Guardianship of the Elderly
Joy, Mark Md, Jd, Care Management Journals
GUARDIANSHIP OF THE ELDERLY George H. Zimny, PhD and George T. Grossberg, MD New York: Springer Publishing Company, 1998, 144pp., $31.95 (softcover).
We enter this world in a state of total dependency; many people in their advancing years experience a return of dependence, which may bear a strong similitude to that of our infancy. As children, for the fortunate ones, we have our parents to provide for our manifold needs. As progressive age encroaches, after the bloom of youth has passed, one's need of help from others may require that someone act in a role akin to that of a parent. Often, that means the creation of a guardianship.
The appointment of an adult to be a guardian of another is a legal process which in every jurisdiction in this country involves a court. Physicians are invariably involved, because it is a decline in one's cognitive or physical health, or both, which necessitates the appointment of a guardian. In many cases, an assessment by a psychiatrist is essential. It is to those two elements of guardianship, as is indicated in the book's subtitle, "Psychiatric and Judicial Aspects," that Guardianship of the Elderly is directed. It appears as part of the Springer Series on Ethics, Law, and Aging.
The book's two editors, who also wrote two of its chapters, come from the mental health field, one as a research psychologist and one as a geriatric psychiatrist. The 12 contributing authors include psychiatrists, psychologists, judges, lawyers, a law professor, and a nurse who is Director of Probate Court Services in San Francisco.
One intent of Guardianship of the Elderly, as indicated in the foreward, is to, ". . . collect in one place materials that will be useful for practitioners and students in disciplines that involve issues of legal incompetence of the elderly." It is also directed toward those who might help "develop or influence public policies" affecting elderly persons who are no longer capable of managing some or all of the most significant aspects of their lives. The book is meant to provide a basic overview of what guardianship is as it involves the elderly and to explain the process by which it occurs. For persons from a wide array of disciplines, extending beyond medicine and law to such areas as finance, and working in diverse fields, such as health care providers, advocates for the elderly, policy makers, judges, enforcement personnel, and legislators, this book is an excellent introduction to the topic and a well-organized basic reference.
The book is divided into four parts of varying lengths. The first is an introduction comprising two chapters, one dealing with general aspects of "Guardianship of the Elderly" and the second, the "Legal Basis of Guardianship." The other sections consider psychiatric and judicial aspects of guardianship of the elderly, and the final section contains one chapter on research in that field. The section devoted to the judicial component is the most lengthy.
Many persons who read this book will find at least one section covering a topic with which they feel very familiar, and there might be a tendency by some to complain that particular topics are dealt with in a broad, superficial manner. To do so, however, would be to misrepresent this book's purpose. It is not intended to be an all-encompassing source of information or to provide a detailed explication of complex subjects such as assessment of competency or procedural requirements in the judicial system. Rather, Guardianship of the Elderly will serve as an introduction to those seeking an overview who have little or no experience in that area, while for those who have dealt with the matter in more detail, it will fill in many gaps in their knowledge and understanding. To those ends, the book fulfills its intentions superbly.
The first chapter places the issue of guardianship within the context of the rapidly growing numbers of the elderly in our society and the harms they may suffer through selfneglect or abuse by others. …