Whether it's a child with an intellectual disability, an aging parent with early dementia symptoms or a spouse suffering a grave medical condition that renders them incapable of making their wishes known, the result is that there are people who will face the prospect of having to make choices for their loved ones.
To help navigate the options for doing that, LifeWorks Community Services hosted a guardian seminar Thursday evening during which Iowa Department of Aging attorney Paige Thorson discussed some of their options for about 50 people.
Her first advice, regardless of the issue facing the patient, is doing less.
-Messenger photo by Hans Madsen
Paige Thorson, an attorney with the Iowa Department of Aging, presents information of guardianships, power of attorney and other legal issues during a seminar at Life Works Community Services Thursday evening.
"Always look for the least restrictive option," she said. "It's not just the right thing to do, it's also required by law."
Those options range from involvement with the person's decisions to a full guardianship, a legal condition in which the court grants someone responsibility for a patient's physical custody.
Power of Attorney for Health Care is a document that allows someone to make a medical decision for another. It requires the choices be made in the patient's best interest and according to their wishes.
It has restrictions.
"It doesn't say you get to make all my decisions," Thorson said. "It's only for health care decisions."
Creating a power of attorney can actually be done without an attorney; forms for drawing one up can be found on the Iowa State Bar Association website. Most hospitals also have forms available too.
Thorson stressed that it's a last resort.
"We want them to make their own decisions as long as they're able to," she said.
A guardianship is a much higher level of control over the patient's affairs. Because a patient loses so many rights under one, it's a step not to be taken lightly, she said.
Guardianships exist in four degrees: general or full, limited, temporary and standby.
Regardless of the type sought, the process involves filing a petition in court.
While there are many things an appointed guardian can do without further court authority, there are also restrictions that require seeking a judge's approval. Examples include moving them to a more restrictive permanent residence, consenting to major elective or non-emergency surgery, or consenting to a Do Not Resuscitate order.
"You have to go back to court to ask for permission for those," Thorson said.
The ward, as the person under guardianship is legally called, also retains many rights - they can vote, marry, have a will and visit with whom they like.
"Just because somebody has a guardian doesn't mean that they have no rights," Thorson said.
She also talked about the new Iowa Uniform Power of Attorney Act. The bill was signed into law by Gov. Terry Branstad on April 10 and goes into effect July 1. It essentially ensures that Iowa law is in alignment with most other states' laws.
"As long as a document is validly drawn up in another state it should be good here," she said.
The law has other important provisions as well.
For example, a guardian found to be stealing from their ward can be removed and the list of those requesting that removal, expanded. It also allows the court to attempt to recover stolen assets.
"If you had somebody that was stealing," she said, "it was hard to do anything about it. Now you're going to have to reimburse mom."
That can also include attorney's fees and interest, she said.
Teresa Naughton, LifeWorks Community Services executive director, said they hosted the program to help meet a need and an interest in the community for the information.
"It's critical to know what sort of options they have," she said.