Guardianship Overview: From Capacity Assessments to Ethical Decision-Making

Sponsored by the Ethics Committee and the Elder Mistreatment SIG

Moderator: Caroline A. Vitale, MD, AGSF

This session will provide an overview of the topic of guardianship as it pertains to the care of older adults, presented by a multidisciplinary panel. Learning Objectives: (1) describe guardianship and the process for petitioning for guardianship, acknowledging state to state variability in this process; (2) review the clinician’s role in guardianship, including the possibility of being asked to provide testimony in evidentiary hearings, how to best advocate for patients who are wards under guardianship, and the importance of regular screening for elder abuse and exploitation; (3) perform capacity assessments, with special consideration of the non-medical aspects of characteristics that affect capacity, such as functional, financial, and housekeeping capabilities; (4) discuss aspects of ethical surrogate decision-making and how to discuss topics such as substituted judgement with guardians and other surrogate decision-makers; (5) recognize alternatives to guardianship, including the concept of supported decision-making for those with marginal decision-making capacity.