Abstract
A Statewide survey of 104 individuals (81 clinicians, 11 guardians, 12 hospital counsel) was used to gather data on guardianship for adults who are without family and friends to serve as surrogates. Clinicians report variable experiences with guardians; 2/3 report experiencing delays in appointments and delays in action once appointed by guardians. Consequences reported for adults who are incapacitated and without family and friends to serve as surrogates are significant including prolonged hospital stays, delays in transition to palliative care, and distress by patients and clinicians. Clinicians in hospitals rate their overall experiences with guardians worse than those in other settings; they express the most concern about prolonged hospitalization. Clinicians in SNF most frequently cited concern is delay in transition to palliative care. 1/2 do not have access to Ethics committees or Risk management officers. Integrating perspectives of different stakeholders documents problems and informs potential solutions.