Guardianship

Table of Contents

Chapter One

Adult Guardianship

I. The Effect of Guardianship ..................................................................................... 1

II. Adversarial Proceedings ......................................................................................... 2

Chapter Two

Assessing Capacity and Incapacity
in Persons with Disabilities

I. Incapacity Defined ................................................................................................. 5

II. Maryland Definition ................................................................................................ 6

III. Mental Disabilities .................................................................................................. 7

A. Mental Illnesses ................................................................................................ 7

1. Mental Illness/Affective Disorders .......................................................... 7

2. Mental Illness/Organic Brain Disorders .................................................... 8

B. Developmental Disabilities ................................................................................. 9

1. Mental Retardation ................................................................................. 9

2. Epilepsy and Autism ............................................................................. 10

C. Cognitive Communication Disorders ................................................................. 10

D. Drug Dependency ........................................................................................... 11

IV. Physical Disabilities .............................................................................................. 12

A. Hearing Loss .................................................................................................. 12

B. Vision Loss ..................................................................................................... 13

C. Speech Loss ................................................................................................... 14

D. Manipulatory and Locomotor Disabilities ........................................................... 14

V. Proof of Incompetency in Maryland ...................................................................... 15

VI. Medical Evaluations of Competency ..................................................................... 16

A. History ........................................................................................................... 16

B. Tests for Mental Capacity ................................................................................ 16

C. Tests for Physical Causes of Incompetency ...................................................... 17

D. Laboratory Tests ............................................................................................. 17

VII. Decision Making by the Questionably Competent ................................................. 17

Chapter Three

Guardianship of the Person

I. Standard for Appointment of a Guardian of the Person .......................................... 19

II. Persons Who May Petition for Guardianship, and Proper Venue ........................... 19

III. Contents of the Petition ........................................................................................ 20

IV. Representation of the Alleged Disabled Person ..................................................... 21

V. Role of the Court-Appointed Attorney .................................................................. 23

VI. Process after the Petition is Filed .......................................................................... 24

VII. Discovery ............................................................................................................ 25

VIII. The Hearing and the Alleged Disabled Person’s Rights .......................................... 25

IX. Standard of Proof to be Met by the Petitioner ....................................................... 27

X. Persons Who May be Appointed Guardian of the Person ...................................... 27

XI. Contents of the Appointment Order ...................................................................... 28

XII. The Guardian’s Scope of Authority ....................................................................... 28

XIII. Statutory Limitations on the Guardian’s Powers .................................................... 30

A. Change in Abode ............................................................................................. 30

B. Commitment to a Mental Health Facility ........................................................... 31

C. Health Care Decision Making .......................................................................... 31

XIV. Reporting to the Court .......................................................................................... 33

XV. Renewal of a Guardianship of the Person .............................................................. 34

XVI. Replacement of a Guardian of the Person ............................................................ 34

A. Resignation ..................................................................................................... 34

B. Removal for Cause and Other Sanctions ........................................................... 35

XVII............................................................. Termination of a Guardianship of the Person 35

XVIII............................................................... Adult Public Guardianship Review Boards 36

Chapter Four

Guardianship of the Property

I. Standard for Appointment of a Guardian of the Property ....................................... 37

II. Persons Who May Petition for Guardianship, and Proper Venue ........................... 37

III. Contents of the Petition ........................................................................................ 38

IV. Representation of the Alleged Disabled Person ..................................................... 38

V. Role of the Court-appointed Attorney ................................................................... 39

VI. Procedure after the Petition is Filed ....................................................................... 40

VII. Discovery ............................................................................................................ 41

VIII. The Hearing and the Alleged Disabled Person’s Rights ......................................... 41

IX. Standard of Proof to be Met by the Petitioner ....................................................... 42

X. Persons Who May be Appointed Guardian of the Property ................................... 43

XI. Contents of the Appointment Order ...................................................................... 43

XII. Degree of Skill and Care of Guardian ................................................................... 44

XIII. Bond Requirements ............................................................................................. 44

XIV. The Guardian’s Scope of Authority ...................................................................... 45

XV. Powers with Respect to Care of the Disabled Person ........................................... 48

XVI. Reporting to the Court ......................................................................................... 48

XVII............................................................... Replacement of a Guardian of the Property 49

