As an attorney who has dedicated much of my career to providing guardianship services for vulnerable people, watching the recent Netflix film, I Care A Lot,
The film portrays a corrupt private guardian named Marla Grayson, played by Rosamund Pike. Pike won the Golden Globe Award for best actress for her performance.
Grayson preys on the people under her guardianship, some of whom do not need a guardian at all. She moves them to nursing homes for no clinical reason so that she can sell their homes and plunder the proceeds. She orders unnecessary sedatives and psychotropic drugs if an individual dares complain. To add insult to injury, she pays herself extravagant fees from the estates for her “services.” At the end of the film (warning - spoiler alert)
, she partners with the Russian mafia to create a national syndicate to exploit helpless people through guardianships.
It’s easy to dismiss I Care A Lot
as Hollywood fantasy. But the film comes just two years after the 2019 Amazon documentary, The Guardians,2
which details the true story of widespread corruption within the guardianship system in Clark County, Nevada. Clark County includes Las Vegas and is one of the country’s top retirement destinations. The corruption, malfeasance, and complicity allegedly involved public and private guardians, attorneys, health care providers, and even a judge. A private guardian and three others, including an attorney she employed, were convicted of perjury, offering false instrument for filing or record, theft, exploitation, and racketeering.
Most of the guardians I have had the privilege of knowing and working with over the years, along with the attorneys and other professionals who work with them, provide outstanding, compassionate services. I suspect that’s true for most NAELA members who work in the guardianship arena. Such attorneys are likely as pained and disheartened as I am by these films and other depictions of corrupt and inept guardians.
The hard, day-to-day work of good and compassionate guardians is often mundane. It just doesn’t make for sexy movies. As a result, this often-extraordinary work is largely unknown.
What can we, as members of the elder law community, do to counter the negative images of guardianship depicted in these recent films and elsewhere? Here are some suggestions:
• We must not shy away from the fact that there are, in fact, bad and even corrupt guardians within our midst and that they pose grave dangers given the unique vulnerability, even helplessness, of the people they purport to serve. Instead, we must be aggressive in ensuring that sub-par guardians are swiftly identified, barred from practice, and criminally prosecuted where appropriate.
• Similarly, we must never lose sight that guardianship is a profound intrusion on a person’s civil rights, liberty, and dignity. We must therefore ensure that guardianship is used only when necessary and when there are not less restrictive alternatives. When guardianship is necessary to protect the individual, limited guardianships should be utilized whenever possible so that the individual retains maximum autonomy, liberty, and decision-making authority.
• When you have a guardianship “success story,” publicize it. For example, about half of our office’s cases come to us due to abuse including financial exploitation. To combat this problem, we have an innovative financial recovery program staffed with tenacious senior attorneys who focus their full-time practice on complex litigation to recover assets that had been stolen before our appointment. The program has been extremely successful, having recovered more than $60 million over the past 10 years for the people we serve.3
When we achieve a recovery, we try to publicize the victory.4
Some of our cases have received national and even international news coverage.5
One of our financial recovery cases was featured in an award-winning documentary film.6
• Work on national guardianship reform projects. For example, NAELA members played a key role in revising the Uniform Guardianship, Conservatorship, and Other Protective Arrangements Act (UGCOPAA) (formerly the Uniform Guardianship and Protective Proceedings Act (UGPPA)). NAELA had three representatives, known as observers – Frank Johns, CELA, CAP; Wendy Cappelletto, Esq., CAP; and Catherine Seal, CELA, CAP, Fellow – on the drafting committee. Other NAELA members served as observers representing organizations such as the Alzheimer’s Association, AARP, and the National Guardianship Association. NAELA members have also played key roles in many other important guardianship reform projects, for example, all of the National Guardianship Summits.
• Work on state and local guardianship reform projects. For example, NAELA’s Illinois Chapter, and many other state chapters, are active in drafting and advocating for legislation and policy initiatives impacting guardianship.
• Work to ensure that your jurisdiction imposes high minimum qualifications for guardians and has robust mandatory training and continuing education requirements.
• There is scant data on guardianship including which models work best. Advocate for scholarship in this area.
