The full issue, in which this article as well as any footnotes and endnotes appears, can be found here.
It has been a busy six months. We have a consulting contract to review state legislation on guardianship, adult abuse, and health care decision making. Leading the way this legislative season was guardianship reform, including expanded alternatives, some due process issues, and visitation issues. A few states are looking at major revision or updates including the Uniform Guardianship, Conservatorship and Other Protective Arrangements Act. Real reform is hampered by a lack of resources to treat these cases with the seriousness that they deserve. We are once again working on the Legislative Update to be presented at the National Guardianship Association conference in Orlando in October.
Regarding financial abuse, the most active legislative change was financial services “report and hold laws.” These laws protect financial services providers who believe a transaction is part of a fraud or financial exploitation and report it, and temporarily hold disbursement while the transaction is investigated. Those laws try to balance the protection against the rights of the account owner to do what they want with their money.
Probably the biggest development in health care decision-making is that all 50 states now have a provision for Physicians Orders for Life Sustaining Treatment (POLST) in place. While the name varies from state to state, these portable medical orders specify the health care desires of a person who is seriously or terminally ill, developed in consultation the health care professional and the patient or the patients representative if the patient is unable to give informed consent. POLST is rapidly replacing out of hospital Do Not Resuscitate (DNR) forms. Out of hospital DNRs were always problematic in that they were not medical orders and were not honored by many first responders. POLST is developed closer to the time of need for critical health care decisions, are made between the patient and the physician or other qualified health care provider, and more accurately reflects what the patient really wants or does not want based on their current health care condition. POLST is rapidly replacing “Living Wills.” POLST is a better system, in that it is medically based, and it is contemporary to the need. The role of non-medical advocates in POLST is to spread the word about this option and encourage people to ask their health care professional if POLST is appropriate.
We have co-authored with the ABA Section on Civil Rights and Social Justice policy for consideration by the ABA House of Delegates at the August ABA Annual Meeting on a Guardianship Bill of Rights. One of the recommendations of the Fourth National Guardianship Summit was development of a Bill of Rights for persons who have had a guardian or conservator appointed. This policy urges states to use provisions of the Bill of Rights developed by a panel of experts led by the National Guardianship Network, in developing or updating a Bill of Rights at the state level.
National Center on Law and Elder Rights
We are in our 7th year of developing and presenting content for the National Center on Law and Elder Rights. Our latest webinar was presented on June 28th on “Family Violence and Abuse in Later Life”. All of the training is offered free of charge, and is posted online, along with written materials expanding on the subject at https://ncler.acl.gov/. There are some really great resources available on the NCLER website. We are looking forward to year 8, starting in the fall.