SALT LAKE CITY — To watch them interact, the two women appear to be old family friends.
Xia Litz is delivering Christmas presents to an older woman.
"This is for me?" she says, looking quizzically at a large gift bag stuffed with tissue paper, a blanket and a new winter coat.
After a little coaxing from Litz, the elderly woman gingerly delves into the bag.
"Beautiful," she says. "Me no cold. That's very good.
"Thank you. Thank you, very much."
This is a good day for the elder woman, who is a ward of the state. The younger woman is her state guardian. It's a happy occasion for her, too.
The time may come that Litz or another of her colleagues in the state Office of Public Guardian will need to give consent to a physician to carry out the elder woman's end-of-life directives. When she passes away, Litz will release her body to a funeral home. There probably won't be a funeral because the woman is alone in the world, aside from a few acquaintances.
Her husband died several years ago. "No family," she says. "No children."
Litz has a caseload of about 20 people who have different histories but also have become wards of the state.
Some are people with multiple disabilities who have outlived their parents. They are the children of "pioneering, feisty mothers" who rejected the instructions of doctors who advised them to place their disabled sons or daughters in institutions. Instead, they cared for them at home, often without outside support, said Donna Russell, director of the Office of Public Guardian.
Other wards are adults who were taken into state custody after they were physically abused, financially exploited and/or neglected by members of their own families. It is not safe or healthy for them to remain in their care.
Once they come to the attention of the Office of Public Guardian and their situation meets statutory criteria to petition the court, the office seeks a court hearing to determine whether the proposed ward is incapacitated. Proposed wards are represented by counsel to ensure their rights are protected.
If the court finds the person lacks capacity to make executive decisions, the judge appoints a conservator to oversee the person's income, property and resources and a guardian for their physical or emotional care. The conservator and guardian can be the same person.
The office first attempts to locate an appropriate family member or friend to assume the responsibility of their care. The state is the "guardian of last resort," Russell said.
"As the state, we don't want to be the guardian of everyone," she said.
Some families are separated when a parent or child becomes homeless. Often, untreated mental illness and substance abuse play a role.
One man contacted by the office was overjoyed to learn the whereabouts of his father after they had become estranged.
"He flew in from another state and took his dad home with him to take care of him," Russell said.
Other times, no one can be located. No one steps forward.
Depending on their circumstances, a person could conceivably be a ward of the state for life.
Half of the clients currently served by the Office of Public Guardian are under the age of 60. The youngest is 19 years old. The oldest ward just turned 100.
"Some are truly alone in this world as far as we can figure out," Russell said.
While the guardians' relationship with their clients is professional, the job requires a personal touch.
"We shop for them and get them the clothing that they need. If they want something special, we try to get that for them, too," Russell said.
For instance, one client particularly enjoyed Western cinema so his guardian bought him videos of his favorite films.
Another of Litz's clients, a young man who lives in a care facility for people with disabilities, asked her, on a recent visit, to help him repair his razor.
"Try it on your husband to see if it works," he suggested.
The young man, too, received a blanket and coat for Christmas. His coat is embroidered with a university logo because Litz has learned during their regular visits that the man is a sports fan.
Litz sees each of her clients in person at least once a month. In the interim, she keeps in touch with the people responsible for their day-to-day care.
"I enjoy taking the time to visit with them. I like talking to them, learning more about them. I feel it's such a neglected part of the population," Litz said.
While earning her master's degree in social work, Litz discovered that relatively few of her classmates were interested in working with seniors and people with disabilities.
But the two groups clearly need advocates because their status renders them vulnerable to abuse and exploitation because they often are isolated from people who could intervene on their behalf. "They're invisible," Russell said.
But once the office learns of the case of an elder who has been abused by family members or a person with disabilities who needs an advocate, the office has the legal tools to help ensure their ongoing safety and well-being.
While the work can be emotionally taxing, Russell said the guardians know their work ensures that their clients are treated with dignity. There is relatively little turnover in the office, which is the equivalent of six full-time employees and an assistant attorney general to serve the entire state.
Russell is proud of the fact, in spite of a $200,000 budget cut, the agency has managed to serve a caseload that hovers around 200 people each. Each caseworker personally oversees about 20 clients, while others are managed by contract agencies.
The most frustrating aspect of the job is not being able to find appropriate resources for a client when they need them most. "That's what wears us out," Russell said.
While each client requires a mountain of paperwork, there are times that the job simply boils down to being a comforting presence to a person who is alone in the world.
"Literally, you sit there and hold their hands. If a guardian knows a person is close to passing, they will go and sit with that person," Russell said.
Their deaths can exact a personal toll because "you get attached to the person," Russell said. But the guardians take solace in the fact that the office has worked to ensure their clients have been well cared for and they have been safe, she said.
"They have been given dignity, respect, safety and peace. That's a really good thing."
RIGHTS OF WARDS AND RESPONSIBILITIES OF GUARDIANS AND CONSERVATORS
Wards have the right to:
Dress and groom themselves as they wish
Choose what they eat
Keep a personal routine
Choose their friends and associates
Keep and use personal possessions
Private time and space
Be intimate with others of their choosing
Know why decisions about them are made and appeal those decisions they disagree with
As the court to end a guardianship, appoint a different guardian or modify a guardianship
Not be sterilized
Guardians are generally responsible for:
Determining where the ward lives
Making sure the ward's basic needs are met
Making decisions about the ward's health care, rehabilitation and treatment
Keeping track and taking care of the ward's property and personal possessions
Making some financial decisions for the ward, if the ward does not have a conservator
Protecting and advocating for the ward's rights
Conservators are generally responsible for:
Using the protected person's income and financial resources to provide for the person's care, support and comfort, and to pay the person's bills and debts
Keeping track and taking care of the protected person's property and personal possessions
Investing or selling the protected person's assets and property, if this must be done to meet the person's needs
SOURCE: "A Guide to Guardian Services in Utah," Utah Department of Human Services Office of Public Guardian