No one, no matter one’s profession, income or background, has an absolute guarantee they won’t become incapacitated in later life. That debilitation, physical or mental, can cause them to need help in managing personal financial and household needs.
Vulnerable, too, are non-elderly residents coping with disabilities, mental health challenges, substance abuse problems or other impairments.
Troubling instances of financial abuse of such individuals have sometimes arisen in Nebraska, such as the court-appointed guardian in Omaha who took at least $350,000 from several wards.
To prevent such abuses, the Nebraska state government took commendable action in 2014 by creating publicly funded guardians, under the Nebraska court system, to help vulnerable adults. Then-State Sen. Colby Coash of Lincoln introduced the legislation after World-Herald investigative reporting on the issue.
The program has charted encouraging successes, but it also faces daunting challenges as the state-paid public guardians work to provide these needed services, according to a new report from the Office of Public Guardian. The state currently has 17 public guardians, who each handle a maximum of 20 wards. Cases are assigned based on their crisis level, with lower-level cases placed on a waiting list. At the end of October, 40 cases had been referred to the waiting list.
The guardians face considerable stress in their work, the report says, and turnover is considerable, which adds to the burdens of remaining guardians and lengthens the waiting list. Six applicants died in 2017 while waiting for services. The Supreme Court is trying to help by allowing guardians to earn compensatory time or overtime for handling cases after hours or on weekends.
A frequent problem, the report says, is that medical and mental health services are inadequate in many cases for wards’ needs. The report cites concern, for example, regarding “hospitals and inpatient facilities (that) discharge wards without appropriate discharge planning resulting in lack of adequate services, putting at risk the health and well-being of wards.”
Other problems: “lack of permanent supportive housing for individuals with mental illness,” “nursing home and assisted living facilities with multiple licensure and regulation issues” and “difficulties in obtaining Medicaid when a ward has been a victim of financial abuse.”
The Office of Public Guardian works to recruit guardians and promote alternative supports. The office held 102 presentations across Nebraska from December 2017 through October 2018 to train private guardians and conservators. The office has developed procedures to better identify relatives and friends who could help individuals in need.
This need for assistance for elderly Nebraskans from public or private guardians is likely to increase in coming years. From 2010 to 2030, the number of the state’s residents ages 65 and above is projected to increase from 240,000 to 400,000.
The new report describes encouraging instances of how public guardians have helped wards. One example is a retired minister, described in the report by the pseudonym Mark. Mark had properly prepared his retirement finances through investments, annuities, long-term care insurance and a pre-paid burial plan. But he fell into a catastrophic situation after entrusting his assets to his only grandchild, who suffered from a drug addiction. The granddaughter liquidated his assets, had check deposits redirected to her and took out multiple lines of credits in Mark’s name. Mark lost personal items dear to him, including family photos and heirlooms.
The Nebraska Department of Health and Human Services nominated Mark for emergency protection by a state guardian, and matters turned around. He entered a nursing home and enrolled in Medicaid. He was able to resume contacts with friends in a local club. The guardian helped document Mark’s preferences for his memorial service, burial and organ donation.
Before he died, he told his guardian, “I feel so fortunate to have you.”
The Office of Public Guardian is to be commended for the services it’s providing to such Nebraskans — the need is great. This initiative deserves continued support, buttressed by a strengthening of Nebraska’s medical and behavioral health communities.