WINGS Minnesota

Working Interdisciplinary Network of Guardianship Stakeholders

WINGS stands for Working Interdisciplinary Network of Guardianship Stakeholders. We are part of a national movement for improving guardianship and conservatorship practices, supported by grant funding from the National Guardianship Network.  Our members include disability advocates, lawyers, judges, social service professionals, healthcare providers, guardians, and conservators.
 
People seek guardianship or conservatorship because they are worried about a loved one or a client. They are concerned that a person has a disability and is having trouble making choices about their healthcare or other matters. But these aren’t always the right tools for every situation.
 
There is strong and growing evidence that people with disabilities are happier, safer, and healthier when they are empowered to make choices about their own lives. 
 
Alternatives exist and the law requires that we think about those alternatives before moving to guardianship or conservatorship. Even when a person has significant difficulty understanding choices, there are reasons why alternatives might be a better fit.
 
WINGS Minnesota is dedicated to:
  • Supporting guardians and conservators, particularly family members or friends, through education to better understand best practices and their responsibilities.
  • Building awareness and processes that ensure that less restrictive alternatives are the default choice.
  • Sustaining a cooperative conversation where all members work to improve outcomes and increase self-determination for individuals who may need assistance making legal or medical choices.
 

Resources

The boundaries of guardianships and conservatorships are set in statute, court rules, and most of all, in an individual order from the court.  No two guardianship situations are exactly the same and different powers might be assigned based on a person’s needs.  The following are some of the limitations people should consider.
 

Guardianship and conservatorship are:

Not required to access services. People have the right to access disability waivers or nursing facilities based on their medical needs. In fact, those supports might be exactly what a person needs to avoid guardianship or conservatorship. Minnesota’s Olmstead Plan affirms the goal of “the opportunity and freedom for meaningful choice [and] self-determination…[and the] supports needed to allow for these choices.” This plan is a commitment from the State of Minnesota in fulfilling (Olmstead Plan Aug 2015, Subcommittee Vision Statement)
 
Not required just because a person has a disability.  A person might have significant impairments, but already have the supports they need. For example, a person with dementia might forget to eat. Family members set up a meal service, and check in with them on a regular basis. A person is injured in car accident and is in a coma. A signed healthcare directive lets the hospital know who that person wanted to make medical choices. (524.5-310 sub a, c)
 
Not the end of the conversation. Under Minnesota’s bill of rights for wards and protected persons, guardians and conservators have the duty to consult the individual and consider their wishes when making choices. Services must be individually suited to the person’s needs. A guardian or conservator must remain open to input from the person they serve, even if they disagree strongly. (524.5-120)
 
Not unlimited. Minnesota law requires a person requesting an order for guardianship or conservatorship to explain what powers they are requesting, and why they are needed. Some decisions always require the court’s permission, and the individual retains any right not specifically granted to the guardian or conservator. (524.5-120, 524.5-313 c4)
 
Not forever.  Minnesota law requires that whenever feasible, that orders for guardianship and conservatorship be tailored so that they will encourage the development of the ward's maximum self-reliance and independence. Guardians must report to the court at least every year on the well-being of the individual they serve, and tell the court if the persons needs have changed. Conservators must report to the court at least once a year reporting income and expenses.  The judge can remove or change an order that does not line up with what that person needs.  And the individual under guardianship or conservatorship can always ask the court to remove or change their order. (524.5-310 c, 524.5-316, 524.5-317)
 
Not an easy process. The duties of a guardian or conservator are very serious and are conducted under the court’s supervision. This means they must respond to questions the court asks, file timely reports on how money is being spent, and follow instructions or orders carefully.(524.5-313, 524.5-316)
Minnesota law provides for many kinds of supports for people who may need help with medical or legal choices.
  • Health Care Directives allow a person to nominate another person to make health care decisions for them. The directive must be completed at a time when the person understands what this means, but will remain effective if the person loses that ability later on. A person can also include specific directions about health care they do or don’t want.  A health care agent can view relevant medical records.
  • Power of Attorney designates a person allowed to act on another person’s behalf. A range of powers can be assigned or denied, including the ability to buy or sell property, open bank accounts, or other matters.  The person who makes this document is a “principal” and the person chosen to act on the principals’ behalf is an “attorney-in-fact.” This person will have significant powers, and should be chosen carefully. They do not need to be a lawyer. Minnesota law requires that a power of attorney be designated as “durable” if it is to remain in effect if the principal loses the capacity to make decisions on his or her own.
  • Technological assistance is one of the factors that must be considered before a judge orders guardianship or conservatorship. This might include setting up balance alerts for a bank account, or obtaining an automatic pill monitoring box.
  • Services Assessment: A person with disabilities or long-term care needs can contact their county for a MnCHOICES assessment. A trained assessor visits the person in their home to understand what activities of daily living are challenging for the person, the strengths and preferences that person has, and to determine what programs or waivers that person might be eligible to receive.
 
Each person’s needs are different, and we all build supports around ourselves in different ways. Even if we don’t have the experience of a cognitive disability, most people can relate to not fully understanding a choice they need to make.  We might ask a friend about what kind of car to buy, or need a doctor to use simpler language to explain our options. Practices of supportive decision making build on the choices we can make to help us with the ones we are struggling with. The following story comes from a social worker asked to help a person who wasn’t getting the help and care she needed.
 

“Emma” had been living in her own home, and, until recently, was active in her social community. She was widowed, and had no children or extended family, but did have a number of friends in her area. They were worried that she was depressed and living in filth. But they didn’t know how to ask her to accept help.  
 
Emma fell, and ended up in the hospital.  There, her providers grew worried that she was neglecting herself due to cognitive difficulties. Once admitted, a psychiatrist determined that she was incapacitated, and therefore needed a guardian/conservator.  

But this wasn’t the whole picture. Emma said she was ready to die, but she also talked about the long full life she had lived, and how she missed her husband. Despite health challenges, she was reflecting on her life and preparing herself as best she could.  She knew who her friends were, and could clearly say who she trusted to help when it came to medical choices and managing her money. A social worker recorded her strengths as well as her challenges to form a plan.
 
With the help of her friends, an elder law attorney met with Emma, and she completed a health-care directive and power of attorney form.
 
Emma had significant difficulties because of her health, but she was able to understand this particular decision: who she trusted to make decisions for her.  

Emma passed away a few weeks later. Her friends were by her side, and she had gotten appropriate care. She did not lose the time, money, or energy that a guardianship/conservatorship process would have taken from her. Careful planning addressed potential vulnerabilities for Emma, while drawing on supports she had cultivated instead of an outside decision maker.