Defenseless Hoosiers in Allen County and across Indiana have no one to look out for them. They are forced to live at public expense in nursing homes or in the community without any money or family of their own. They often suffer from dementia, mental retardation or another condition that impairs their judgment or ability to communicate.
Health care experts agree that their numbers will explode as baby boomers age.
There is only one state-funded program that is assigned to help at least some of this population, but they have 134 on its waiting list. The director of that program locally, Ruth Anne Sprunger, said, 'We get calls all the time from nursing homes and hospitals, looking for a guardian for someone.' However the Mental Health Association's program is limited to those who've lived in state institutions and since its funding was cut last year, she turns them away.
One of such people who have been turned away is a profoundly retarded woman - unable to speak - who gave 'written consent' for a medical procedure that carried the risk of perforating her digestive tract, according to state records. Although the nursing home where she lives, Byron Health Center at 12101 Lima Road, is supposed to provide her with music, exercise and other activities, state health inspectors found she was restrained in her bed for up to eight hours a day.
Her nursing home has been unsuccessful in their efforts to find her a guardian. At the county-owned Byron Health Center, at least 10 other residents are in the same situation.
In Byron Health Center her care plan said that she 'would benefit from a guardian to assist with decision-making,' besides which she 'needs regular monitoring by her health-care representative.'
In June, the state cited Byron for not finding the woman a guardian. In the nursing home's written rebuttal, administrator Peter Marotti contended no guardian could be found, and no money was available to pay for one.
Private guardianship costs $1,500 or more for attorney fees, plus court costs.
'This is a mandate with no funding,' Marotti said, adding the home made a 'good-faith effort' to find a guardian for the woman.
The state accepted Byron's plan-of-correction, which documented the center's efforts and said it would ensure the woman participated in activities.
Still, Sue Hornstein, director of the state's Long-Term Care Division, said, 'I know from this (survey), this woman's needs are not being met.'
But finding guardians is not the responsibility of Long-Term Care. 'We're the regulatory agency,' Hornstein said.
Byron contacted Park Center Inc., a community mental health center in Fort Wayne, seeking a guardian. The response from the center's court liaison, Peg Larson said, 'Unfortunately, Park Center does not have any service for persons who do not have a family member, friend or trained volunteer to become the guardian for persons without the money to hire an attorney to act as guardian. Park Center has the same problem Byron is experiencing.'
Six other entities, including the local Mental Health Association and private attorneys, also told Byron they had could not afford to provide a guardian.
Adult Protective Services, the state agency that investigates adult abuse or neglect, does not mandate that a guardian be appointed in a nursing home because it is 'a protective place,' said Milo Gray, client and legal services representative for Indiana and Protection Advocacy Services, the state agency that protects Hoosiers with disabilities.
According to Gray for every case such as the Byron woman, at least 10 more exist.
'Somebody needs to look at what the quality of care is,' he said, 'what the quality assurance is going to be for the most vulnerable people.'
The need for guardianship has only been growing in recent years. Statistics show that one in 10 over 65 has Alzheimer's disease and about five in 10 have Alzheimer's or some form of dementia by age 85. Presently one in eight Americans is 65 and older. This has been projected to rise to one in five Americans will be 65 and older by 2030.
Around 35,000 Hoosiers are estimated to be living with a developmental disability such as mental retardation or autism and over 301,000 non institutionalized Hoosiers have a diagnosed disability of some kind, including 209,000 with a physical disability and 70,700 with a mental disability.
The lack of state guardianship programs has translated into limited services for wards (those needing guardians) and inadequate staffing to meet ward needs.'
Regarding Indiana, researchers wrote: 'The (state-funded) program is neither involved in educating the public about guardianship in general nor about public guardianship specifically. Information about the program was 'buried' in the state's governmental Web site.'