Guardianship

Guardian
Guardianship is a major responsibility for the person assigned by a court to assume decision-making for a person who is clinical determined to be unable to care for themself, or make adequate decisions regarding their finances, health, or living (placement) arrangements. Conservatorship is a separate function. A conservator is court appointed to take over financial decision-making for someone. Often both guardianship and conservatorship are awarded by the court to the same (or different) people, but one may be awarded without the other. Here are official details, as provided by the Massachusetts Court System: Massachusetts Law about Guardianship and Conservatorship


Rogers Guardian
A Rogers guardianship is a special application in the situation where a guardian needs to make decisions regarding “extraordinary” treatments for a ward. This procedure was established in 1983 by the Supreme Court for parents of special needs children turning 18. At that age, in Massachusetts, an individual is considered an adult and is presumed competent to make his or her own placement, financial and medical decisions.

Imagine your autistic son is turning 18 and does not have the capacity to make such decisions for himself such as whether to take antipsychotic medication. In such a case a parent might apply to be the Rogers Monitor. This is also necessary when decisions need to be made about abortion, sterilization, ECT, or removal of food and drink during hospice care for a special needs individual with severe disabilities. The most common application with seniors is when a guardianship petition to the court regards an elder who is taking antipsychotic medication of any type.

In the case of an intellectually disabled (previously referred to as mental retarded) person, a Clinical Team Report needs to be submitted to the court at the same time the petition (a Medical Certificate) is filed. The Report is brief, but must be signed by a physician, a licensed psychologist, and a licensed social worker and all must be experienced in working with intellectual disabilities. This step is not needed for someone who develops dementia as they are not considered “intellectually disabled” even thought their capacity is diminished in many of the same ways as a mentally retarded person.

In the case of a person on a prescribed antipsychotic drug, a Clinician’s Affidavit regarding the competency and treatment of the individual (called a respondent) must be shared with all parties involved in the guardianship and submitted to the court at a hearing. This is a proposed Treatment Plan completed by a licensed physician, psychiatrist or clinical nurse practitioner who has evaluated the respondent. If accepted by the court, the guardian become the Rogers Monitor and must file a Guardian’s Care Plan/Report within 60 days of appointment as permanent guardian and then annual thereafter. This is a form, available on the internet, in which the monitor lists the antipsychotic medications the person takes, the date of the last consultation with the prescribing provider, or details of the “…attempts you made to contact the treating physician during that time period” if consultation has not be maintained. Clearly, there are ongoing obligations for the guardian once made permanent which s/he needs to be able to perform.

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