In a horrible abuse of the law, lawyers, doctors, judges and social workers in Massachusetts regularly commit senior citizens who have no family or friends to nursing homes. Judges rubber-stamp the process in 2 minute hearings, often without asking the senior a single question before taking away their freedom.

Think I’m exaggerating? I wish.

Today’s Boston Globe has the Page 1 story, Courts strip elders of their independence, with an accompanying photo of a woman who has to wear an ankle monitoring bracelet. You know, the same type they put on criminals who are under house arrest or probation.

The reasons for the involuntary guardianship of seniors in Massachusetts usually comes down to a question of mental competence. Doctors sign off on the person’s mental state, often

Too many judges, as Merrill did with Cromwell, award custody of elders to guardians without insisting on the minimal medical documentation required by court rules; without asking about the patient’s long-term prognosis; and without considering whether an independent fact-finder should conduct an inquiry before such a life-altering judgment is rendered. And those whose lives are so radically affected are given no legal representation.

This story makes me livid. That we’re sentencing seniors to nursing homes on such flimsy evidence, and that the people who often make the decisions about whether to seek guardianship or not — lawyers and social workers — often have a direct financial interest in obtaining such guardianship. For instance, in one of the cases highlighted in the Globe article, the hospital’s owners, Partners Healthcare, owns the nursing home where many of the guardianship patients are sent. So it’s in the financial interest of the hospital to file for guardianship.

The Boston Globe, in a review of Sussex Probate Court cases, found:

After the court declares someone mentally ill and appoints a guardian, for all practical purposes most of the patients officially vanish. Almost none of the state’s probate courts have any mechanism to track their whereabouts, monitor their treatment, determine whether they have recovered enough to reclaim their freedom and autonomy, or even learn whether they are dead or alive.

Handcuffed by an antiquated computer system, the courts know how many cases are filed but do not know how many people judges put under the control of guardians each year. The number in Massachusetts each year almost certainly exceeds 2,000.

Virtually unregulated, guardians, many of them lawyers and social workers, regularly ignore requirements that they file an initial inventory of assets of the people they are responsible for and an annual accounting of how they managed a person’s finances. In Suffolk Probate Court, where five years of guardianship filings were examined, there were no financial reports in 85 percent of the cases.

The reason many of these seniors are being sentenced to a nursing home and their freedom taken away is simple — lack of specialists in aging who can properly evaluate the person’s mental status. These specialists are known as gerontologists or psychologists who specialize in gerontology, and of course, hospitals are not required to have seniors seen by these specialists when making a case for commitment.

I live in this state, and stories like this are a reminder of how backward our system can be and what a far, long way it has to go.

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

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Lobotomies for All - World of Psychology (1/15/2008)

    Last reviewed: By John M. Grohol, Psy.D. on 13 Jan 2008
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