On Guardian and Conservator Responsibilities

Attorney Leanna Hamill provides estate planning and related legal services to clients of all ages, with a focus on the needs of older individuals and their families.
160 Old Derby St., Suite 456
Hingham, Ma 02043
Phone: 781-749-2284 Fax: 866-573-6429
Leanna@HamillLawOffice.com

Responsibilities of a Guardian & Conservator
Written on December 6, 2010 in Guardianship
Have you thought about pursuing guardianship or conservatorship over an adult family member who you believe can no longer handle their affairs? A guardianship is a legal relationship created by a court between a guardian and her ward, usually an incapacitated adult. The guardian has a legal right and duty to care for the ward. A conservatorship is a like a guardianship but refers only to property.

After you are appointed by the Court, you have a lot of responsibilities to properly carry out your duties. Here are some of the ongoing responsibilities of a guardian and conservator:

•Filing a report with the Court at 60 days and annually outlining your plans for the ward, their care, and their property,
•Filing a yearly report with the Court outlining the ward’s living situation, medical condition, how often you’ve visited them, what services they are receiving and related issues.
•Caring for the ward – making health care decisions, living decisions and decisions about how to manage their property for their benefit,
•Involving the ward as much as possible taking into account their condition and circumstances,
•Filing Roger’s Monitor reports annually, if you are also appointed in that capacity,
•In the case of a Conservatorship, fileing annual accountings showing what has occured over the last year with the property you are managing,
•Responding to any requests from the Court for more frequent recording.
A guardian or conservator is always subject to the oversight of the Court and can be penalized for failing to properly account for funds and monitor their ward.

(The term “ward” is used here for convenience. The legal term for someone under a guardianship is “incapacitated person” and for someone under a conservatorship is “protected person.”)

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Estate Planning, Probate and Trusts involve complex areas of law. Individual circumstances must be considered before any advice can be given. The general information above is not to be construed as legal advice, which can only be given after consideration of the unique facts of each matter. Please seek the advice or counsel of your attorney, financial advisor or CPA as it may be appropriate.

Reader feedback is very appreciated!

I'm not sure how many authors hear from readers, but I sure appreciate the feedback I'm getting from young and old, family caregivers and professionals. Recently I've heard from a 93 year old woman who said the book eased care for her, another is a LTC Insurance benefits adjuster who either recommends my book or gives a copy to her clients. A reverse mortgage person gives a copy to anyone seeking a reverse mortgage to help pay for care for someone with Alzheimer's.
I love hearing from you and listening to your stories. I'm moving along on my second book (no title yet) that addresses new trends in Alzheimer care with more true stories from caregivers, including my story of caring reluctantly for my mother in law.
Email me @ Beverly.Moore@Stilmee.com

Matters of the mind...and the heart

I'm on my way to writing an extended version of my book. I think that including my oft trying journey with my mother-in-law Better to the book will add to its authenticity. It was a trying journey all right. I found dealing with her resistance very troublesome and arduous. I didn't like the role I was called to play and I often resented my role in it all. So, to relieve other caregivers of their guilt hating their need to be the primary caregiver, I decided to write about it. My role was not one I would have chosen but it was assigned me as many have been in my life due to my role as NURSE. Ugh! Anyway, it did teach me many things to pass on to other caregivers and taught me my limitations. A very good lesson to learn by the way for all caregivers.

Book # 2

I'm working albeit slowly on my second book. I don't know its title as yet but it will include new trends in treating Alzheimer's non-pharmacologically (love that word). It will also include my journey with my mother in law through 14 years of Alzheimer's. Here is an excerpt. More fiblets

