Helping your adult child with mental health care

 When reading about the misadventures and exploits of singer Britney Spears, you might find yourself wrangling with legal-ese. Aside from custody struggles for her two young sons, Spears has most recently found herself in probate court, with a judge assigning conservators (her father and an attorney) to take care of her.But what does that mean, exactly?While the media circus surrounding the pop star — and many others — might indicate otherwise, conservatorship (known in Ohio as “guardianship”) is not a lighthearted matter, said Deb Stinson, recovery services manager at Lutheran Social Services in Lima. Only when no options exist, she said, should a guardianship be considered.“It’s generally used as a last resort,” she said.  What is a guardian?On its Web site, the Ohio State Bar Association describes a guardian as someone assigned by the court to be legally responsible for another person or another person’s estate. The courts assign these guardians because the ward (the person being cared for) cannot manage aspects of his life “because of advanced age or some other physical or mental disability.”  Who needs a guardian?People who need guardians range in age and abilities, Stinson said. Often, adult children can become guardians of their elderly parents, who might suffer from Alzheimer’s or some form of dementia and are unable to care for themselves. Other times, parents might become guardians of their adult children who suffer from mental illness, physical disability or other issues.  Who acts as a guardian?Guardians are not always family members of the ward. Attorneys or even outside organizations can be considered guardians for a person. According to Anne McCracken, a social worker at St. Rita’s Medical Center, previous conflicts with family can sometimes lead to need for a different guardian.“Sometimes it’s not a good idea with the family,” she said. “Some patients have poor histories with their families, so its best if a third party comes in or an attorney.”  How does becoming a guardian work?The guardianship process can start in several ways. Sometimes family members notice a loved one may be in need of care, McCracken said, while other times a family doctor, psychiatrist or psychologist might initiate the idea of guardianship “because of the continued needs of the patient.” Social workers at hospitals might also initiate the process if they see a repeat patient whose problems might suggest guardianship is necessary.All guardianship cases are handled in probate court in the county where the person of concern resides, said Tim Hamman, probate court magistrate and administrator for Allen County. All incompetent adult guardianship cases require a “statement of expert evaluation,” in which a doctor or psychiatrist describes whether guardianship is necessary, along with application to be a guardian, which describes how a person would benefit from a guardian’s care.In urgent cases, a potential guardian can work with social workers and doctors on an emergency guardianship, Mary Doerter, a social worker at Lima Memorial Health System. Emergency guardianships are for situations in which there is risk of harm for the person concerned. An emergency guardianship can be put together and approved in as little as a day without a formal hearing, and it lasts for 72 hours. At the end of the 72 hours, the guardianship is re-assessed in probate court, and can be renewed for an additional 30 days.In contrast, a regular guardianship requires a hearing before a probate judge, Hamman said. The evidence for guardianship must be convincing before a judge will grant guardianship.There are several types of guardianships that can be appointed. A “guardianship of person” provides for the day-to-day care of a ward, including clothing, shelter, food healthcare and other items as needed. A “guardianship of estate” gives the guardian custody over the ward’s financial assets, allowing the guardian to manage it in the best interests of the ward.  How long do guardianships last?Guardianships can vary in duration, McCracken said. Depending on the reasons behind a guardianship, some people might find they are no longer in need of a guardian and can resume caring for themselves. Others, however, will need guardianship for the rest of their lives (someone with a severe mental disability or an elderly parent with advancing Alzheimer’s, for example). Wards also have windows of opportunity to lobby for their guardianship’s termination, Hamman said.For adult guardianships, Ohio law mandates guardians file a new statement of expert evaluation and a guardian’s report every two years, Hamman said. A guardian’s report includes information on a ward’s basic information and current condition.