Working To Improve & Standardize the Guardianship Process

The Guardianship Serious Illness-MOLST Advisory Committee (Guardianship Committee) is working diligently to ensure that all adults with serious illness, whether they have the capacity (ability) to make health care decisions or a Health Care Agent or Guardian is making decisions on their behalf, have equal access to high quality care all throughout their serious illness.

The Guardianship Committee is working with key stakeholders such as the state, hospitals, nursing facilities, and the Probate and Family Court, to better understand the complex systematic challenges and mis-alignment of our current guardianship process across settings. Reportedly, these challenges too frequently result in inequitable and substandard care, and at times harm and suffering for incapacitated adults with serious illness and their families and caregivers.

The Guardianship Committee is moving towards a collaborative solution to create an improved process. Their mission is to help enable guardians to understand their role and authority to safeguard the autonomy of the incapacitated adult, and advocate for person-centered, high quality care all through the serious illness– at first diagnosis, to actively managing treatment options, through to end of life care.

The Guardianship Committee works in tandem with the Department of Public Health (DPH)  MA MOLST Advisory Subcommittee by providing essential information on Massachusetts law and the court process regarding use of the MOLST forms.

Recently the Guardianship Committee voted unanimously to join the MA MOLST Advisory Committee’s recommendation to adopt the new national POLST form and standard of care for use in Massachusetts. In doing so, every key stakeholder organization can align under one standard of care regardless of an adult’s capacity. It will greatly help to create a consistent, well-defined guardianship process that safeguards the rights of adults, helps to clarify and expand the role of the guardian, offer new decision-making tools to better understand and honor an adult’s preferences, and importantly aligns our policies and procedures to provide high quality, coordinated care across all settings.

YOU CAN HELP TOO!  Tell us your experience in your role as an attorney or court personnel, a care provider, a guardian or family member of an incapacitated person. Your comments can be held confidential if you like.  Just drop a quick email to Ellen DiPaola, edipaola@honoringchoicesmass.com to comment on:

• Is the MOLST form effectively working to communicate treatment preferences as health needs change;
• Where is the process breaking down- what are the consequences for seriously ill adults and families;
• When and how does the process work well for adults and families?
• Suggestions for change

The Guardianship Committee is co-hosted by Honoring Choices MA and the Massachusetts Health & Hospital Association.  Read more about Serious Illness Care MOLST Challenge and the stakeholders working to build a collaborative process here.