research

Basic research on guardianship issues generally is underrepresented in the social sciences, especially on topics relevant to public guardianship services.  Among the most urgent questions are (1) how extensive is the need for public guardianship; (2) how to balance autonomy and safety when making decisions as a surrogate; (3) the cost to society when a public guardian is not available for those who have no other option; (4) how Courts should oversee the work of guardians; (5) how to evaluate the effectiveness of a public guardian; and (6) how to develop less-restrictive alternatives, such as supported decision-making, and how to expand the use of limited guardianship when plenary powers are not needed.

The Institute, through its affiliation with Guardian Community Trust, is funding or collaborating in several original research initiatives designed to improve our understanding of guardianship and the public policy affecting those involved: 

1. Needs Assessment for Massachusetts
Topic: This is an extensive, multi-phase and multi-year project to determine what kinds of guardianship services are available in Massachusetts, who receives and does not receive them, how a public guardian would fit within the existing system, and how best to meet the unmet need.
Facility:  Boston VA Research Institute
Relationship: Sponsoring
Principal Investigator: Jennifer Moye, Ph.D., Director of Geriatric Psychology at Boston VA Health Care System, and Associate Professor of Psychiatry at Harvard Medical School
  Title Status
Phase I: Examining the Need for a Public Guardian in Massachusetts — Phase I Complete
Phase II: Evaluating What Works and Doesn’t in Current System
A Survey of Hospital Social Workers, Guardians & Counsel
In Progress
Phase III: How Guardians Make Decisions for the Unbefriended
Survey of Members of the American Geriatric Society
Concept

2. Examining Costs of Not Providing a Public Guardian
Topic: This is an analysis of cost savings that may be realized if Massachusetts were to establish a Public Guardian, through reduced expenditures for emergency health care, protective services and social service agency interventions.
Facility: Donahue Institute at U. Mass Amherst
Relationship: Sponsoring
Principal Investigator: Eliot Levine, Ph.D.
Title Status
Phase I:

Study Design – Identifying Data Sources and Procedures In Progress
Phase II:

Evaluation and Report of Collected Data Design Stage
Phase III: Tracking of ongoing cases Concept

3. Assessing Stage of Dementia and Decision-Making Capacity
Topic: A VA initiative to develop an interactive, web-based learning product that helps clinicians better assess stage of illness and decision-making capacity among Veterans with dementia.
Facility:   Boston VA Research Institute
Relationship: Collaborating
Principal Investigator: Jennifer Moye, Ph.D., Director of Geriatric Psychology at Boston VA Health Care System, and Associate Professor of Psychiatry at Harvard Medical School
Status: Design stage

4. Surrogate Decision-Making
Topic: This is a study of decision-making by Guardians with the goal of developing a decision-making training protocol for new guardians and a curriculum for the general public to learn more about Health Care Proxies and Durable Powers of Attorney.
Facility: Guardian Community Trust Harvard Medical School
Relationship: Sponsoring
Principal Investigator:
Heather L. Connor, Ph.D., Director of Research for Guardian Community Trust
Traci Cucinotta, LICSW, Masters Degree Candidate in Ethics and Biology at Harvard Medical School
  Title Status
Phase I: Guardianship Decision-Making In Progress
Phase II: Healthcare Proxy Decision Making Literature Review

5. Limited Guardianships
Topic: A review of literature and policy to evaluate the successes and challenges surrounding limiting guardianship.
Facility: Guardian Community Trust
Relationship: Sponsoring
Principal Investigator: Heather L. Connor, Ph.D. Director of Research for Guardian Community Trust
Status: Design stage