Guardianship: A medicolegal review for clinicians
dc.contributor.author | Zietlow, Kahli | |
dc.contributor.author | Dubin, Leslie | |
dc.contributor.author | Battles, Alethia | |
dc.contributor.author | Vitale, Caroline | |
dc.date.accessioned | 2022-12-05T16:39:48Z | |
dc.date.available | 2023-12-05 11:39:47 | en |
dc.date.available | 2022-12-05T16:39:48Z | |
dc.date.issued | 2022-11 | |
dc.identifier.citation | Zietlow, Kahli; Dubin, Leslie; Battles, Alethia; Vitale, Caroline (2022). "Guardianship: A medicolegal review for clinicians." Journal of the American Geriatrics Society 70(11): 3070-3079. | |
dc.identifier.issn | 0002-8614 | |
dc.identifier.issn | 1532-5415 | |
dc.identifier.uri | https://hdl.handle.net/2027.42/175202 | |
dc.description.abstract | Guardianship may pose an ethical dilemma for physicians, who must balance protecting vulnerable patients from potential safety concerns with respecting their autonomy. Older adults with dementia are particularly susceptible to loss of independence and the ability to participate in medical decision making. To have the capacity for medical decision making, individuals must understand relevant information, appreciate their circumstances, demonstrate reasoning, and express a consistent choice free from coercion. Although capacity assessments are usually task-specific, geriatricians and other specialists may be asked to comment on capacity more globally. These determinations may be used to support a Petition for the Appointment of a Guardian of a Legally Incapacitated Adult, the legal process of pursuing guardianship in probate court. Assigned guardians may be known to the incapacitated individual (e.g., a family member or friend) or may be professional guardians with no prior relationship to the ward. Guardians are encouraged to use substituted decision-making, taking into account the ward’s previously expressed values and preferences. Although a number of viable alternatives to guardianship exist, numerous systemic barriers may prevent these from being fully explored. The ongoing need for guardianship should be periodically revisited and reassessed. Data about guardians and wards is shockingly sparse, as there are no centralized databases. Laws and regulations for guardianships vary significantly between states. Physicians can serve as important allies and advocates for patients with cognitive impairment at risk of incapacity, can help preserve their autonomy for as long as possible, and ensure appropriate protections are in place if the patient does lose their decision-making ability.See related Editorial by Chodos et al. in this issue. | |
dc.publisher | John Wiley & Sons, Inc. | |
dc.subject.other | dementia | |
dc.subject.other | guardianship | |
dc.subject.other | capacity | |
dc.subject.other | advocacy | |
dc.title | Guardianship: A medicolegal review for clinicians | |
dc.type | Article | |
dc.rights.robots | IndexNoFollow | |
dc.subject.hlbsecondlevel | Geriatrics | |
dc.subject.hlbtoplevel | Health Sciences | |
dc.description.peerreviewed | Peer Reviewed | |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/175202/1/jgs17797_am.pdf | |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/175202/2/jgs17797.pdf | |
dc.identifier.doi | 10.1111/jgs.17797 | |
dc.identifier.source | Journal of the American Geriatrics Society | |
dc.identifier.citedreference | Hastings KB. Hardships of end-of-life care with court-appointed guardians. Am J Hosp Palliat Med. 2014; 31 ( 1 ): 57 - 60. | |
dc.identifier.citedreference | Grisso T, Appelbaum PS, Hill-Fotouhi C. The MacCAT-T: a clinical tool to assess patients’ capacities to make treatment decisions. Psychiatr Serv. 1997; 48 ( 11 ): 1415 - 1419. | |
dc.identifier.citedreference | Lai JM, Gill TM, Cooney LM, Bradley EH, Hawkins KA, Karlawish JH. Everyday decision-making ability in older persons with cognitive impairment. Am J Geriatr Psychiatry. 2008; 16 ( 8 ): 693 - 696. | |
dc.identifier.citedreference | Wong SP, Sharda N, Zietlow KE, Heflin MT. Planning for a safe discharge: more than a capacity evaluation. J Am Geriatr Soc. 2020; 68 ( 4 ): 859 - 866. | |
dc.identifier.citedreference | Mills WL, Regev T, Kunik ME, et al. Making and Executing Decisions for Safe and Independent Living (MED-SAIL): development and validation of a brief screening tool. Am J Geriatr Psychiatry. 2014; 22 ( 3 ): 285 - 293. | |
