California conservatorship: A system in crisis

Best practices in elder care necessarily focus on maintaining optimal levels of physical, cognitive and psychosocial functioning. Best practices also require that elders' civil rights be respected, and that denial of rights be promptly corrected through procedural and legal safeguards.

California's court system provides little oversight of the conservatorship (guardianship) system. Courts presume that conservators are true guardians, granting them deference and foregoing justice. Thus, elders are routinely placed in conservatorship without due process. Conservators routinely remove elders from their homes without cause, confine and isolate elders from their loved ones, and plunder elders' hard earned savings.

California leads the nation in social services agencies assigned welfare of elders. However, agencies such as Adult Protective Services, the Long-Term Care Ombudsman, and Community Care Licensing routinely fail to provide mandated services. Conservators unlawfully exercise absolute power over their conservatees. State officials at the highest levels sanction rampant abuse

The public health community can address the gap between best practices and performance as it relates to conservatorship. • Define best practices in conservatorship, • Improve competencies of conservators, • Improve competencies of social service agencies.

California's Elder Abuse Act and Probate Code could serve as models for the nation. Case studies juxtapose the darker side of California's conservatorship system, a system in crisis that permits wanton abuse of vulnerable elders. The contrast will call on the public health community to close the gap between policy and practice. Lessons learned in California can apply to the nation.