Lutheran Metropolitan Ministry
In Lutheran Metropolitan Ministry’s two guardianship programs, well-thought-through training and support are the keys to effectiveness.
In the Critical Field of Adult Guardianship, Great Training is Key
Cuyahoga County, Ohio has seen large growth in its population of older adults, specifically those over age 85, and other adults with severe and persistent mental illness. One result has been that staff at hospitals and social service agencies who work with the elderly and with persons with mental illness have recognized an increased need for trained volunteers willing to serve as legal decision-makers for seniors whom the courts have judged incompetent. So Lutheran Metropolitan Ministry (LMM), a faith-based organization that Mitchel Balk of Mt. Sinai Healthcare Foundation credits as “being great at filling in the gaps no one else is meeting,” stepped in to address the need.
LMM initially designed a program relying primarily on volunteers with just one part–time staff. Over time, though, the demand for guardians grew to the point where LMM had to hire more staff to manage and support the initiative. Last year LMM mobilized over 200 new volunteers, including about 35 attorneys offering pro-bono aid, through two separate programs–Adult Guardianship Services in Cuyahoga County and the Volunteer Guardianship Program in Lorain County.
Roughly three-quarters of the 635 individuals LMM serves in the guardianship programs are over age 60. The rest are younger and struggle with mental health issues such as schizophrenia. While being a volunteer guardian isn’t typically a heavy burden time-wise—volunteers spend perhaps 2-3 hours per month interacting with their wards—it is a big responsibility. “Guardians are appointed by the Probate Court to make healthcare and other life decisions for individuals deemed incompetent and unable to care for themselves, otherwise known as wards of the state,” explained Maria Foschia, Vice President of Adult Support and Advocacy at LMM. “They might have to consider such decisions as whether the ward should have a particular medical treatment or whether it’s time for the person to move into a nursing home or other supportive living environment.”
LMM’s volunteer guardians serve on average for five years and “very few resign while they have an active ward,” Foschia reported. She believes the strong support and training LMM offers, plus the inherent reward of meeting a critical need, explain the organization’s success in recruiting and retaining their volunteers.
Dick, one of the Volunteer Guardians, agrees. “I get good support from the staff,” he said. “I don’t feel like I’m out here all by myself. If I have a difficult decision to make, I feel I can get help and support in making those decisions.”
Individuals interested in serving as volunteer guardians participate in an intensive 5-hour training to help them discern the role and whether it’s for them. They are educated on all aspects of guardianship. LMM also brings in seasoned volunteers who have been serving as guardians to share about their experiences. Most importantly, the training includes a major focus on ethical decision-making, facilitated by a bioethicist. During this time the potential volunteers work through case studies based on real, though anonymous, client stories. “This really helps the volunteers get into the shoes of the clients, thinking through what choices he/she could make,” says Foschia. The bioethicist reviews the Code of Ethics that has been adopted by the National Guardianship Association and the volunteers consider the kinds of decisions they may be faced with, how to involve their wards in decision-making as much as possible, and how to consider things from multiple perspectives to make the best decision.
Once volunteers begin serving as Guardians, they can turn to LMM’s volunteer attorneys for legal advice as needed and to LMM staff any time, day or night. “We also offer ongoing training for volunteers and staff on timely topics related to guardianship practice and we participate in the Ohio Guardianship Association’s Annual Educational conference,” added Foschia.
“LMM does a great job of preparing us to be a volunteer guardian,” said Pat, a guardian who has served alongside her ward, Jasmine, for 13 years. “These [wards] are for the most part people that don’t have families involved with them to assist them, and they’re in need of assistance. So I feel honored that I was able to find out about it and become involved.”