An age-friendly society works, first, to prevent guardianship; second, to delay it; and third, to guarantee qualified, person-centered care.
Such an approach prioritizes the humanity and dignity of people as they age while saving public dollars by supporting people who want to grow old in their homes and communities and avoid institutional placements.
Unfortunately, this is not the case in New York, where — despite a booming population of older adults and a legal mandate to provide a guardian, who makes personal and/or financial decisions for someone who does not have capacity to make decisions for themselves— resources for adult guardianship and its alternatives are abysmal. Instead, an outdated system continues to rely on unpaid family caregivers, or the personal wealth of older people to underwrite their own care. This is an issue of staggering inequality with harrowing ramifications.
New Yorkers are increasingly aging alone and aging in poverty. The number of older New Yorkers living below the poverty line increased by over 37% over the past decade. Our
guardianship system cannot meet the demand for services today, never mind in the near future when that demand multiplies.
A recent ProPublica investigation highlighted an extreme case of elder abuse via for-profit
guardianship and revealed unchecked illicit dealings and the lack of court resources for the guardianship system. The story echoed what many of us in the guardianship world have known all along: We need all hands on deck. Caring for an increasingly aging and ailing population will take a meaningful investment in our guardianship system, from more resources for qualified guardians and the courts to better data collection and oversight.
The good news is that nonprofits are ready and willing to do this work. They have developed multidisciplinary models and established high standards of care. They have identified the areas of greatest need across our state and created training and educational programs and materials to support fellow nonprofit and lay guardians. Further, they have researched and learned from other state’s initiatives, such as Florida’s Office of Public and Professional Guardians.
What’s needed is sustained funding to comprehensively support nonprofit guardianship services statewide. A funding commitment of $15 million would ensure a right to a qualified guardian for every New Yorker who needs one, regardless of ability to pay. This funding would also result in significant Medicaid cost savings because nonprofit guardians work to prevent unnecessary institutionalization.
Such an investment would also stimulate the economy because effective guardians would be able to secure comprehensive benefits for individuals and help drive their local economies, potentially resulting in savings to the state through the realization of untapped federal disability aid, Supplemental Security Income, and other benefits. And importantly, the $15 million would develop a workforce skilled in coordinating care, securing housing and benefits, and managing finances on a fixed income.
This workforce would also enable judges to appoint the optimal guardian for an individual,
regardless of that person’s financial or social circumstances. With a roster of qualified, person-centered guardians to appoint, judges will no longer have to make the difficult choice between delaying a necessary guardianship appointment and appointing a questionable guardian to fulfill their legal mandate.
The solution to New York’s guardianship problem exists and is ready to be implemented. What will it take for New York to act?