The purpose of this study was to determine the contribution of interdisciplinary teams (IDT) assessments to guardianship decisions for older adults in two Kentucky counties. A random sample of 80 written IDT assessments from 2004-2006 and verbal court testimony from 36 of these cases were reviewed. Most respondents were women (71.3%). Ages ranged from 50 to 100, with the median age being 76.
Social workers and psychologists were quite similar to the extent that their assessments met the requirements of Kentucky law on 17 indicators (means equaled 11.45 and 11.98, respectively). The mean score for physicians was 8.35.
In 30% of the sampled cases, two of the three IDT members agreed on a recommendation to the court, and in 6.3% of the cases, none of the three IDT members agreed. When there was not unanimous IDT agreement, juries agreed more often with the social workers' recommendations. When juries found that a respondent retained some functional abilities, judges still tended to restrict all rights except for voting.
Post hoc, a nonrandom sample from one county was used to compare full guardianships to limited guardianships. This sample included all of the full guardianship cases from the original sample (n = 29) and all of the limited guardianships from 2004, 2005, and 2007 (N = 27). The sample consisted of 33 women, 21 men, and 2 of unknown gender. Ages ranged from 17 to 100, with a median age of 63.5.
The Mini Mental State Exam (MMSE) used by the social workers was strongly correlated with their recommendations regarding personal affairs ( r = -.653, p = .000), and moderately correlated with their recommendation regarding financial affairs (r = -.405, p =.003). The mean MMSE score for the full guardianship group was lower than for the limited guardianship group. However, individuals could receive a score of 27 out of 30 points and still receive full guardianship despite the fact that a cut off score of 24 is commonly used to distinguish individuals with cognitive impairment from those who are unimpaired.
Specific examples are discussed to illustrate findings. Recommendations are offered to improve assessments at both the practice level and at the policy level.