A new report by the Government Accountability Office uncovered hundreds of allegations of physical abuse, neglect and financial exploitation by guardians in 45 states and the District of Columbia between 1990 and 2010.

The GAO said it could not determine whether allegations of abuse by guardians are widespread, however.

In 20 selected closed cases, the GAO found that guardians stole or otherwise improperly obtained $5.4 million in assets from 158 incapacitated victims, many of whom were seniors. In some instances, guardians also physically neglected and abused their victims. The guardians in these cases came from diverse professional backgrounds and were overseen by local courts in 15 states and the District of Columbia.

The GAO found several common themes. In six of the 20 cases, the courts failed to adequately screen potential guardians, appointing individuals with criminal convictions or significant financial problems to manage large estates. In 12 of the 20 cases, the courts failed to oversee the guardians once they were appointed, allowing the abuse of vulnerable seniors and their assets to continue.

Lastly, in 11 of the 20 cases, courts and federal agencies did not communicate effectively or at all with each other about abusive guardians, allowing the guardian to continue the abuse of the victim.

In one case in 2001, a Texas probate judge was appointed as the guardian for a 91-year-old woman who displayed signs of senility. She later changed her will for the first time in 40 years, bequeathing $250,000 to the probate judge, the court-appointed guardian, the judge’s personal accountant, and the court-appointed attorney associated with her case.

In another case cited in the report, a 93-year-old Florida woman died after her grandson became her temporary guardian by claiming she had terminal colon cancer. He then moved her to hospice care, where she died 12 days later from the effects of morphine. The woman’s condition was later determined to be ulcerative colitis, and the guardian’s claims that she had six months to live were false. In addition, the guardian is accused of stealing $250,000 from the woman’s estate.

The GAO did an undercover investigation in the course of preparing its report. Using two fictitious identities—one with bad credit and one with the Social Security number of a deceased person—the GAO obtained guardianship certification or met certification requirements in the four states where it applied: Illinois, Nevada, New York and North Carolina. Though certification is intended to provide assurance that guardians are qualified to fulfill their role, none of the courts or certification organizations utilized by these states checked the credit history or validated the Social Security number of the fictitious applicants.

An individual who is financially overextended is at a higher risk of engaging in illegal acts to generate funds, the GAO noted. In addition, people with criminal convictions could easily conceal their pasts by stealing a deceased person’s identity. The tests raise questions about the effectiveness of these four state certification programs.

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