A. Resignation ..................................................................................................... 49

B. Removal for Cause and Other Sanctions ........................................................... 50

XVIII............................................................................... Termination of the Guardianship 51

Chapter Five

Emergency Guardianship

I. Standard for Appointment of an Emergency Guardian ........................................... 53

II. Definition ............................................................................................................. 54

III. Petition ................................................................................................................ 54

IV. Procedural Rights ................................................................................................. 55

A. Right to Notice ................................................................................................ 55

B. Right to a Hearing ........................................................................................... 55

C. Right to Counsel .............................................................................................. 55

V. Standard for Emergency Order ............................................................................. 56

VI. Limitations on Court Order ................................................................................... 56

VII. Appeal ................................................................................................................. 57

Chapter Six

Guardianship Hearings

I. Motions .............................................................................................................. 59

A. Presence of the Physician ................................................................................ 59

B. Jury Trial ........................................................................................................ 59

C. Place of Trial .................................................................................................. 60

D. Closed Hearing ............................................................................................... 60

E. Privileged Information ...................................................................................... 60

II. Hearing ................................................................................................................ 60

Chapter Seven

Less Restrictive Alternatives to Guardianship

I. Introduction ......................................................................................................... 63

II. Reasons to Seek Alternatives to Guardianship ....................................................... 63

III. Personal Safety .................................................................................................... 64

A. Persuasion by a Trusted Family Member or Friend ............................................ 64

B. Adult Protective Services ................................................................................. 64

1. Case Management ................................................................................ 65

2. Home Health Services .......................................................................... 65

3. Senior Care .......................................................................................... 65

4. Adult Day Care .................................................................................... 65

5. Respite Care ........................................................................................ 66

6. Meals on Wheels .................................................................................. 66

7. Transportation to Medical and Other Appointments ................................. 66

8. Food and Prescription Drug Deliveries ................................................... 66

9. Telephone Reassurance Programs ......................................................... 66

10. Home Visitors and Pets on Wheels ........................................................ 66

11. Unpaid Utility Bills ................................................................................ 66

12. Postal Service Checks .......................................................................... 66

IV. Alternative Housing Arrangements ........................................................................ 66

A. Assisted Living Facilities .................................................................................. 67

B. Continuing Care Retirement Communities ......................................................... 68

V. Substituted Consent to Medical Treatment ............................................................ 68

A. Advance Directives ......................................................................................... 69

1. Appointment of Health Care Agent ........................................................ 69

2. Health Care Instructions ....................................................................... 69

3. Oral Directives ..................................................................................... 69

B. Surrogate Decision Making .............................................................................. 69

1. Surrogate Decision Makers ................................................................... 70

2. Surrogates vs. Guardians ....................................................................... 70

3. Disputes Among Surrogates .................................................................. 72

4. Limitations on Surrogates ...................................................................... 73

VI. Protection of Property .......................................................................................... 73

A. Representative Payee ...................................................................................... 73

B. Power of Attorney .......................................................................................... 74

C. Banking Services ............................................................................................. 75

1. Direct Deposit ...................................................................................... 75

2. Direct Payment .................................................................................... 75

3. Power of Attorney Accounts ................................................................. 75

D. Joint Ownership of Bank Accounts ................................................................... 75

E. Specific Transactions ....................................................................................... 75

F. Trusts ............................................................................................................. 76

