As a guardian for your ward, you should make decisions on behalf of your ward based on the standard of what is in the "best interests" of the ward. Sec. 880.39 of the Wisconsin Statutes states, "Any guardian of the person is immune from civil liability for his or her acts or omissions in performing the duties of the guardianship if he or she performs the duties in good faith, in the best interests of the ward and with the degree of diligence and prudence that an ordinarily prudent person exercises in his or her own affairs." In other words, a guardian who makes decisions for his or her ward based on what is best or easiest for the himself or herself, or for any other person, rather than solely for the benefit of the ward, is acting outside the authority granted to a guardian by Wisconsin state law.

The standard of "best interests" under guardianship law is different from the "substituted judgement" decision-making standard role a person assumes when he or she becomes an agent under a Power of Attorney for Health Care. As an agent, you are bound to carry out the wishes of the person as spelled out in that person's advance directive document, or as you are instructed to act by that person. Even if you disagree with what that person wants, it is your duty to carry out those wishes as a "substitute" for that person or as if he or she were not incapacitated or incompetent.

For example, in a situation where a guardian is faced with the decision of whether to consent to transplanting one the ward's kidneys to the ward's sister, for whom the kidney is a perfect match. Under "substituted judgement," where a guardian could make a decision based on what the ward would have chosen, the guardian might consent. The consent would be based on whether or not the guardian believed the ward would want to undergo this surgery and give up a kidney for his sick sister. BUT, under Wisconsin guardianship law's "in the best interests of the ward" standard, consent to removal and transplant of the kidney is not allowed. This is because it would not be in the ward's best interest to undergo surgery and give up a kidney since there is no benefit to the ward in doing so.

The "best interests" standard is not meant to say that a guardian should not take into consideration the wishes expressed by the ward. If the ward had previously expressed his or her wishes in a fundamental area, unless these express wishes go strongly against the best interests standard, these express wishes should always be taken into consideration by the guardian when decisions are being made. Also, simply because a person currently has a guardian does not mean he or she can no longer participate in any life decisions.

Wards should be allowed to participate in any decision in an area where he or she has capabilities. Guardians may also be able to assist the ward in making decisions about his or her life that the ward may have been unable to previously make without the assistance of another person.

Section 880.38(2) of the Wisconsin Statutes states, "A guardian of the person shall endeavor to secure necessary care, services or appropriate protective placement on behalf of the ward."

As guardian, the services you chose should provide a wide range of choices and provide support for decisions in whatever areas the ward shows interest and ability. Services should be delivered in ways that recognize each person's humanity, dignity, and uniqueness. You should attempt to choose services which reflect the life experiences of the ward and the experiences that most other people the ward would identify with would choose for themselves. As much as possible, try to make arrangements that allow the ward to receive services in "ordinary places." For example, seek services that can be provided in the ward's own home, or another community setting such as an adult day care center, or small Community Based Residential Facility (group home).

A good advocate should also attempt to secure funding for community-based services through the Community Options Program, the Medical Assistance Program, Alzheimer's Support funding, Supportive Home Care money or other programs. Contact your county human services department for information about local funding programs that may be available to help your ward.

To be a good advocate for your ward, it is important that you are involved in the ward's life. It is important that contact is kept with the ward through visits, phone contact with the ward or care providers, and attending care planning meetings if necessary for your ward. Many times a family member who is a very caring guardian may not live near his or her ward. Telephones, FAX machines and written documentation may provide a way of keeping the guardian very involved in the ward's life. A person who lives close to the ward should make regular in-person visits and report on those visits to the guardian. When visiting: Keep notes on personal visits and specifically notice:

• How is the ward's physical appearance, health, and emotional status?
• Does he or she seem happy?
• What specific things have changed since your last visit?
• Did you give your ward an opportunity to let you know about any problems? Were there any? What are your follow-up plans?

When as guardian you have contracted with service providers to provide care or assistance to your ward, it is also important to keep in contact with these people on a regular basis. Keep a record of names of agencies, individuals providing service, and phone numbers so you can contact them for current information about your ward. Note the questions you want to ask and identify concerns you have and want addressed. Keep notes about what was said and whom you spoke to during these contacts.

A good advocate is assertive, while respecting the concerns of everyone involved in the situation. Questions to ask yourself:

How will assertive behavior on my part help resolve this situation?

• Am I holding onto an irrational goal? Expecting too much from everybody? (my ward, my family, caregivers and service providers, and myself).

What are my rights in this situation?

• Have I done my homework? Do I have the information I need to go ahead and act?
• Can I let other people know how I feel?
• Can I communicate what needs to be said and heard?

A guardian has the right to request the opportunity to review or have copies of health care records pertaining to his or her wards. Section 146.83(4) of Wisconsin Statutes states that "No person may do any of the following: (b) conceal or withhold a patient health care record with intent to prevent its release to the patient, to his or her guardian appointed under ch. 880 or to a person with the informed written consent of the patient or with intent to prevent or obstruct an investigation or prosecution." Resident rights provisions which apply to nursing facilities also state that records must be made available to the resident or the resident's legal representative within 24 hours of a written or oral request. If you want to have copies of your ward's records,the charge for photocopying these records cannot exceed the community standard, and a two day advance notice is required.

If a ward has been the victim of financial elder abuse, it may be necessary to appoint a guardian of the estate to take over management of finances to stop continued abuse. Many times the abuse was done using a Power of Attorney-Financial document to gain access to the person's money and other assets. A guardian may file a complaint on behalf of their ward with a county elder abuse agency. Elder Abuse Specialists are located in all 72 Wisconsin counties. Complaints may also be filed with local law enforcement agencies or District Attorney offices. It is always in the best interests of the ward to regain access and ownership of money and property that can be used to support and pay for care of the ward.

Wisconsin Statute section 880.19, states that a guardian must "protect and preserve" his or her ward's assets. A guardian may never make gifts of the ward's money or assets. The no gifting provision was upheld in a Wisconsin Court of Appeals case dated September 19, 1995 In the Matter of the Guardianship of Stanley B.: Michael S.B., Guardian of the Estate of Stanley B., v. Frederic J. Berns, Guardian ad Litem. (Case No. 95-0580). This court decision gives clear guidance to all Wisconsin guardians. No matter what the ward's previous pattern of giving, a guardian has no authority to give away the funds or assets of his or her ward.

In summary, it is your responsibility as guardian to know and defend your ward's rights, and to make sure these rights are protected and not sacrificed for the sake of expediency. If possible, advocate for your ward to move towards a limited rather than a full guardianship if rights in certain areas can be retained or restored. Your ward should be treated with dignity and respect. Consult your ward about his or her wishes, and when that is not appropriate, always make decisions that are in the ward's best interests.

Being a good advocate for your ward also means being a good advocate for yourself - learn to find resources for both of you, and don't be afraid to ask for help when you need it.