Articulation of a Best Practice Model of Guardianship Advocacy Services: For Older People and People with Cognitive Disability at Risk of Abuse or Neglect

Articulation of a Best Practice Model of Guardianship Advocacy Services: For Older People and People with Cognitive
Disability at Risk of Abuse or Neglect

Guardianship and the associated administration processes provide legal safeguard mechanisms for adults with decision-making disability (Bedson, Chesterman, & Woods, 2018). This can include people with cognitive disabilities, intellectual impairment, age related conditions, mental health problems, and mental illness (Arstein-Kerslake, 2014; Jeste et al, 2018). One of the core processes of this legal framework is to assign a vulnerable adult a formal substitute decision-maker (Queensland Government, 2017). Specifically, a guardian may be appointed to make decisions about personal matters which can include accommodation options and medical treatments; or, an administrator can be selected to be responsible for that adult’s financial circumstances (Queensland Civil and Administrative Tribunal (QCAT) (2017).

Aged and Disability Advocacy Australia (ADA Australia) identified the need to develop an evidence-based advocacy model for guardianship and related areas. This organisation employed Dr Edwards and Dr King, QUT researchers from the QUT School of Public Health and Social Work to address this task. The research project examined and analysed existing and future services, practices, enablers, barriers and key elements of current and potential advocacy models in guardianship, administration and other associated domains.

This research contributes to an important area of practice as there are ongoing national and international concerns that formal substitute decision-making has been overused (Chesterman, 2013); as opposed to adopting supported decision-making (SDM). This is because these restrictive measures remove individuals’ decision- making rights and can drastically limit their autonomy and self-determination (Carney, 2012; Giertz, 2018; Millar 2013; Wood, 2018; Wright, 2010; Wyllie & Saunders, 2018). Furthermore, Australian and international research indicates there is a projected sizeable increase in guardianship and administration applications, due in part to this country’s aging population (Chamberlain, Baik; Estabrooks, 2018; Chesterman, 2013; Office of Public Advocate (Queensland (Qld), 2016). Of note, in 2017/2018 there were over new 22,200 guardianship applications in Queensland, the Northern Territory (NT), New South Wales (NSW), the Australian Capital Territory (ACT) and Victoria (Australian Guardianship and Administration Council (AGAC, 2019).

The influence of guardianship and administration has been further emphasised as these can be a crucial intervention to respond to the abuse and neglect of vulnerable Australian, especially older people (Bedson et al., 2018; Chesterman, 2016; NSW Ombudsman, 2018; Older Persons Advocacy Network (OPAN), 2018). The challenges of agency, voice and the associated vulnerability of older people and people with cognitive impairment, is particularly relevant and highlighted given the current operation of two Australian Commissions of Inquiry: Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, and the Royal Commission into Aged Care Quality and Safety.

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