dc.identifier.citedreference | Lam A, Anderson K, Borson S, Smith F. A pilot study to assess cognition and pillbox fill accuracy by community-dwelling older adults. Consult Pharm. 2011; 26 ( 4 ): 256 - 263. | |
dc.identifier.citedreference | Ghesquiere AR, McAfee C, Burnett J. Measures of financial capacity: a review. Gerontologist. 2019; 59 ( 2 ): e109 - e129. | |
dc.identifier.citedreference | Rubright J, Casarett DJ, Gur R, Xie SX, Karlawish J, Sankar P. A memory and organizational aid improves Alzheimer disease research consent capacity: results of a randomized, controlled trial. Am J Geriatr Psychiatry. 2010; 18 ( 12 ): 1124 - 1132. | |
dc.identifier.citedreference | New York’s Family Health Care Decisions Act, NY PHL Article 29-CC; 2010. | |
dc.identifier.citedreference | Wood E. Recharging adult guardianship reform: six current paths forward. J Aging Longevity Law Policy. 2016; 1 ( 1 ): 5. | |
dc.identifier.citedreference | Hamel L, Wu B, Brodie M. Views and Experiences with End-of-Life Medical Care in the US. The Henry J Kaiser Family Foundation; 2017. | |
dc.identifier.citedreference | Yadav KN, Gabler NB, Cooney E, et al. Approximately one in three US adults completes any type of advance directive for end-of-life care. Health Aff. 2017; 36 ( 7 ): 1244 - 1251. | |
dc.identifier.citedreference | State Adult Guardianship Summary: Directions of Reform; 2017. | |
dc.identifier.citedreference | Working Interdisciplinary Networks of Guardianship Stakeholders (WINGS): A Briefing Paper. 2020. | |
dc.identifier.citedreference | Hurme SB. Criminal and Credit Background Checks for Guardians. 2020. Accessed April 29, 2021. https://www.americanbar.org/groups/law_aging/resources/guardianship_law_practice/ | |
dc.identifier.citedreference | Uekert BK, Van Duizend R. Adult guardianships: a “best guess” national estimate and the momentum for reform. Future trends in state courts 2011: special focus on access to justice; 2011. | |
dc.identifier.citedreference | Cohen AB, Han L, OʼLeary JR, Fried TR. Guardianship and end-of-life care for veterans with dementia in nursing homes. J Am Geriatr Soc. 2021; 69 ( 2 ): 342 – 348. doi: 10.1111/jgs.16900 | |
dc.identifier.citedreference | Ensuring Trust: Strengthening State Efforts to Overhaul the Guardianship Process and Protect Older Americans. United States Senate Special Committee on Aging; 2018. | |
dc.identifier.citedreference | Guardianship: Key Concepts and Resources. Accessed February 7, 2022. https://www.justice.gov/elderjustice/guardianship-key-concepts-and-resources | |
dc.identifier.citedreference | Campbell KP, Ball P, Coulter M, et al. The restoration of capacity for persons under guardianship with developmental disabilities in Florida. J Int Aging Law Policy. 2016; 9: 55. | |
dc.identifier.citedreference | Page KS, Hinrichs KL. Swimming against the tide: a case study on the removal of conservatorship and guardianship. Clin Gerontol. 2017; 40 ( 1 ): 35 - 42. | |
dc.identifier.citedreference | Wiglesworth A, Mosqueda L, Mulnard R, Liao S, Gibbs L, Fitzgerald W. Screening for abuse and neglect of people with dementia. J Am Geriatr Soc. 2010; 58 ( 3 ): 493 - 500. doi: 10.1111/j.1532-5415.2010.02737.x | |
dc.identifier.citedreference | Nationwide Survey of Mandatory Reporting Requirements for Elderly and/or Vulnerable Persons. 2015. Accessed March 14, 2022. http://www.napsa-now.org/wp-content/uploads/2016/05/Mandatory-Reporting-Chart-Updated-December-2015-FINAL.pdf | |
dc.identifier.citedreference | Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005; 53 ( 4 ): 695 - 699. | |
dc.identifier.citedreference | Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: the confusion assessment method: a new method for detection of delirium. Ann Intern Med. 1990; 113 ( 12 ): 941 - 948. | |
dc.identifier.citedreference | Morphew J, Fitzgerald JT, Zietlow KE, Vitale C. Attitudes among medical residents caring for patients requiring a court-appointed guardian. Paper presented at: American Geriatrics Society Annual Scientific Meeting 2021; Virtual. | |
dc.identifier.citedreference | Appelbaum PS, Grisso T. Assessing patients’ capacities to consent to treatment. N Engl J Med. 1988; 319 ( 25 ): 1635 - 1638. | |
dc.working.doi | NO | en |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
Files in this item
Remediation of Harmful Language
The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.
Accessibility
If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.