At 9 a.m. before I left on a business appointment, I called Bette to update her about Curt’s health. “He is feeling better but the doctor says he can’t have visitors yet.” She repeated the same questions I had just answered, and told me to tell the doctor that he had a mother and she WOULD visit him, whether the doctor liked the idea or not! I think we have to think of a way to alleviate her concern; perhaps Curt will have to talk to her over the phone in a croaky voice so she limits her time with him. We’re still telling her he has a bad cold with laryngitis. We don’t want her to fret over his well being.
At 2:30 p.m. She called for the 11th time (the rest were voice messages) to ask me about him and where her car keys were. Oh, I am running low on patience with this today. I started off the day anxious and tearful. I am going to the YMCA to work off some of the tension. Curt insists he can’t deal with her right now, but I think he’s got to do something soon to get her out of my hair. I have needs too. Those are important too, aren’t they?
It is 8 p.m. Curt was on the phone for 5 minutes with her and blew up, telling her he was sick of her many phone calls. He is so quick to tell me something I’ve thought up to reduce her calls is not feasible and then he yells at her,….like she is going to now phone less that he’s yelled at her!
I am amazed how family members cannot maintain an understanding of the disease. I know because I am a family member...and a trained one.... so called, and I sometimes lack understanding, and often lack patience.

September 10, 1999
Today she says she is displeased with the place, the rug, the kitchen in her living area. I almost told her how little gratitude and how spoiled she was. But my professional self prevailed over my inclinations and I said, “It makes me sad you are so displeased with what we looked so long for.” Later she called to thank me for the groceries she ‘found’ in her refrigerator, and to tell me someone stole $10.00 from her purse. She suspects one of the aides because ‘she was just too friendly’. I let her tell the whole story, told her to just watch the girl and see. I added that she wouldn’t want to accuse someone unjustly. She is manufacturing reasons why she needs to move somewhere else. This time she can ‘look’ for herself. I’ll encourage it but give her no assistance as will anyone else. Hopefully if we don’t encourage conversation about it, or reason her out of it (like that would do any good anyway!), and just listen and sympathize, she will go on to some other fixation! Today I am impatient. I don’t want to do anything for her. The worst personality traits, hers and mine, are rising to the top and both are annoying me!

More on the telephone…
It is time to get caller ID. Curt’s already ordered it for our phones. I called the residence to see how they viewed her and, it appears, she is not troublesome to them. Hopefully the voice message system with Curt’s voice on it will suffice to keep her calm. As it turns out, it is an annoyance to her. She can’t reason why if his voice is on the phone, why he won’t answer her questions. This enrages her and she bangs the phone down. We’ve had 60 angry recorded calls today.
Ellen the nurse had gotten the message that we were going to ‘steal’ the car. She stated she was afraid that if she talked in the dining room about her car being stolen, it would raise all kinds of problems of suspicion and fear for the other residents. So, when the time comes, we will tell her the car was sold on order of the doctor. Oh, boy, then the fur will surely fly! It is so important to confer with the staff; I wouldn’t have even have thought beyond her to the other residents needs. I’m on a learning curve I’d never had anticipated.

What do you want to learn?

I'm in the planning stages of expanding my book into a second edition. I'd love to hear from some of you about what you'd like included. I intend to expand on the new trends in Alzheimer treatment and care, the value of participating in research, the new AlzArts program and new care strategies I've learned from my coaching team.

PDF file of book

I don't know how many like to read on the computer rather than from a hard or soft cover book, but just so you know, my book is available in PDF format for any who would like it. You can ask for it through the website www.StilMee.com and pay $ 10.00with a credit card by PayPal. Then I can send you the download. I personally love the feel of a book in my hands and the feel of the pages as I turn them. I also write in my books; notes, hightlighted areas, marginal musings and dogeared pages. My Bible is like that too. My husband wouldn't write in his Bible to save his soul, but after all, it is MY book. Later I can reread what my thoughts were the last time I read it.Each time I read scripture, for example, it seems that the Holy Spirit reveals more to me than I might have grasped the last time. I also write my prayers. I'm not too good at staying undistracted in prayer, so I write to God. It is amazing what comes out of the tip of a pen intent on sending a message to Him.
My business books as well are written in. This way I can go back and take notes from my notes. Then I share them with my team so all can learn. I guess I just love to read and to write.