G. Md. Rule 2‑202 — Capacity ............................................................................ 76

Chapter Eight

Court Accessibility for Specific Populations

I. Access to Court for Older Persons and People with Disabilities ............................. 77

II. People with Disabilities in American Society .......................................................... 78

III. Barriers to Accessibility of the Courts ................................................................... 79

A. Attitudinal and Procedural Barriers ................................................................... 79

1. Courtroom Procedures .......................................................................... 79

2. Court Personnel Attitudes ..................................................................... 80

B. Communications Barriers ................................................................................. 80

1. Lighting ................................................................................................ 80

2. Printed Materials .................................................................................. 81

3. Handwritten Materials .......................................................................... 81

4. Acoustics ............................................................................................. 81

5. Signs .................................................................................................... 81

6. Positioning ............................................................................................ 81

7. Fixed Courtroom Arrangements ............................................................. 81

C. Architectural and Other Physical Barriers ......................................................... 81

1. Transportation and Parking .................................................................... 81

2. Access to the Entrance ......................................................................... 81

3. Accessible Court Entrance ............................................................................ 82

4. Court Entrance ..................................................................................... 82

5. Court Security ...................................................................................... 82

6. Interior Stairs/Elevators ......................................................................... 82

7. Floors .................................................................................................. 82

8. Hallways .............................................................................................. 82

9. Restrooms ............................................................................................ 82

10. Counters .............................................................................................. 82

11. Waiting Rooms ..................................................................................... 83

12. Public Telephones ................................................................................. 83

13. Water Fountains/Cafeterias ................................................................... 83

14. Witness Box ......................................................................................... 83

15. Counsel Tables ..................................................................................... 83

16. Microphones ........................................................................................ 83

17. Public Seating in Courtroom .................................................................. 83

IV. Equal Access Measures ....................................................................................... 83

A. Ensuring Physical and Communications Access to and in Court .......................... 85

1. Cognitive or Affective Disabilities .......................................................... 85

2. Vision Disabilities ................................................................................. 86

3. Hearing Disabilities ............................................................................... 87

4. Speech Disabilities ................................................................................ 88

5. Manipulatory and Locomotor Disabilities ................................................ 88

V. Eliminating Stereotypes ......................................................................................... 89

Appendix A

Checklists of Procedures

1. Checklist for Petitioner for Guardianship ............................................................... 92

2. Checklist for Venue .............................................................................................. 93

3. Checklist for Contents of Petition .......................................................................... 94

4. Checklist for Physician’s or Psychologist’s Certificate ........................................... 97

5. Checklist for Delayed Filing of Certificates ............................................................ 99

6. Checklist for Appointment of Attorney for the Alleged Disabled
Person and Investigator Fees .............................................................................. 100

7. Checklist for Show Cause Order ........................................................................ 102

8. Checklist for Service of Notice and Required Forms ........................................... 103

9. Checklist for Trial ............................................................................................... 105

10. Checklist for Grounds for Appointment of Guardian of the Person ....................... 108

11. Checklist for Grounds for Appointment of Guardian of the
Property ............................................................................................................ 111

12. Checklist for Investigating Suitability of Proposed Guardian of
the Person .......................................................................................................... 114

13. Checklist for Investigating Suitability of Proposed Guardian of
the Property ....................................................................................................... 115

14. Checklist for Order Appointing Guardian ............................................................ 117

15. Checklist for Review of Guardian’s Report(s) ..................................................... 118

16. Checklist for Resignation or Death/Disability of Guardian .................................... 120

17. Checklist for Removal of Guardian for Cause ...................................................... 123

18. Checklist for Termination of Guardianship of the Person ...................................... 126

19. Checklist for Termination of Guardianship of the Property ................................... 128

Appendix B

Sample Forms

1. Sample Petition for Appointment of Guardian ...................................................... 132

2. Sample Physician’s Certificate ............................................................................ 135

3. Sample Medical Report ...................................................................................... 137

4. Sample Order for Appointment of Attorney for Alleged
Disabled Person ................................................................................................. 138

5. Sample Show Cause Order ................................................................................ 139

6. Sample Certificate of Service .............................................................................. 140

7. Sample Notice to Interested Persons Form ......................................................... 142

8. Sample Advice of Rights to Alleged Disabled Person Form ................................. 143

9. Sample Answer to Complaint ............................................................................. 144

10. Sample Special Verdict ...................................................................................... 146

11. Sample Order Appointing Guardian of the Person ............................................... 147

12. Sample Limited Order for Guardian of the Person for
Medical Intervention ........................................................................................... 150

13. Sample Order Appointing Guardian of the Property ............................................ 151

14. Sample Inventory and Information Report of Guardian of Property ...................... 153

15. Sample Annual Report of Guardian of the Person ................................................ 156

16. Sample Annual Report of Guardian of the Property
(Fiduciary’s Account) ......................................................................................... 158

