By Katie Ellington, reporting for the Ohio Center for Investigative Journalism, Eye on Ohio
Broadcast version by Mary Schuermann for Ohio News Connection

Ohio has struggled to care for vulnerable seniors, and it’s getting worse.

The state’s probate courts are responsible for creating and monitoring guardianships of the frail elderly, balancing freedom and protection. They are already strained. And yet, between 2010 and 2030, the number of Ohioans over 65 is projected to rise by half, from 1.6 million to 2.4 million. Over the next seven years the number of Alzheimer’s patients in the state is projected to rise by 13.6 percent.

Authorities don’t even claim to know how many guardianship abuse cases are out there. “Once a guardianship is imposed, there are few safeguards in place to protect against individuals who choose to abuse the system,” wrote the United States Senate Committee on Aging in its 2018 report on guardianship. “Few states are able to report accurate or detailed guardianship data.”

Since 2015, Ohio probate courts have been required to monitor complaints and have a response system in place. While this information can be requested by the public, no single agency tracks it across the state.

Already, state probate courts charged with protecting vulnerable citizens are strained. During 2017, the courts opened 6,864 adult guardianship cases, versus 2,159 involving children. As caseloads rise, courts struggle to find, pay, and monitor guardians. The resource shortage leaves older adults even more vulnerable to exploitation or abuse.

County	# of Adult Wards	Number of Guardians of Adult Wards	Complaints Filed Against Guardians in 2018	Full Time Court Investigators	Full Time Guardianship Investigators
Franklin	4226	3113	101	NA	5
Cuyahoga	6723	–	115	–	4
Hamilton	3229	3839	27	1	0
Summit	2580	–	6	3.5	–
Montgomery	1497*	1218*	51	1	–
Lucas	2046	1447	30*	0, 2 part time	0

Figures provided by court personnel. “-” indicates unavailable figures. * indicates estimates.

Some counties keep tabs on the well-being of wards through visits with court investigators or volunteer visitors. In others, the guardian is the only person who reports the condition of the ward back to the probate court.

A study by the Scripps Gerontology Center found that while most courts have investigators, only 28% of them said that monitoring guardianship is a regular part of their job. Just one in four Ohio probate courts have at least one full-time investigator on staff.

“I think one of the major issues that every county is experiencing is a lack of funding for these services,” said Amy Restorick Roberts, who studies guardianship and teaches at the Scripps Gerontology Center. “Monitoring and oversight are critical steps that are very difficult to devote resources to if counties are strapped financially.”

Restorick Roberts said that some smaller and rural counties still lack information management systems to help track general guardianship information. In her survey of 55 Ohio probate courts, only six counties could provide statistics on the reason adults were placed under guardianship.

“We need to have a better tracking system of who is involved and what their needs are and to ensure that their best interests are taken into consideration,” she said.

“We have a real challenge in terms of making sure that these individuals are being served appropriately when we can’t even track and identify who they are and what their situation really entails.”

Adults who cannot care for themselves due to a mental impairment can be declared legally incompetent and thus become a ward of the state. A legal guardian can be a person, corporation or organization with the authority to make personal, financial and/or property decisions for an individual who lacks the capacity to do so.

“Being a guardian is pretty much like being a parent,” said Judge Randy Rogers of the Butler County Probate Court. “It’s a tremendous responsibility.”

Someone has applied to become my guardian. What are my rights?
During a hearing for guardianship of an alleged incompetent adult, the prospective ward has the following rights under ORC 2111.02 (C)(7):
The right to be represented by independent counsel of his/her choice
The right to have a friend or family member present
The right to have evidence of an independent expert evaluation introduced
The right to request the following resources if the alleged incompetent cannot afford them:
The right to have counsel and an independent expert evaluator appointed at court expense
If the guardianship decision is appealed, the right to have counsel appointed and necessary transcripts for appeal prepared at court expensse.