Second Edition

In case this is the blog you follow or just read (shame on you; comment!), I've decided there is much more that is needed to be written down. I'm beginning plans to write a 2nd edition of Matters of the Mind. There are new stories, new trends, new news about caring for a family member with Alzheimer's, I have to add to the book. Write me your stories and I'll include them and thank you in the acknowledgement. Email them to StilMee@comcast.net. There is a story in each caregiver that will help another caregiver. I'm going to include my mistakes with my family member, funny stories that I can now laugh at 1 1/2 years later! I smile just thinking about them. Do you have smile-inducing stories of caregiving? Share them.

Balancing Caregiving and Work

Balancing Caregiving and Work
Beverly Moore, RN, CS

Recently at a workshop for employers about caregiving and work productivity, a new word was introduced; ‘presenteeism’. This term describes an employee who is present bodily at work but not emotionally due to concerns about an elder at home. Work productivity starts to decline; the employee himself is often the first to notice. They come in late due to duties at home, perhaps getting mother to a day program, phone calls are made, to check in at home to be sure everything is ok or perhaps to follow up on a doctor’s suggestions for medication and treatments. Many caregivers do not recognize the stress they feel is due to caregiving responsibilities at all, and continue to handle everything themselves; home care, family obligations and work. Their attention to their personal needs takes a back seat, adding to the stress. Physical and emotional illness may exacerbate the strain of the balancing act, or be the result.
Caregivers generally experience an incremental increase in responsibility for an elder, not identifying themselves as caregivers at all. They may first help handling the bills, then help with the shopping, perhaps later accompany their family member on doctors’ appointments or pick up medications. They may start to notice the elder is not nourished adequately, preferring to eat simple sweets and tea rather than prepare a meal. So they stop in more frequently to deliver or prepare and share meals. The caregiver may finally realize that they need help. “Where do I go to find what help is available?” “Am I doing the right thing by mom?” “Is this the right decision?” Finally, “I can’t do this alone anymore.”
When the elder has Alzheimer’s which affects memory, reason and judgment, the responsibilities of the caregiver increase significantly. Safety and well being become a major concern. Alzheimer’s, a progressive cognitive illness, presents the caregiver with a long term commitment. This realization alone can be overwhelming. There is a comparison made that someone caring for a person with Alzheimer’s experiences the same stress as a soldier in combat; both are on duty 24/7, hyper-vigilant, waiting for the next emergency to appear, and not knowing when it will happen.
Many employees, I learned at the conference, do not access their Employee Assistance Program. Perhaps they fear being seen as weak and will eventually lose their job if they reveal the struggle balancing work and caregiving. Many are unaware of the wealth of information to be gained about resources for caregivers through their employer. Instead, they continue to muddle along alone.
It is the job of the Employee Assistance Program to research resources for their employees; it is unfortunate that caregivers don’t access help from their EAP sooner. Resources for caregivers can also be accessed at the local council on aging and, in Massachusetts, at one of the 27 Aging Service Access Point agencies that provide numerous services to elders and their caregivers. Each ASAP, funded and overseen by the Executive Office of Elder Affairs, has a care management program for income eligible seniors over 60. Elders served under the care management program receive services like nutritional meals, housekeeping, laundry and shopping services, companionship and personal care. Their caregiver programs offer help for those family members caring for elders. Caregiver programs offer a variety of services including respite funds for in home helpers or a few days at a local day program for seniors, as well as an array of other services to ensure safety. There are also grant funded programs and scholarships to further help caregivers.
Another helpful resource is a caregiver support group. These groups minimize the feeling of being alone; caregivers find others who, like them, need information and support in the caregiving role. Support groups on site at work, perhaps during the lunch hour, ease the employee attending one after work hours. A list of groups specific for Alzheimer’s can be found on the Alzheimer’s Association website www.alz.org/manh serving Massachusetts and New Hampshire.
It is essential that the caregiver is educated about Alzheimer’s disease and behavior changes to expect. There are always significant behavior changes if it is a memory disorder. Learning how to relate to someone with Alzheimer’s is important to gain their cooperation. Education and support significantly reduce the perceived burden of care. Research shows that telephone support for the Alzheimer caregiver can reduce the perceived burden of care. Recognizing their limits, learning about resources and asking for help, the caregiver finds relief in the care partnering role. Coping skills are improved as the care is shared, and work productivity is enhanced.

