As guardian of the person, the Public Guardian’s Office often must interact with other court systems to represent or otherwise protect the disabled person’s interest. For example, as guardian of the person, the Public Guardian’s Office may need to appear in mental health court if the disabled person needs but refuses mental health care, services, or medication. A guardian does not have the authority to consent to mental health treatment or medication for a disabled person who is objecting without a court order. See 405 ILCS 5/2-102, and 5/2-107.1.
The Probate Act authorizes the guardian of the person to maintain an action for dissolution of marriage if the disabled person filed for dissolution prior to an adjudication of disability. See 755 ILCS 5/11a-17. A guardian does not have authority to initiate a divorce for a disabled person. If a dissolution of marriage action is pending, the Public Guardian’s Office may handle the matter internally or work with a divorce attorney if one was already retained by the individual prior to being disabled.
Maintaining as much independence as possible in the disabled adult’s life has always been a guiding factor in cases where the Public Guardian serves as guardian of the person. About one-third of the individuals in the Public Guardian’s care reside in their homes in the community. Individuals are included in the decision making to the best of their ability and encouraged to perform activities of daily living to the extent they are able. Rehabilitation programs, counseling, and other social activities are incorporated into the disabled person’s life to promote the highest possible level of independence and socialization. The Public Guardian’s Office strives to find all available resources in the community to maintain or improve the individual’s level of functioning and rehabilitative potential. These include adult day care; psychiatric day programming; in-home medical services; art, music, and occupational therapies; job training; and employment services, to name a few.
Placement/Living Environment Options
The Public Guardian’s Office strives to place each disabled adult in the least restrictive environment possible. This is accomplished through both community placements and long-term care facilities. Community placements include, but are not limited to: the disabled person’s own home, rental properties, home sharing, group homes, community integrated living arrangements (CILA), supportive living, assisted living, independent living facilities, and single room occupancies (SRO’s).
If living in the community is not an option because of the person’s required level of care and finances, the Public Guardian’s Office strives to match the person’s needs, desires, and cultural and religious backgrounds in determining an appropriate nursing home. The Public Guardian’s Office communicates with the nursing home staff regularly and monitors the nursing homes to ensure that the disabled adults receive the highest level of care.
Making health care decisions for each individual often becomes the most difficult role of the guardian. Treatment and advance directive decisions are based upon both medical indicators and any information that can be learned about the person’s wishes and beliefs. Disabled adults are included in medical decisions to the best of their ability. The Public Guardian, as guardian of the person, may serve as the surrogate health care decision maker pursuant to the Illinois Health Care Surrogate Act. The Public Guardian’s health care consultant assesses the individual’s health care needs and assists the Public Guardian’s staff in understanding those needs in determining treatment and care. Health care services are provided by professionals independent of the Public Guardian’s Office.
- Health Care and Mental Health Services–All medical, mental health, and other health care related services are provided by professionals independent of the Public Guardian’s Office. All services provided to the disabled person should be under the direction, coordination and consent of the guardian. Services are obtained from a multitude of providers in the community based on the medical and care needs of the individual. Quality of care is the only criteria for providing services as there are no exclusive or contracted service providers.
- End of Life Decisions and Hospice–A court appointed guardian of the person makes end of life decisions in accordance with the Illinois Health Care Surrogate Act. Per the requirements of the Act, all types of advance medical directives can be established, including do-not-resuscitate (DNR) orders, withholding certain treatments, or withdrawal of treatment. Decisions can be made regarding end of life care, such as hospice. See the Illinois Health Care Surrogate Act at www.ilga.gov.