Source: Ohio Revised Code

Ohio Boosts Protections

Before the summer of 2015, guardians were not legally obligated even to visit their wards.“It was kind of a sad state of affairs,” said Jack R. Kullman, the director of Franklin County’s Guardianship Service Board.

Now, a guardian must meet with the prospective ward at least once before being appointed, and a minimum of four times a year afterwards.

The 2015 updates also require guardians to pass a background check and take a course offered by the Ohio Supreme Court before being appointed. Continuing education courses are now mandatory. These courses encourage guardians to consider the desires and preferences of wards whenever possible.

“Even though the guardian may be actually making the final decision the individual under guardianship should be involved to the extent they can in the decision-making process,” said David English, a professor at University of Missouri School of Law who specializes in guardianship

Generally, he added, the aim is to “banish the view that the person is totally incompetent and ‘Now I make all the decisions for you.’”

But even now, only 9 percent of Ohio’s probate courts require that the ward be present for an initial court hearing, if able.

Adult wards have no rights guaranteed under Ohio law. A ward’s bill of rights was initially part of the Ohio Legislature’s reform bill, House Bill 50, but that section was dropped before the bill was passed.

And the reforms have not been free. Judge Randy Rogers of the Butler County Probate Court, which oversees about 1,000 guardianship cases, said his court filed 20% more documents from just two new mandated forms.

“It’s a lot of work for probate courts and it’s a lot of work that was created without any increase in resources,” said Rogers. His staff is still still working on tracking down all the guardians appointed before the change, to make sure they’ve taken the course. Despite the challenges, Rogers said he believes the new requirements will have a positive impact, provided the courts embrace them.

“Was it good for us, to help us focus on what would make things better? Yes, it was good and a lot of work went into it,” he said. “Now the job is for us in the probate courts to implement these changes.”

Even after the reforms, contentious cases can be costly for the ward, partly for lack of a mediation program.

Legal fees pile up during arguments over who should be appointed guardian. Wards can lose a considerable amount of money in a legal battle over who gets control over their life, a battle in which they have little to no say.

What Can We Learn From Other States?

Ohio isn’t the only state seeking answers.

Minnesota tackled financial elder abuse in 2012 by establishing a Conservator Account Auditing Program (CAAP). It created an online system for uploading records of court-appointed conservators and hired a team of auditors to periodically review them. A related initiative is called the Conservator Account Review Program (CARP).

According to Minnesota Judicial Branch Audit Manager Jamie Majerus, roughly 4,800 Minnesotans had assets under conservatorship in 2018 that were monitored by the programs. The value of these assets totalled $950 million.

In both programs, professionals supervised by certified fraud examiners oversee wards’ finances. CAAP audits all conservator-managed accounts after the first year and all accounts with assets exceeding $10,000 every four years. CARP routinely audits all conservator-managed accounts, regardless of size, and can refer those accounts to CAAP if it spots potential problems.

After the audit, judges get an Account Review Report summarizing the auditor’s findings and recommendations. A similar document is provided to the judge before conservatorship hearings.

One expert calls it the model for an auditing system.

Nevada addressed guardianship abuse after a fraud case drew national attention. Professional guardian April Parks used her court-appointed position to isolate and financially exploit more than 150 individuals in Las Vegas before she was caught. She got the maximum sentence of 16-40 years in prison after pleading guilty last November.

Nevada’s reform efforts since have made it a national example, said Rick Black, Director of the Center for Estate Administration Reform.

In 2017, the Supreme Court of Nevada created the Permanent Guardianship Commission, made up of judges, advocates and attorneys, to oversee and improve the state’s guardianship practices.

Wards must be present at a hearing, if physically able, and must have legal representation. A proposed ward can hire his or her own lawyer, but many are appointed by the court through legal aid centers.

“Now, protected persons and proposed protected persons have trained lawyers fighting for what they want, not what everyone thinks is in their best interest,” said Jim Berchtold, who leads the Guardianship Advocacy Program at the Legal Aid Center of Southern Nevada.