17. Report of the Trust Clerk and Order of the Court ............................................... 162

18. Petition to Terminate Guardianship of Person and Property ................................. 163

19. Order of Court Terminating Guardianship of Person and Property ....................... 165

Appendix C

Relevant Opinions of the Attorney General

1. 78 Op. Att’y Gen. 208 (June 1, 1993) (Opinion No. 93-019).............. 168

I. Background ....................................................................................................... 168

II. “End-Stage Condition” ....................................................................................... 169

III. Clarifications in Forms ........................................................................................ 171

IV. Surrogate Decision Making ................................................................................ 172

A. Guardian as Surrogate .................................................................................... 172

B. Disputes Among Surrogates ........................................................................... 173

V. EMS “Do Not Resuscitate Orders” .................................................................... 174

VI. Distribution of Information .................................................................................. 174

VII. Standards for Guardians ..................................................................................... 175

VIII. Conclusion ........................................................................................................ 176

2. 79 Op. Att’y Gen. 218 (May 3, 1994) (Opinion No. 94-023)............... 179

I. Cardiopulmonary Resuscitation and DNR Orders ............................................... 181

A. Resuscitation Procedures ............................................................................... 181

B. CPR As A “Life-Sustaining Procedure” .......................................................... 183

II. Surrogate Consent to a DNR Order ................................................................... 186

III. Guardian Consent to a DNR Order .................................................................... 187

IV. Physician Entry of a DNR Order ........................................................................ 187

A. Medically Ineffective CPR ............................................................................. 187

B. Patients Under Guardianship .......................................................................... 189

V. Health Care Agent Consent To A DNR Order ................................................... 190

VI. DNR Orders Entered Prior to the Health Care Decisions Act .............................. 190

A. Patient Consent ............................................................................................. 190

B. Attorney-in-Fact Consent ............................................................................... 191

C. Family Consent .............................................................................................. 191

VII. DNR Decisions in Advance Directives and Informed Consent
Discussions ........................................................................................................ 192

VIII. Mandating Consent to a DNR Order ................................................................. 193

IX. Conclusion ......................................................................................................... 193

Appendix D

Maryland Case Law

Bliss v. Bliss, 133 Md. 61, 104 A. 467 (1918) ........................................................................ 197

Green v. Lombard, 28 Md. App. 1, 343 A.2d 905 (1975) ...................................................... 197

In re Easton, 214 Md. 176, 133 A.2d 441 (1957) .................................................................. 197

In re Riddlemoser, 317 Md. 496, 564 A.2d 812 (1989) ......................................................... 198

In re Sonny E. Lee, 132 Md. App. 696, 754 A.2d 426 (2000) ......................................... 198

Kicherer v. Kicherer, 285 Md. 114, 400 A.2d 1097 (1979) ................................................... 198

Law v. John Hanson Sav. & Loan, Inc.,
42 Md. App. 505, 400 A.2d 1154 (1979) .......................................................................... 199

Mack v. Mack, 329 Md. 188, 618 A.2d 744 (1993) .............................................................. 199

State el rel. Adams v. May, 196 Md. 152, 75 A.2d 839 (1950) .............................................. 200

Wentzel v. Montgomery General Hospital, Inc.,
293 Md. 685, 447 A.2d 1244 (1982),
cert. denied, 459 U.S. 1147 (1983) .................................................................................... 200

Williams v. Moran, 248 Md. 279, 236 A.2d 274 (1967) ......................................................... 200

Appendix E

In re Sonny E. Lee

In re Sonny E. Lee, 132 Md. App. 696, 754 A.2d 426 (2000) ............................................... 201

Appendix F

Case Law from Other States

Conservatorship of Gilbuena,
209 Cal. Rptr. 556, 1985 Cal. App. LEXIS 1494 (1985) ................................................... 223

Guardianship of Phillip B., 139 Cal. App. 3d 407, 188 Cal. Rptr. 781 (1983) ......................... 223

In re Estate of Silverman, 257 Ill. App. 3d 162, 628 N.E.2d 763 (1993) ................................. 223

In re Estate of Thompson, 186 Ill. App. 3d 874, 542 N.E.2d 949 (1989) ................................ 224

In re Estate of Wood, 368 Pa. Super. 173, 533 A.2d 772 (1987) ........................................... 224

