By Paul R. Pace
Social workers, along with psychologists and judges, play a key role in determining guardianship of adults who have limited capacity to manage their lives.
To aid social workers in understanding the guardianship process, Jennifer Crumlish, PhD, ABPP, and Malika Moore, MSW, LICSW, LCSW-C, presented the NASW Specialty Practice Sections webinar, Taking a Look at Guardianship: Important Factors for Social Workers, which is available on demand.
Crumlish and Moore both work in Washington, D.C. They explained that each state may have its own guardianship laws. In D.C., for example, the guardian law defines an “incapacitated individual” as an adult whose ability to receive and evaluate information effectively or to communicate decisions is impaired to such an extent that he or she lacks the capacity to manage all or some of his or her financial resources or to meet all or some essential requirements for his or her physical health, safety, habilitation, or therapeutic needs without court-ordered assistance or the appointment of a guardian or conservator.
Moore said there are two types of guardianship: full, where the appointed individual makes all the decisions for the person; or limited, where an appointed individual makes specific decisions, such as medical, financial, or legal, for the person.
Alternatives to guardianship include power of attorney, an advance directive, or those who are outlined as supportive decisionmakers and surrogate decisionmakers.
Moore gave examples of common assessment tools social workers use to determine guardianship. They are the Mini-Mental State exam, the Brief Interview for Mental Status, the Patient Health Questionaire-9 and the Geriatric Depression Scale. These tools can be used to create a capacity-risk model. They are not diagnostic tools, however, but guidelines that may aid in developing plans, Moore explained.
Crumlish also pointed out the benefits of collaborating with a psychologist for evaluations. “The key person in all of this is the judge who will make a decision to determine the next steps to determine if the person becomes a ward.”
- Explains the elements of the capacity risk model;
- Identifies domains evaluated in determining capacity;
- Describes issues that would contribute to the need for guardianship and resources for individuals with diminished capacity;
- Identifies alternatives to guardianship; and
- Helps explain the ethical implications of the guardianship recommendation.