• Write about guardianship, what good guardianship looks like, areas for reform, and guardianship “success stories.” NAELA News
and NAELA Journal
have actively published about guardianship. In fact, NAELA Journal devoted an entire issue to guardianship with comprehensive articles on topics such as voting rights for people under guardianship, a critique of New York’s guardianship laws, whether guardians should be allowed to initiate a divorce, and a review of the proceedings of the First World Congress on Adult Guardianship Law.7
• Finally, I am deeply concerned about the recent infusion of a profit motive into guardianship with the proliferation of for-profit guardianship corporations for helpless people with no families.
Frankly, for-profit guardianship scares the blizzard out of me. While there is little data on guardianship and which models work best, there is ample data showing that our experiment with injecting a profit motive into nursing home care has been an abysmal failure. Abundant research shows that for-profit nursing homes have far inferior outcomes for their residents than not-for-profit facilities.8
While I’m not worried about the Russian mafia infiltrating guardianship services, as depicted in I Care A Lot,
the recent upsurge of for-profit guardianship entities must be closely monitored, studied, and regulated.
Rather than being disheartened by the recent negative depictions of guardianship in the cinema and elsewhere, let’s redouble our efforts to ensure that people who require guardianship receive the highest quality, compassionate, and least restrictive services possible.
I Care A Lot (Netflix 2021).
The Guardians (Amazon 2019).
For more information about this program, see Charles Golbert, “Taking the Initiative: Office of the Cook County Public Guardian’s Financial Recovery Program,” 43 Generations 4, p. 108 (Winter 2019-20); Charles Golbert, “Combatting Financial Abuse of the Elderly: The Experience of the Cook County Public Guardian’s Office, Illinois, U.S.,” in Ralph Ruebner et al. (eds.), “International and Comparative Law on the Rights of Older Persons” (Vandeplas 2015).
For a sampling of cases we were able to publicize, see, e.g., Elyssa Cherney, “Public Guardian Alleges Nursing Home Workers Took $750,000 From Dementia Patient,” Chi. Trib., § C, p. 6 (Nov. 16, 2018); Dana Kozlov, “Cook County Public Guardian Wants to Know Why Kim Foxx Has Not Brought Charges in Case of Swindled Nursing Home Resident,” CBS News (June 25, 2019); Tina Sfondeles, “Cop Accused of Forging $20,000 Check from Man with Dementia,” Chi. Sun-Times, § 1, p. 5 (Dec. 28, 2013); Cynthia Dizikes and David Jackson, “Bill Due for Nonprofit Chief: Public Guardian Wants CEO Robert Wharton Jailed After Default on $71,000 He Owes to Disabled Ex-Secretary,” Chi. Trib., § 1, p. 1 (Jan. 10, 2012); David Jackson, “Priest Investigated Over Estate Deal: With Help From Law Firm, Pastor Obtained Ownership of Elderly Parishioner’s Home,” Chi. Trib., § 1, p. 7 (Feb. 14, 2011); Serena Daniels, “Disabled Man’s Fortune Stolen: Authorities Say Savings Drained By Family Friends,” Chi. Trib., § 1, p. 11 (Sept. 23, 2010); Annie Sweeney and Dan Rozek, “’She Was So Nice’: But that ‘Nice’ Teller was Siphoning Away 86-Year-Old Jessie McDonald’s Cash, the Public Guardian’s Office Says – And So Far Chase Bank Hasn’t Paid It Back,” Chi. Sun-Times, § 1, p. 8 (June 24, 2008).
See, e.g., “Senior Home Workers Accused of Stealing from Resident,” Associated Press (Sept. 7, 2018) (this Associated Press story was published in U.S. News and World Report and in newspapers from coast-to-coast); “Lawsuit Claims Megachurch in Ohio Swindled Mentally Ill Woman,” CBS News (Dec. 18, 2017) (this CBS News story was published all over the world including in the United Kingdom, the Netherlands, Vietnam, and Nigeria).
Silent Lie$ (World Cinema 2007).
NAELA Journal Vol. 10, No. 2 (Fall 2014).
See, e.g., Lee Friedman et al., “Association Between Types of Residence and Clinical Signs of Neglect in Older Adults,” 65 Gerontology 1, p. 30 (2019); David Grabowski et al., “Effect of Nursing Home Ownership on the Quality of Post-Acute Care: An Instrumental Variables Approach,” 32 J. of Health Economics 1, p. 12 (Jan. 2013); “Non-Profit vs. For-Profit Nursing Homes: Is There a Difference in Care?,” Center for Medicare Advocacy (Mch. 2012) (summarizing research).