And those of us responsible for ensuring that you are protected are running out of people willing to serve as guardians for those who lack the private funds to pay for care. With an average of 300 guardianship applications annually in Nassau County over the last five years, and the over-65 population approaching a quarter of a million in the county, this is a looming crisis in elder care.
Under state law, a person can go to court and advise judges that someone they know can no longer take care of himself or herself or their property needs and may be harmed if a guardian is not appointed. If there is a relative or friend who can serve as guardian, we willingly appoint that person. But if there is no one available -- now a frequent scenario -- then it's up to the courts to appoint attorneys as independent guardians from an already approved list. They would be paid as guardians -- usually working four to five hours a month in a simple case -- from the person's funds.
Increasingly, however, there are no private funds from which to pay a guardian because the money of those who need the help barely covers their living expenses. As a result, more and more attorneys are dropping off the guardian list. Still, judges are legally responsible for appointing a guardian for a needy person.
The many cases that come before my court have some common denominators: In their own ways, people are incapacitated and need guardians to perform various tasks, including making serious medical and personal decisions.
Should an 83-year-old retiree widower in Levittown be trusted to live in a home where he believes his wife still lives? If a Long Beach widow has become a hoarder, should she be forced to sell her home and move to a facility? Should an 85-year-old man who never married be forced to have health aides four hours a day at his Franklin Square home if he objects?
The Nassau County Department of Social Services contracts with two private agencies that act as guardians for people who qualify for its public guardian program. The program is helpful, but it is much more restrictive than similar programs in New York City, and it doesn't accept anyone who is homeless, or lives in a nursing home, hospital or long-term care facility. But those individuals can have as many needs as those living alone at home.
Until we as a society give the neediest among us the help they deserve, the problem will only get worse. While there may be no one answer, there are several things that could be -- and must be -- done immediately.
Form a task force. Dr. Maria Torroella Carney, chief of geriatric and palliative care of North Shore-Long Island Jewish Health System, has called for the creation of an expert group to begin to address the medical needs of the elderly in our area. Having also served as the Nassau health commissioner, she is uniquely qualified to head up the task force.
Get more funding. Nassau County government must increase its spending on the public guardian program while lobbying Albany and Washington to allow us to pay guardians out of an individual's Medicaid funds. We are no longer allowed to do that because the state does not consider guardians part of "medical care."
Kick off an education effort. We desperately need to educate the public -- at libraries and community centers -- about this impending crisis and get people to volunteer to become guardians for friends and neighbors.
A doctor once testified before me that from the day we are born, we begin aging. That process may be inevitable, but how we treat the neediest and voiceless in our society is not.
Let's do the right thing now.
Arthur M. Diamond is a state Supreme Court justice in Nassau County.
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Elderly LIers need friends and neighbors as guardians
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