Guardian Who Provided Care To Ward in Ward’s Home, Refusing To Place Ward in Nursing Home Against Her Wishes, Found Not Guilty of Neglect

Reversing state agency and appeals court rulings, the highest court of the State of Washington ruled that a guardian cannot be charged with neglect based on the guardian’s good-faith decision to provide care for the ward in her home rather than place her in a nursing home against the ward’s wishes. Raven v. Department of Social and Health Services (Wash., No. 87483-2, July 18, 2013).

Resa Raven, a professional guardian, was appointed guardian of the person of Ida, who became bedbound after a fall fractured a bone in her knee. Ida received care at home, but she required more nursing care than home health aides could provide, and she frequently developed bedsores. Ms. Raven spent time after her appointment as guardian familiarizing herself with Ida’s history and medical situation. Based on her review of Ida’s history and conversations with Ida’s family, Ms. Raven determined that Ida, when competent, consistently refused to be placed in a nursing home or other long-term care facility. Accordingly, Ms. Raven consented to a plan of care on Ida’s behalf that kept Ida in her home, refusing to seek nursing home placement for Ida. Ms. Raven believed nursing home placement would be against Ida’s wishes.

The state charged Ms. Raven with neglect. The hearing officer found that Ms. Raven’s conduct met the criteria for neglect because she failed to provide services to maintain Ida’s health. An appeals court agreed, ruling that the neglect finding was appropriate because Ms. Raven did not pursue residential treatment for Ida. Ms. Raven appealed.

The Washington Supreme Court reversed, holding that

A guardian’s good-faith decision not to place an incapacitated person in a nursing home against the incapacitated person’s wishes cannot be the basis for a finding of neglect [because] … in matters of consent, though a ward may choose a course of action that would strike many as unreasonable, if the guardian can determine that the ward would choose such an action if competent, the guardian is bound to advocate for that position.

The Supreme Court also made efforts to provide guardians tasked with decision-making responsibilities for a ward, with the factors to consider in reaching a decision. The Court stated that

[T]he goal is to do what the ward would do, if she were competent to make the decision. … The goal is not to do what most people would do, or what the court believes is the wise thing to do, but rather what this particular individual would do if she were competent and understood all the circumstances, including her present and future competency. In other words, courts cannot apply a “reasonable person” test, but must apply a subjective test based on the ward’s “attitudes, biases, and preferences.

According to the Court, because Ms. Raven made a good-faith determination about what Ida would have wanted if she were competent, it didn’t matter whether Ms. Raven “based her determination on historic or contemporaneous facts (or both).”

Finally, the Court held the State’s actions to be substantially justified, although the evidence did not support a finding of neglect against Ms. Raven. Therefore, the Supreme Court denied Ms. Raven’s request for attorney fees.

The Washington Supreme Court’s decision can be found here – Raven v. Department of Social and Health Services