Berchtold believes that a lawyer independent from the probate system can best serve wards as an impartial advocate.

“Even if a protected person is unable to express his or her wishes, the mere presence of an attorney to represent them helps to ensure compliance with the statutes and dissuades financial exploitation and other abuses,” he said.

Nevada also created a Guardianship Compliance Office, which supports district probate courts by reviewing cases and performing investigations upon request. It can investigate the health and welfare of a protected person, locate guardians the court has lost contact with, and run forensic audits if a judge is concerned about a ward’s accounting.

“Before the court didn’t have those resources to dig in and investigate,” said Guardianship Compliance Manager Kate McCloskey. “We have one district court that calls our audits ‘liquid gold.’”

The GCO also operates a hotline for anyone who has questions about guardianship or needs help reporting guardianship abuse.

Berchtold and McCloskey said Nevada’s 2017 Protected Person’s Bill of Rights was another major step forward. It includes the right to be educated about guardianships, to participate in developing plans that will affect the ward’s future, and to remain as independent as possible.

Overburdened Ohio courts can be particularly overwhelmed when family members disagree on the proper way to care for loved ones who can’t care for themselves.

In April 2013, Fourough Bakhtiar, an Alzheimer’s patient, went to lunch with her daughter, Jaleh Presutto. She never returned.

Ten days later, Bakhtiar signed a document giving Presutto power of attorney. Bakhtiar had originally filed for divorce in 1988 but later dropped the case. Soon after she went to live with Presutto, she filed for, and was granted a divorce, after about 50 years of marriage.

Neurologists who examined Bakhtiar at the time said dementia made her “vulnerable to exploitation.”

The question of her care has plagued the courts in Lorain and Cuyahoga County for six years.

The court later removed Presutto and her husband as guardians after they pled guilty to separate felony counts of forgery and unlawful use of property for misappropriating money from their son’s school district.

Bakhtiar’s new guardian, attorney Zachary Simonoff, supported Bakhtiar’s petition to end her marriage. He said that while she was incompetent as a matter of law, her dementia did not bar her from expressing her wishes. He also pointed out that it’s not the first time Bakhtiar has filed for divorce. She and her husband were separated for about four months in 1988; Bakhtiar began divorce proceedings, but ended up moving back in with her husband instead.

Her four sons disagree. They allege that their mother was unduly influenced by Presutto, who wanted access to the funds from a hefty divorce settlement. They said the lawyers involved in Bakhtiar’s care have supported the divorce because they profit from the legal fees.

Simonoff said the only reason the Saghafis oppose the divorce is that they want their father to keep the settlement money. He said the family’s appeals are to blame for the legal fees billed to Bakhtiar’s estate.

“If they would stop suing the guardianship, there would be a severe drop off in the money that’s going to attorneys,” he said.

Jamsheed Saghafi vehemently disagreed. “I couldn’t care less about the money that was stolen,” he said. “I want my mom returned. If (the attorneys) want the money, go ahead and burn it all.”

It’s been years since Bakhtiar last saw her family. The court has ordered that Mehdi Saghafi not contact his ex-wife. The rest of the family is welcome to visit, says Simonoff, provided they give him one business day’s notice. Jamsheed Saghafi said the family won’t visit her until his father is allowed to join them, but they will continue to appeal the case.

Katie Ellington is an education reporter based in Mansfield, Ohio. Follow her on Twitter at @KT_Ellington. Mary Schuermann reports for Ohio News Connection.

Note: This is the first installment of a two-part series on guardianship for the Ohio Center for Investigative Journalism. The second installment will examine how Ohio courts and communities are collaborating to provide responsible guardianship in the face of ever-increasing demand. This collaboration is funded in part by the Ohio News Media Foundation and the George Gund Foundation, and produced in association with Media in the Public Interest.


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Oregon is working to address the state's digital divide with hundreds of millions of dollars in funding.

Infrastructure presents the largest challenges for connecting people in Oregon to high-speed broadband internet.