The Changing Challenges of Alzheimer Care

The Changing Challenges of Alzheimer Care

How did last year’s caregiving experience go? Caring for a family member with Alzheimer’s or related memory disorder is an ongoing learning process, so if last year was a hard challenge, this year can be better.
Alzheimer caregiving is like parenting children; the parent must keep up with the child’s growth to relate well. Similarly, relating with someone with Alzheimer’s, has to be flexible because the progressive nature of the disease. Alzheimer’s has been described as human development in reverse. Children expand their learning as they grow; persons with Alzheimer’s are losing abilities as the illness progresses. The caregiver must recognize when changes occur and respond accordingly. What worked last year may not this year; adapt your behavior to the decline in ability.

Some suggestions to get you on your way:
• Observe the level of frustration he expresses when trying to do something.
• Offer to help but ask permission. “Do you need some help?” “May I help you?”
• Give only as much help as he needs to proceed with the task. Often all that he needs is a ‘jump start’ and then can figure out the rest. Don’t take over!
• Visual reminders are great ways to give him the jump start. Simply putting something in eye’s view prompts him to begin a task.
• Structure his day; thinking up something to do and organizing is hard for him. It might be time to think of a day program to offer that structure.
• Keep the person socially engaged but not overwhelmed. Doing things with others has a double benefit. It adds purpose to the day and offers socialization.
• The person with Alzheimer’s needs to feel in charge of his life, feel valued and emotionally safe. It is up to the caregiver to provide these.

The Heart of a caregiver

The Heart of the Alzheimer Caregiver

Not all caregivers have a willingness to give care when their family member is diagnosed with Alzheimer’s or other memory disorder. They are scared and unsure what to do and say.
Can being invested in caring in a positive way be learned? I know it can; I’ve seen a very reluctant caregiver daughter develop a heart for caring for her mother who had not been there for her in the past. How is this accomplished?
Caregivers need three (3) things to care willingly. The first is having a sense of competence in managing the changes to their family member that Alzheimer’s brings, The second is validation; being appreciated for what they do. The third is finding satisfaction in the job. Often this is a challenge if going it alone.
It becomes doable with the help of a coach, especially if family support is lacking. A coach teaches you the ‘why’ of the changes in ability and behavior of your family member. She teaches you new ways to respond to those changes that preserve dignity for them and eases caring for you. She points out your successes and celebrates them with you. You find satisfaction in doing things that, although different, work.
The reluctant daughter mentioned above found healing when she gave the care and attention to her mother and realized her mother hadn’t had the capacity to give at the time of the daughter’s childhood. As a result the daughter mended her relationship and ridded herself of old resentments and hurts.

Educate yourself

The most important activity a family member caring for someone with Alzheimer's or related memory disorder can do is to educate themselves. This will save a lot of frustration later on. Learn what is happening to the brain, what common responses are from the person with the disease, and how you must and I say must if you want to be a good caregiver), and what and where your local resources are. The best place to start is the Alzheimer's Association website. It is www.Alz.org. Contact your state's association and learn. Many, if not all, have 24/7 hot lines for caregivers to have 1:1 help understanding common challenges.
If there has been no formal diagnosis, get one from a neurologist, neuropsychologist,geriatrician or physician educated in Alzheimer's. Don't settle for "It is just old age." There are more than 100 causes for dementia (a change in brain function atypical of persons of that age). Many are reversible. All are treatable.
Get books on the subject (like mine, Matters of the Mind)or Learning to Speak Alzheimer's by Joanne Koenig Coste. There are many good ones.
Google Alzheimer's on the web and you'll find thousands of referenced papers and resources (this can be a daunting task). For personalized education there is telephone coaching through StilMee.com. We have coaches with many years of experience in dementia care, both personal and professional, who are there to be your trusted advisor and supporter. Go to StilMee.com and email a coach for a preliminary talk with her.

Book success

I am so pleased with the response I receive from readers of my book, Matters of the Mind...and the Heart; that it is a helpful, understandable and a good read. It is now published by Strategic Book Publishing of New York. I'd love to hear from some of you who have read it what your experience has been. Beverly