Guardianship Before and Following Hospitalization

HEC Forum:1-22 (forthcoming)


When ethics committees are consulted about patients who have or need court-appointed guardians, they lack empirical evidence about several common issues, including the relationship between guardianship and prolonged, potentially medically unnecessary hospitalizations for patients. To provide information about this issue, we conducted quantitative and qualitative analyses using a retrospective cohort from Veterans Healthcare Administration. To examine the relationship between guardianship appointment and hospital length of stay, we first compared 116 persons hospitalized prior to guardianship appointment to a comparison group 3:1 matched for age, diagnosis, date of admission, and comorbidity. We then compared 91 persons hospitalized in the year following guardianship appointment to a second matched comparison group. Mean length of stay was 30.75 days amongst those admitted prior to guardianship, which was higher than the comparison group. Length of stay was lower following guardianship appointment ; while higher than the comparison group, differences were not associated with guardianship status. In a separate analysis involving 35 individuals who were hospitalized both prior to and following guardianship, length of stay was longer in the year prior versus after guardianship. In qualitative analyses, four themes associated with lengths of stay exceeding 45 days prior to guardianship appointment were: administrative issues, family conflict, neuropsychiatric comorbidity, and medical complications. Our results suggest that persons who are admitted to hospitals, and subsequently require a guardian, experience extended lengths of stay for multiple complex reasons. Once a guardian has been appointed, however, differences in hospital lengths of stay between patients with and without guardians are reduced.

Download options


    Upload a copy of this work     Papers currently archived: 72,805

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library


Added to PP

4 (#1,287,712)

6 months
1 (#386,499)

Historical graph of downloads
How can I increase my downloads?

Citations of this work

No citations found.

Add more citations

Similar books and articles

Guardianship in Mulla Sadra's Philosophy.Abdul'ali Shukr - 2012 - Kheradnameh Sadra Quarterly 66.
Guardianship in Mulla Sadra.Faizah Taleqhani - unknown - Kheradnameh Sadra Quarterly 35.
How the Guardianship System Can Help Address Gun Violence.Nina A. Kohn - 2020 - Journal of Law, Medicine and Ethics 48 (S4):133-136.
Theory of Ending of Guardianship According to the Works of Seyed Jalal-Al-Din Ashtiani.Ishagh Asudeh - 2009 - Journal of Philosophical Theological Research 11 (42):121-155.
Normativity, Guardianship, and the Elderly.Lorraine Y. Landry - 1999 - Theoretical Medicine and Bioethics 20 (1):69-84.
The VLRC Report on Guardianship and Catholic Teaching.Kevin McGovern - 2011 - Chisholm Health Ethics Bulletin 17 (4):1.
Agency and Moral Relationship in Dementia.Bruce Jennings - 2009 - Metaphilosophy 40 (3-4):425-437.
The Economics of the Right to Keep a Dog.Shuk Man Chiu & Yung Yau - 2015 - Society and Animals 23 (4):343-362.