Nick Batz, director of the Oregon Broadband Office, said there are more than 170,000 residencies in the state with no or slow internet access.

"Our goal through the broadband office and with all our stakeholders throughout Oregon is to provide access to all 112,000 unserved locations and as many of the 60,000 underserved locations as we can," Batz explained.

The state has received federal funding from a variety of sources, including nearly $690 million from the Broadband Equity, Access and Deployment program, and more than $150 million from the Capital Projects Fund approved in the American Rescue Plan Act from 2021.

Oregon's Digital Equity Plan has also been approved and along with it, nearly $10 million in funding.

Bandana Shrestha, state director of AARP Oregon, said there was a time when high-speed broadband internet was considered a luxury.

"Now, it's such a big necessity for everyone, including for older adults," Shrestha pointed out. "Because we know that if you don't have connectivity, you're not going to be able to see your doctor when you want to. Telemedicine is not going to be possible."

Batz added his office is working to ensure every Oregonian can get on the internet.

"It is an interesting challenge," Batz observed. "Nothing has been done like this in Oregon's history of trying to get internet access to everybody. So, it's going to be quite the challenge and it's absolutely going to require participation from everybody to make this happen."

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Nursing homes across South Dakota will soon receive a boost in support, as part of the most recent legislative session.

Facilities caring for Medicaid recipients are reimbursed by the state for some of the cost. Reimbursement rates have been calculated based on patient needs, occupancy and funds available in the state budget. Last year, the South Dakota Legislature increased the rate from about 75% to 100%.

House Bill 1167 now allows the Medicaid reimbursement rate to be adjusted annually, to keep up with inflation and other changes.

Erik Nelson, advocacy director for AARP South Dakota, is glad lawmakers are giving nursing homes attention.

"We have seen a number of nursing homes close in recent years," Nelson pointed out. "Financial considerations were a factor in that, along with workforce and some other issues."

Since 2019, 15 nursing homes have closed across the state, with six of the remaining 98 on a federal list of facilities not meeting basic standards of care. In addition to a lack of funding, the average staff turnover rate is 54%.

State lawmakers also approved the use of $5 million in American Rescue Plan Act funding toward expanding telehealth services in facilities including nursing homes, allowing patients to receive some health care services remotely.

Nelson noted telehealth is one way to supply needed support.

"For not only the residents, but the family caregivers that are supporting their loved ones in the nursing homes," Nelson emphasized. "And of course, the staff of the nursing home that's in the community."

Census data show South Dakota's population is aging and by 2030, one-fifth of residents will be older than 65.

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Meals on Wheels programs could be a powerful tool for addressing the needs of people living with dementia, according to a study from Ohio State University researchers.

The community-based program delivers weekly meals to food-insecure seniors.

Lisa Juckett, assistant professor of occupational therapy at Ohio State University, conducted interviews with caregivers, people living with dementia, and the staff of LifeCare Alliance, the largest Meals on Wheels provider in the state. She said the findings revealed delivery drivers are often a critical source of social interaction and an "extra set of eyes" on homebound individuals.

"That Meals on Wheels driver is then able to perform very brief but important wellness checks and safety checks," Juckett explained. "To make sure that meal is actually being delivered, the door is being answered."

According to Meals on Wheels America, last year more than 90,000 Ohio seniors received over eight million home-delivered meals through the program. More than 80% of people with dementia in the U.S. live at home, and an estimated 60% are unable to eat or prepare food on their own.

States rely on a combination of federal funding, private donations and fundraising agencies to keep local Meals on Wheels programs operating. Juckett added the findings come on the heels of Congress deciding to cut funding for the Older Americans Act, which allocates money to Meals on Wheels programs nationwide.

"Meals on Wheels programs are always on the chopping block, when it comes to federal budgets being adjusted every year," Juckett pointed out. "We need more advocacy efforts to validate or justify the importance of these programs."

According to the group Alzheimer's disease International, more than 55 million people around the world live with dementia, a number expected to double over the next two decades.

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