In re Fey v. Curtis, 624 So. 2d 770, 1993 Fla. App. LEXIS 9179 (1993) ............................... 224

In re Guardianship of Deere, 708 P.2d 1123, 1985 Okla. LEXIS 152 (1985) ......................... 225

In re Guardianship of F.E.H., 154 Wis. 2d 576, 453 N.W.2d 882 (1990) ............................... 225

In re Boyer, 636 P.2d 1085, 1981 Utah LEXIS 886 (1981) ................................................... 226

In re Maher, 621 N.Y.S.2d 617, 207 A.D.2d 133 (1994) ...................................................... 226

In re Mason, 305 N.J. Super. 120, 701 A.2d 979 (1997) ....................................................... 226

In re M.R., 135 N.J. 155, 638 A.2d 1274 (1994) .................................................................. 227

In re R.H., 35 Mass. App. Ct. 478, 622 N.E.2d 1071 (1993) ................................................ 227

In re Terwilliger, 304 Pa. Super. 553, 450 A.2d 1376 (1982) ................................................. 228

Myrtle Mabry v. Roberts, 281 Ill. App. 3d 76, 666 N.E.2d 16 (1996) .................................... 228

State ex rel. Shamblin v. Collier, 191 W. Va. 349, 445 S.E.2d 736 (1994) ............................. 229

Superintendent of Belchertown State School v. Saikewicz,
373 Mass. 728, 370 N.E.2d 417 (1977) ............................................................................ 229

Appendix G

Ethics Opinions and Articles

Ethics Opinions ....................................................................................................................... 231

Articles ................................................................................................................................... 231

Appendix H

Statement of Recommended Judicial Practices

I. Introduction ....................................................................................................... 233

II. Recommendations .............................................................................................. 233

A. Procedure: Ensuring Due Process Protections ................................................. 233

1. Notice to the alleged incompetent ............................................................. 233

2. Presence of the alleged incompetent at the hearing ............................... 234

3. Representation of the alleged incompetent ............................................ 234

B. Evidence: Applying Legal Standards to Medical/Social Information ................... 234

1. Assessment of medical diagnosis of the alleged incompetent .................. 234

2. Use of investigative resources to assist the court ................................... 234

3. Advanced age of the alleged incompetent ............................................. 235

C. Court Order: Maximizng Autonomy of the Ward .............................................. 235

D. Supervision: Ensuring the Effectiveness of Guardianship Services ..................... 235

1. Submission and review of guardian reports ........................................... 235

2. Training of guardians ........................................................................... 235

3. Use of guardianship agencies ............................................................... 235

E. Alternative Positions ...................................................................................... 235

Use of Guardianship Agencies ..................................................................... 236

Appendix I

National Probate Court Standards 237

3.3 Guardianship .................................................................................................................... 240

Standard 3.3.1 Petition .................................................................................................... 241

Standard 3.3.2 Screening ................................................................................................. 242

Standard 3.3.3 Early Control And Expeditious Processing .................................................. 243

Standard 3.3.4 Court Visitor ............................................................................................ 244

Standard 3.3.5 Appointment Of Counsel ........................................................................... 246

Standard 3.3.6 Emergency Appointment Of A Temporary Guardian ................................... 248

Standard 3.3.7 Notice ...................................................................................................... 250

Standard 3.3.8 Hearing............................................................................................... 251

Standard 3.3.9 Determination Of Incapacity ..................................................................... 252

Standard 3.3.10 Less Intrusive Alternatives ...................................................................... 254

Standard 3.3.11 Qualifications And Appointments Of Guardians ........................................ 256

Standard 3.3.12 Order ..................................................................................................... 258

Standard 3.3.13 Training And Orientation ......................................................................... 260

Standard 3.3.14 Reports By The Guardian ........................................................................ 261

Standard 3.3.15 Monitoring Of The Guardian .................................................................... 262

Standard 3.3.16 Reevaluation Of Necessity For Guardianship ............................................ 263

Standard 3.3.17 Enforcement ........................................................................................... 264

Standard 3.3.18 Final Report And Discharge .................................................................... 265

3.4 Conservatorship ............................................................................................................... 266

Standard 3.4.1 Petition ...................................................................................................