Disrespecting our elders

(PAUL LACHINE ILLUSTRATION)

WHAT'S TAKING Massachusetts so long? Your article "Courts strip elders of their independence" (Page A1, Jan. 13) underscores the pressing need for passage of key legislation scheduled for a hearing on Thursday. Massachusetts Uniform Probate Code legislation would require that any petition for guardianship must be accompanied by a medical certificate containing detailed facts about the way a frail individual is unable to care for himself or herself.

The court would be required to make specific findings of incapacity before appointing a guardian, and the guardian's powers would be limited to specific needs. In most cases, the frail individual whose liberty is at stake would be entitled to be present at the hearing, and to appointment of counsel, regardless of ability to pay. Once appointed, the guardian would be required to submit detailed annual reports regarding the frail individual's mental, social, and physical conditions. As advocates for a civil right to counsel in cases where basic human needs are at stake, and for adoption of the Uniform Probate Code, we hope that your article will provide a much-needed impetus for the passage of this legislation.

ANTHONY M. DONIGER
President
Boston Bar Association
Boston

THANK YOU for putting problems related to guardians for the elderly on the front page. The writers did an excellent job describing challenges of the guardian system, in which professionals are appointed to make decisions for elders who lack family or friends to advocate on their behalf.

However, the story overlooked problems that occur with related guardians, including the following line: "When relatives are involved, there is widespread agreement that judges make sound decisions when they decide a guardian is needed." Unfortunately, relatives are frequent abusers. Even the best-intentioned caregivers may be so stressed they rush into inappropriate decisions. All guardians, including relatives, require much more oversight that the current system allows.

I was appointed my father's guardian before he died of Alzheimer's disease. I was horrified that the appointment process was so easy. The doctor signed the form after a brief interview with no other investigation. By petitioning for guardianship, I was effectively seeking to "adopt" my father, yet there was no home study or verification of my character, nor even a criminal background or credit check. And no one monitored my efforts on his behalf.

Improving the appointment and monitoring of guardians is a human rights issue. Everyone deserves quality care and dignity at the end of life.

ELLEN CONNORTON
Brookline

ALTHOUGH THESE "unbefriended elders" are most at risk for abuse in a distracted, neglectful system, it's a wake-up call for everyone.

With or without advocates, elders and others facing a loss of independence due to illness, cognitive or physical disability, or just normal age-related changes should know to request an "activities of daily living" assessment. This is most often administered by an occupational therapist, and identifies what assistance is necessary to manage the critical tasks of health maintenance, medication management, safety, self-care, and household and community living skills. Most healthcare settings can offer access to this service, which can be in the form of a screening or a comprehensive evaluation.

Functional decline does not automatically mean "dependence" and throwing away the key. This is what saddens me so about the Globe report. There are so many options available between functional independence and dependence; assistance is a continuum, ranging from minimum to maximum, periodic to hands-on.

As for the Massachusetts General Hospital psychiatrist who based his determination that Rose Doyle was mentally incapable because she was unable to discuss her diagnoses or "explain why she takes any of her medicines": I wonder if he thought to recommend a test of how she would function using a weekly medication dispenser available at the drugstore, and set up by a nurse's aide?

MARY ANN MAYER
Sharon
The writer is a retired occupational therapist.