Part I: The Long Arc of Caregiving for Eleanor Neil

Before Eleanor Neil* became a client at Project Guardianship, she had already lived many lives.

She was a writer and an ancient history buff. She self-published a book of poetry and read at independent bookstores around the city. She was a whiz at crossword puzzles. She was quick-witted and unafraid to take up space—a person with a big voice, strong opinions, and a sense of humor that could disarm a room.

Even now, those who work with her will tell you: she can make them laugh in the middle of a difficult day. 

But over time, loss and untreated mental health conditions reshaped the contours of Ms. Neil’s life. After the deaths of her parents, who had long been a source of support, she became increasingly isolated. Her Staten Island apartment—once simply cluttered—became unmanageable. Bills went unpaid, and Ms. Neil soon faced eviction. Relationships frayed under the strain of trying, and failing, to help. 

A close cousin who lived nearby could not reach her in the ways that mattered. What began as concern became urgency, and eventually, a legal intervention: a petition for Ms. Neil to get a guardian.

Guardianship is often misunderstood as a total loss of autonomy. In Ms. Neil’s case, it was carefully limited; a guardian was appointed to manage her finances, stabilize her housing, and arrange for services that could help her remain in her home, while she retained the right to make her own medical decisions. 

Even so, the adjustment was not easy. 

“She’s someone who values control,” a PG staff attorney said. “And she should. So, from the beginning, our job was not to take that away, but to work with it.” 

When Project Guardianship was appointed as guardian, it was in part because Ms. Neil’s case required more than any one person could provide. What she needed—and what she would come to receive—was a coordinated, multidisciplinary approach: legal advocacy, social services, and financial management working in concert. 

At the center of that model is a simple idea: that support should expand a person’s ability to live on their own terms, not narrow it. 

At Project Guardianship, that meant moving slowly. 

Ms. Neil could be both warm and cutting, funny and furious. She struggled with emotional regulation and could become overwhelmed quickly, especially when she felt pressured or unheard. Efforts to introduce services such as home care, apartment cleanings, and financial oversight were often met with resistance. 

“Rapport was everything,” her case manager said. “If she trusted you, you had a chance. If she didn’t, nothing moved.” 

So the team invested time. They listened. They explained. They recalibrated. They showed up again the next day. 

Behind the scenes, the work was constant. Bills were brought current. Safeguards were put in place to prevent financial mismanagement and exploitation. A housing specialist coordinated efforts to make the apartment safe and livable. Her case manager began the long process of identifying home care providers who might be a good fit. 

“This isn’t the kind of work where you check a box and move on,” the attorney said. “It’s relational. It’s ongoing.” 

For a long time, Ms. Neil rarely left her apartment. The world outside had become unfamiliar, even threatening. She worried about how others would see her. She carried the weight of past experiences that made engagement feel scary. 

Still, PG’s team held a consistent goal: to keep her in her home, connected to her community, and as engaged in her own decision-making as much as possible. 

“We’re always asking: how do we preserve dignity here?” a team member shared. “How do we make sure she still has voice and choice?” 

The answers were not always clear. And then, one winter, the stakes sharpened. 

A call came in about unexplained pain in Ms. Neil’s abdomen and a low-grade fever. Her discomfort was worsening and potentially dangerous. 

What happened next would test not only the team’s clinical judgment, but also their commitment to doing this work differently. 

Stay tuned for Part 2....

At its core, Project Guardianship is a caregiver. This May, please take a moment to honor a caregiver who has impacted your life or the life of a person close to you with a gift of any amount to Project Guardianship. Honorees receive a letter of recognition and a permanent place on our virtual Honor Wall. Honor a Caregiver here: https://projectguardianship.org/honor-a-caregiver