In Israel, approximately 150,000 older adults live with dementia, a condition of cognitive decline that can continue over a period as long as 15 years. This population is at particular risk of losing their legal rights; in the past, a vast majority of adults diagnosed with dementia were appointed a legal guardian by the state.

By imposing a guardian onto the older adult, the State interferes with the individual’s autonomy, impinging on his/her freedom of choice and self-esteem, and even on the motivation to seek rehabilitative support. Despite cognitive decline, the older adult still has capabilities as well as the desire to manage his/her own life and live up to his/her beliefs and values. A growing chorus of criticism for the practice of automatic guardianship contributed to a 2016 legislative amendment, promoted by a coalition that included MARVA’s founders, that introduced new legal strategies contributing to the older adult’s safety and health while defending his/her freedom to manage daily life. These strategies include, among others, tailored guardianship, durable power of attorney and advance directives, and supported decision-making.

A two-year partnership between MARVA and EMDA, the Alzheimer’s Association of Israel, is demonstrating that the legal interventions noted above are having a significant impact on the quality of life of thousands of older adults. Marva, working in partnership with EMDA, which is supported by the Milwaukee-based Bader Philanthropies, provides ongoing legal aid to older adults and their families who are part of EMDA’s programmatic pipeline and are seeking aid to protect their independence for as long as possible. At each stage of decline for a person with dementia, MARVA is able to extend legal aid to ensure that he/she remains safe while enjoying as much autonomy as possible. Since the launch of the program, over 1,000 people have received legal consults and interventions. Through EMDA, MARVA also provides workshops and seminars to families and professionals in the field; to date, several hundred workshops and seminars have been provided by MARVA attorneys benefiting thousands of participants.

A woman in her mid-70s, Shula M., contacted MARVA out of concern for her 78-year-old husband who had been diagnosed with moderate cognitive decline. Shula was concerned that her husband would forget that he withdrew money from their joint account and would return to take out more; he would donate to nonprofits multiple times in a row; and in general, was putting their finances at risk. At the same time, she felt that imposing a guardianship arrangement would be a terrible blow to him, with the lack of autonomy causing him great distress. Instead, with the help of MARVA attorneys, Shula was able to make a legal arrangement approved by the court whereby her husband maintains access to funds for daily use, however large bank withdrawals must be approved by her; and any attempt to change the legal standing of their property would be subject to her approval, so as to protect the family’s assets. With these protections in place, Shula’s husband continues to enjoy his independence while his financial and other assets are being managed in a way that protects his interests.

Shlomo C., a professional in his fifties, was devastated to learn that he is in the early stages of Alzheimer’s disease. After hearing of MARVA, Shlomo contacted us to share his deep concern about arrangements for his future and for his family. He was very much against the idea of having a legal guardian, especially during the early stage of his illness, and expressed his wish that his children would have the authority to provide care for him, according to a pre-arranged plan that takes into account his wishes for his care and his finances. The MARVA attorney was able to reassure Shlomo and assisted him in setting up a series of Advance Directives which would enable him to make key healthcare and financial decisions, while he is still able, and prepare him for a time when he is no longer capable.