The March 22, 2022, session of Duke Medicine LEADS featured Jan Dillard, LCSW, Regina Miller, LCSW, Sheila Rittgers, LCSW, and Nathan Amos, LCSW
presenting on "Who's In Charge Here (And Does It Really Matter Anyway)."
Pearls
- Providers need to be a part of the process early on and Primary Care is the Ideal place to start.
- Petitions for Guardianship need to be initiated through the Clerk of Superior Court in the county where the patient lives.
- Guardians should still be considering the wishes of the ward.
- Guardianship is a serious matter and should not be taken lightly
- Providers need to be a part of the evaluative process for guardianship/alternative early on.
- It is important to ask and necessary to get guardianship documentation and have it scanned into the record.
- Guardianship is different from HCPOA or being an SSI payee.
- Clarify relationships before documenting (“mom” could be step-mom, bio mom, play mom, aunt, grandma, etc.).
- Clarify legality before documenting (trust but verify-ask for a copy of the court order)
- Don’t wait until there is a need for a decision maker to start exploring the issue. It’s a process, so start the conversation early!
- Resources
- North Carolina Judicial Branch: https://www.nccourts.gov/help-topics/guardianship/guardianship
- Legal Aid of NC: https://www.legalaidnc.org/
- North Carolina Central Family Law Clinic: https://law.nccu.edu/clinics/family-law/
- ReThinking Guardianship: https://rethinkingguardianshipnc.org/
- Abstract: Competency and the Capacity to Make Treatment Decisions: A Primer for Primary Care Providers, Raphael Leo, MD, Prim Care Companion J Clin Psychiatry. 1999 Oct; 1(5): 131–141
- The ARC of North Carolina: https://www.arcnc.org/programs-and-services/lifeguardianship
- NC Department of Health and Human Services: https://www.ncdhhs.gov/assistance/guardianship/guardianship-alternative…
- Tool for Exploring Shared Decision Making: https://rethinkingguardianshipnc.org/wp-content/uploads/sites/1731/2021…
- First In Families Of NC: http://fifnc.org/programs/connections.html
Duke Medicine Learning, Education, and Discussion Series (LEADS) takes place each Tuesday at 12 p.m. Learn more and see schedule of upcoming sessions.