court order. Once an individual has been declared by a physician to lack competency you simply have to present your Power of Attorney paperwork. However, with a Guardianship you have to follow the court order. Both types of Guardianship give certain or all power to act on the individual’s behalf; however, anything outside of the court order has to be approved by the court. For instance: if someone has a stroke, becomes dependent on life support and it is not in the court order, it is always a best practice to go to court to make the decision whether to end life or not. This protects the Guardian as well as the Ward. In addition, the Guardian of the Person has to file an annual report with the court as a status update affirming continuation of the Guardianship.

Difference between Power of Attorney for Property and Guardian of the Estate

It is a known fact that our ability to reason becomes compromised as we get older. In fact, studies suggest in some people it can be as early as 65. Having someone you trust to manage your financial affairs can prevent you from being exploited, provided the person you choose is of sound integrity. Sadly, I have seen many cases where individuals have been exploited by the Power of Attorney. Transparency and proper accounting are two ways a POA can avoid these issues. I recommend when choosing the POA for property, to pick someone that is good with their own finances if you want to ensure the safety of your financial future. See This Job Sucks! Choosing the right Power of Attorney is imperative

A Guardian of the Estate has little room to exploit anyone

They have to account for every penny that is spent of your money. The court requires the Guardian of the Estate to produce a yearly report and to provide the court with an annual budget. The court will readily pick a family member or close friend over a Corporate or Public Guardian. It is standard practice for family members to contribute to the welfare of their loved one, while a Corporate Guardian or the Public Guardian charge for their services. For this reason, when the court determines someone is not of sound mind, the court will default for family or a loved one to be the Guardian if appropriate.

Mental Health Directive

The state of Illinois requires a Mental Health Directive in addition to a Power of Attorney for Healthcare for treatment of a Mental Health Disorder. I won’t go into the why’s or the politics around it, that is fodder for another blog (next month). Nonetheless, please note that if you are preparing your estate, this should be a consideration when putting your directives in order, regardless of whether you suffer from a mental illness or not. See What is a Health Directive for Dementia?

Your Power of Attorney should know where you keep all of your important documents, and above all, be transparent. This way, if ever anyone wanted to challenge your POA’s intentions or abilities, you have everything documented. NOTE: POAs for Healthcare can easily be revoked, however, Power of Attorney for Property cannot.

Guardians are mandated to do all of the things a Power of Attorney does and are appointed by and accountable to the court. A physician’s report as to whether or not the individual is capable of making their own decisions is a requirement of a petition for Guardianship but ultimately the court, not the medical professional, makes the determination and the designation.

Digital LifeCloud

When Living Life with Dignity is appointed as a Guardian or a Power of Attorney we store all of our clients’ records on digitallifecloud.com. It is a HIPAA compliant cloud that allows you to share documents with doctors, caregivers or anyone that may need to help your POA. You can have everything from family pictures to your final arrangements stored and shared.

Read the latest press release about Digital LifeCloud and get a free gift package: Digital LifeCloud Press Release 120617

Ensure your future

Put a Healthcare Directive and Power into place.

Get a sound estate plan done and share the documentation with your designated Power of Attorney. You don’t have to give them access to everything just let them know where you keep it in case of an emergency. You’ll save money, time and most of all heartache.

For more information on Power of Attorney and Plenary Guardianship, read the following :

Do you have any questions about the difference between Plenary Guardianship and Power of Attorney? Post a comment to get the conversation started or contact us for more information.

8 Questions About Plenary Guardianship Answered

What is a Plenary Guardian?

When it comes to Plenary Guardianship, there are a lot of factors that need to be considered and processes that need to be executed before the plenary guardianship is actually granted. Who will be the guardian? How much does it cost? What are the duties and responsibilities of the guardian and how do Illinois courts decide who to appoint as guardian? Is there already a health care directive in place? Equip yourself with knowledge and let us help you every step of the way before making drastic decisions. Living Life with Dignity offers the assistance of knowledgeable, certified professional guardians who exceed industry standards. We are deliberate, thorough and ethical advocates who prioritize our client’s best interests. Prior to making any legal decisions, we work with the family to ensure sensitive issues are thoughtfully considered and appropriately communicated.

What is plenary guardianship?

Plenary Guardianship, also, referred to as conservatorship, is a legal process, utilized when a person can no longer make or communicate safe or sound decisions about his/her person and/or property or has become susceptible to fraud or undue influence. Because establishing a guardianship may remove considerable rights from an individual, it should only be considered after alternatives to guardianship have proven ineffective or are unavailable.

How do I set up a plenary guardianship in Illinois and how long does it take?

It is best to seek the advice and assistance of a guardianship attorney. You can represent yourself Pro Se, but it is not recommended. However, if you don’t have the money to hire a lawyer there are places like Prairie State Legal or Administer Justice that may be able to help with the plenary guardianship or walk you through the process depending on your individual circumstances. Get in touch with us if you need assistance finding the right people to help.

