In Israel today, legal guardians look after about 60,000 elderly and adults with disabilities who cannot make decisions for themselves about personal, financial, or health matters.
In 2014, public pressure increased awareness of the need to provide greater protection for these wards by putting in place a better system of regulation, supervision, and ongoing monitoring. Thus, the Ministry of Justice decided to develop a system for monitoring how guardians are ensuring appropriate care and looking out for the interests of their wards. To turn this decision into practice, the Ministry turned to MJB, which has extensive experience in developing these kinds of regulatory and monitoring systems for the social services.
Dr. Shirli Resnizky, who is leading this project at the Institute, explains that, first and foremost, the new system must ensure that the guardians are following their legal obligations to address the needs of their wards. Beyond that, it should assess how the guardian relates to their ward as an individual. For example, is the guardian promoting the ward's sense of personal dignity, autonomy, and self-fulfillment? Is the ward given opportunities to communicate and express him or herself?
In developing the system, MJB's researchers collected the input of stakeholders from across the guardianship system: from Ministry policy makers and social service staff, to guardians, family members, and even the wards themselves. The researchers combined the Institute's own expertise together with some of the newest professional techniques in communicating with people with intellectual challenges or communication problems.
A comprehensive database system is being developed by MJB to facilitate the ongoing monitoring process. This will enable Ministry staff to have a much more accurate picture of the characteristics of the wards, their guardians, and the degree to which the needs of the wards are being addressed.
As a basis for developing the system, MJB is carrying out a detailed pilot on 500 guardianship cases. The lessons learned during the pilot will help ensure that the Ministry is collecting the information it needs to make the system effective. In fact, the information that has been obtained is already helping the Ministry develop training programs to help new guardians understand the responsibilities and expectations of their role.
This project is being conducted as a cooperative effort between two divisions of MJB — the Center for Research on Disabilities and the Center for Research on Aging. According to Dori Rivkin, Director of the Center for Research on Disabilities, such cross-divisional cooperation helps to "broaden the perspectives, so as to ensure that the new system is applicable to the full range of guardianship cases."
The new regulatory system will be introduced in 2017. In the meantime, MJB's work has been extended to include developing a similar system for children with guardians.
This study is being funded with the support of MJB Board member Nancy Hackerman, from Baltimore, Maryland.