Feature article by Heather Connors, PhD, Executive Director of The Center for Guardianship Excellence
Person-centered guardianship means making decisions that are important to a client, as well as decisions that are important for the client. Decisions important for a client include attending to the medical, housing, and financial issues with which the person needs assistance. This might mean providing informed consent for cancer treatment or ensuring that an application for subsidized housing is completed and filed on a client’s behalf. These are the types of actions typically associated with guardianship: making decisions for people who are unable to make them independently.
What sets a good guardian apart, however, is understanding what is important to the client. This means getting to know the individual, understanding their needs, goals, and values, and making decisions that support them.
Knowing that a client cherishes their cat, for example, might influence a guardian to use some of the client’s funds to pay for veterinary bills. Or knowing that a client loves gardening might help guide the choice between residential options when a move becomes necessary. Perhaps there is a facility with a patio and rosebushes that could make the transition easier.
Knowing what a client cares about, what is important to the person, helps ensure that guardianship is not one-size-fits-all. It is person-centered.
Best Practices in Guardianship
The National Guardianship Association’s (NGA) Standards of Practice are clear that person-centered guardianship is the best practice. Standards 3, 13, 14 and 18 instruct both guardians of the person and guardians of the estate (also known as conservators) to use a person-centered philosophy.
The NGA Agency Standards further instruct guardians to “learn as much as possible about the person’s history, culture and family background.” This information can be especially important when supporting individuals who are less able to communicate their preferences, such as people with advanced dementia. In these situations, understanding a person’s history may help guide decisions based on what the individual would likely choose for themselves if they were able to do so today.
As guardians, we are expected to make decisions to support the needs of our clients. That is our basic obligation. However, best practices in guardianship also ask us to consider what is important to our clients.
Person-centered guardianship is “grounded in demonstrating respect for the dignity” of the individual and ensures that each person is treated as someone with unique preferences, goals, and values (NGA Standards of Practice). The best guardians do what is important for their clients while also honoring what is important to them.