Is there already a health care directive in place?

Is a Healthcare Directive in place?Each case is different. Given that there are different types of guardianship and 3 types of directives, (health, mental health and property), you need to establish what the need is. If there are directives for health and property but not for mental health and it is the mental health that is the cause for the individual’s lack of capacity, then you may need to consider plenary guardianship. In most cases, if a directive is in place, guardianship should not be necessary provided that there is a physician’s statement declaring that the individual does NOT have capacity. If you do not have that statement, then it is best to consult an attorney. My rule of thumb is when in doubt defer to someone who can give you a definite answer. You may have to pay for that advice but in the long run it will be worth it.

Who will be the guardian?

In most cases the court prefers to appoint a family member or close friend. Guardianship with a corporate guardian or public guardian can be costly to the individual’s estate. In addition, if the individual doesn’t have the means they will end up with the office of state guardianship. While this appointment is free to the individual, it is not the best means of support simply because of the ratio of client to state guardian.

If there is no one willing or able to be the guardian, and the individual has assets of $25,000 or more, a private corporate guardian such as Life with Dignity can be appointed, or the public guardian will be appointed.

What are the costs?

In any guardianship there are costs, which can be as little as $3,000. Let’s use the example of a parent of a disabled adult who seeks guardianship to continue care for their child. In most cases the adult child wants to stay at home and be taken care of by their family so they would not contest the guardianship and the court would see this favorably. The costs in this example would be for the guardian’s attorney and the guardian ad litem (GAL). A GAL is a person the court appoints to investigate whether the guardianship is appropriate. See Living Life with Dignity’s costs here.

In the case of a contested guardianship, whether it is contested by the individual or another friend or family member, the cost can be catastrophic.

Who is responsible for payment?

Living Life with Dignity can assist you secure a financial plan for the future.If you are the petitioner requesting the court to grant guardianship, responsibility for payment will depend on whether you are appointed or not. If you are appointed guardian, the estate of the Ward is responsible for all fees, including those of the GAL and all attorney’s fees. If, however, you are not appointed and it is determined that the individual does not need guardianship then you are responsible for all costs. In some cases, the individual may be expected to pay for their attorney but the GAL and your own attorney fees and any other fees such as medical testing bills would be the petitioners responsibility.

What are the duties and responsibilities of the plenary guardian?

If you are the guardian of the person only, then your duties are limited to making healthcare and mental healthcare, end of life decisions, and residential placement.

If you are guardian of the estate as well you are responsible for all financial matters. Including bill paying, benefits management and bookkeeping.

Regardless of what type of guardian you are each requires you to file an annual report. The county in which the guardianship is in has a form to be filled out annually that walks you through the healthcare portion of it. Annual reporting for guardian of the estate is a bit more intense and requires the guardian to report all expenditures for the Ward and account for any assets that were spent.

In addition, as guardian of the estate you will have to provide an inventory of assets to the court when you are first appointed. You will also have to provide an annual budget. It is important when creating the budget, that all of the ward’s needs are reflected in that budget. As guardian you are also expected to see your ward at least once per month.

What do courts consider when deciding who to appoint as guardian or conservator?

You cannot have a felony when applying to be a guardian and you must be over 18. The court requires the petitioner to prove evidence that the guardianship is necessary. Part of that evidence is a Physician’s report which is a form filled out by a doctor that states the individuals physical or mental health status.

The court will also examine the relationship and personal history of the person petitioning to determine the appropriateness. The GAL will interview the Petitioner and others in the respondent’s life and make a recommendation to the court. I have been involved in cases where the person that petitioned was not the person appointed.

The final verdict is disposed of by the Judge.

Is a guardianship forever?

It doesn’t have to be. If a ward is ill, say in a car accident or because of a mental illness, gets treatment and recovers, the ward can petition the court to have the guardianship removed or at the very least, limited. Again, this can be a costly process without considerable documentation as to the person’s progress. It helps if all parties agree to the guardianship removal.

Glossary of terms:

  • Petition: Formal written request to the court.
  • Petitioner: the person that files the petition.
  • Respondent: the person the petition is filed regarding.
  • Ward: the individual under guardianship
  • Conservator: Interchangeable term for guardian
  • Guardianship: The position of protecting or defending something or someone.
  • Guardian: Protector or Defender
  • Annual Report: A report written to the court on a yearly basis to inform the court of the ward’s status and to reinforce the continued need for the guardianship.
  • Residential Placement: Where the Ward is to live. This can be at his/her home, a group home or support living or nursing home. Most important is that it be appropriate and the least restrictive allowable.
  • Guardian Ad Litem: (GAL): An attorney appointed by the court to represent the court in determining the appropriateness of the guardianship.
  • Felony: a crime, typically one involving violence, regarded as more serious than a misdemeanor, and usually punishable by imprisonment for more than one year or by death.