Our Health Guardians make decisions on behalf of people with a decision-making disability, so they can be discharged from hospital sooner.
The most common situation is when an elderly person experiences a fall or some other event at home, and they need to attend hospital for treatment. Then, during their hospital admission, the treating team determines that the person does not have capacity to make decisions about their care or accommodation.
This is when guardianship comes in. If a person doesn’t have capacity to make certain decisions, guardians can make substitute decisions on their behalf.
If a person doesn’t already have a guardian, the hospital may need to apply to the NSW Civil and Administrative Tribunal (NCAT) for a guardian to be appointed.
NCAT have dedicated staff for guardianship applications that are made while a person is in hospital, explains Health Guardian Donna. They may conduct a guardianship hearing, which brings together the person, if possible, and the key people involved in their life and care.
During the hearing, NCAT will hear from the participants and decide if the person needs to have a guardian appointed, based on the evidence about their disability, support needs and circumstances.
NCAT will only appoint the Public Guardian if there is no close family member or friend who is appropriate and able to take on the role.
Usually that means the Public Guardian is appointed in cases where there is conflict with family members, conflict about what is best for the person to safeguard family relationships, or sadly, where an elderly person just does not have family or friends around them.
The Public Guardian’s role
When a person is in hospital and the Public Guardian has been appointed as their guardian, the first goal is to support them to be safely discharged from hospital.
This involves working with the person, those close to them, and the hospital treating team to understand the person’s needs and wishes.
‘When a person is in hospital, they just want to get home as soon as possible’, says Donna.
‘We want that too. As Health Guardians, we have a legal duty to encourage the freedom of decision and freedom of action of the people we represent as much as possible.’
Health Guardians also have a legal duty to protect them from neglect, abuse and exploitation. Ultimately, a person’s welfare and interests must be our primary consideration.
The hospital treating team may advise that a person requires 24/7 care and that they should be supported in an aged care facility.
It is a Health Guardians role to balance this advice with the person’s wishes – which is usually to return home – and to a decide about where they should live.
‘No decision is taken lightly. In some cases, the person has lived in their home for a long time and moving somewhere new can be very traumatic.’
‘We will always try to make the decisions that our customers want to us to make. As part of our decision-making process, we will explore the least restrictive options before looking at an aged care facility, such as returning home for a trial period or increased support services’, says Donna.