In the Matter of the Guardianship of Jeffrey Erickson

IN THE COURT OF APPEALS OF IOWA

No. 24-0418
Filed July 23, 2025

IN THE MATTER OF THE GUARDIANSHIP OF JEFFREY ERICKSON,

JEFFREY ERICKSON,
Appellant.
________________________________________________________________

Appeal from the Iowa District Court for Polk County, Katie Ranes, Judge.

A protected person appeals the district court order establishing a limited

guardianship for him and appointing his mother as his guardian. AFFIRMED.

Kevin Cunningham of Cunningham & Kelso, P.L.L.C., Urbandale, for

appellant.

Edward Fishman of Fishman Law Firm, Des Moines, for appellee.

Considered without oral argument by Greer, P.J., and Langholz and

Sandy, JJ.
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SANDY, Judge.

A protected person appeals the district court order establishing a limited

guardianship for him and appointing his mother as his limited guardian. He

contends the evidence was insufficient to establish that his decision-making

capacity is so impaired that he is unable to care for his personal safety or provide

necessities for himself. Consequently, he argues the district court erred by

establishing a limited guardianship for him.

Because we conclude substantial evidence supports the district court’s

finding that a limited guardianship was necessary, we affirm.

I. Background Facts and Proceedings

The protected person is a forty-three-year-old man who has frequently

struggled with his mental health.1 His struggles with mental health date back to

his adolescent years, when he began experiencing “major depression” and a “very

debilitating anxiety disorder.” At twenty-five, he was diagnosed with bipolar

disorder type I. He has also been diagnosed with a “cluster B personality disorder.”

Over the years, he has been involuntarily committed numerous times for

psychiatric treatment for episodes of acute psychosis, anxiety, and mania. The

protected person has lived with his mother for the past eight years. He is currently

unemployed and has historically been unable to hold a job for more than two to

three weeks.

Over the last several years, the protected person’s mental health has

progressively gotten worse. According to his mother, he has experienced “psych

1 Out of respect for this individual’s privacy, we refer to him throughout this opinion

as the “protected person.”
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events” with increasing frequency. Generally, these events vary in length from two

to seven weeks. In his mother’s words, during such events:

[H]e becomes manic which means he is up for two, three days at a
time very energized. His thinking is very impaired. He makes poor
decisions. He gets very paranoid. He can become—or almost
always becomes agitated and destructive, does a lot of destruction
around the house, and is threatening to me and scary. He damages
the house and kind of runs around the neighborhood. Like I said,
very distorted thinking.

In the past two years, the protected person has been involuntarily committed for

psychiatric treatment eight times, including twice in the three months preceding the

hearing on his mother’s petition for a limited guardianship. And as his mother

testified at the hearing, his level of functioning continues to decline following a

“psych event.” As she put it, “It used to be when he’s going to the hospital or even

prior to being hospitalized—you know, it used to be that he could get almost back

to his baseline, which is very, very, very high functioning. But over the years that

baseline keeps getting lower, I believe.”

Amid a “psych event,” the protected person is incapable of making medical

decisions for himself. Even when he is not experiencing a “psych event,” he relies

on his mother to remind him of and take him to his medical appointments. In his

mother’s view, he is unlikely to “get to a point where he doesn’t need someone

there for him.”

But as his mother alluded to in her testimony at the hearing, when the

protected person is not experiencing a “psych event,” he functions at a high level.

He graduated high school and attended some college. He does not need

assistance to bathe or dress himself, and he can prepare his own food. And his

mother generally does not sit in on his medical appointments. During the hearing
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on her petition, the mother also expressed her belief that the protected person

should retain the right to vote and make the decision of whether to marry.

Due to the protected person’s declining mental health over the last several

years, his mother filed a petition to establish a limited guardianship for him. The

mother’s petition requested that she be granted the limited powers to “access [the

protected person’s] medical history and records, to communicate with [his] medical

professionals, and to consent to and arrange for medical, dental, and other

healthcare treatment and services for [him].” The district court held a hearing on

the mother’s petition in February 2024. During the hearing, the district court heard

testimony from the mother and admitted into evidence two psychiatric reports.2 Of

note, both reports were written during the protected person’s involuntary

commitment—a month prior to the hearing—at Broadlawns Medical Center in Des

Moines.

One of the reports admitted into evidence was a psychiatric evaluation

performed by a psychiatric mental health nurse practitioner (nurse practitioner). In

her evaluation, the nurse practitioner noted the protected person was displaying

aggressive behavior and delusional thinking during his commitment. She also

opined in her evaluation that the protected person was incapable of making

responsible decisions concerning his treatment due to “poor judgment and insight.”

Additionally, she documented her belief that he was “likely to physically injure self

or others” if he did not receive treatment. She indicated that, in her view, the

2 During the mother’s testimony, she explained she did not pursue requesting the

protected person to grant her power of attorney in order to access his medical
history due to his history of revoking consent for her to access his medical records.
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protected person was incapable of satisfying his “needs for nourishment, clothing,

essential medical care or shelter,” such that he was likely to suffer physical injury,

debilitation, or death. Finally, she wrote that he has a history of hospitalizations

“due to nonadherence to medications” and would likely need ongoing “oversight of

[his] medication administration.”

Following the hearing, the district court issued its order establishing a limited

guardianship for the protected person and appointing his mother as his limited

guardian. The district court’s order granted his mother the limited powers to

(1) make “decisions regarding the care, maintenance, health, education, welfare,

and safety” of him; and (2) consent to and arrange for “medical, dental, and other

health care treatment and services” for him. However, the protected person

retained the right to vote and independently make the decision to marry.

This appeal followed.

II. Standard of Review

“Actions for appointment of a guardian are triable at law and, therefore, are

reviewed for errors at law.” In re Guardianship of Williams, No. 11-2025, 2012 WL

5355865, at *1 (Iowa Ct. App. Oct. 31, 2012); see Iowa Code § 633.33 (2024).

“Findings of fact in a law action have the effect of special jury verdict and are

binding on us if supported by substantial evidence.” In re Conservatorship of

Deremiah, 477 N.W.2d 691, 693 (Iowa Ct. App. 1991). “Evidence is substantial or

sufficient when a reasonable mind would accept it as adequate to reach the same

findings.” Id. However, “[e]vidence is not insubstantial merely because it would

have supported contrary inferences.” Grinnell Mut. Reinsurance Co. v. Voeltz, 431

N.W.2d 783, 785 (Iowa 1988). Finally, [i]n case of doubt or ambiguity we construe
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the findings to uphold, rather than defeat, the [district] court’s judgment.”

Deremiah, 477 N.W.2d at 693.

III. Analysis

The protected person asserts his mother “failed to prove by clear and

convincing evidence that [his] decision-making capacity is so impaired at times that

he is unable to care for his safety or provide for necessities, such as food, shelter,

clothing, or medical care without which physical injury or illness may occur.”

Consequently, he argues the district court erred in establishing a guardianship for

him and appointing his mother as his guardian. While he acknowledges that his

functioning is impaired during “psych events,” he points out that these events do

not occur all the time. He contends he can perform many functions when he is not

experiencing a “psych event.” Additionally, he notes that he is capable of bathing,

dressing, and preparing food for himself. As he puts it, “[a] person like [him] who,

according to [his mother], cannot function at times, but can perform many functions

at other times is not sufficient to remove [his] rights to make decisions regarding

his . . . medical needs.” We disagree and conclude substantial evidence supports

the district court’s finding that a limited guardianship was necessary.

The petitioning party bears the burden of proving the guardianship is

necessary and must do so by clear and convincing evidence. Iowa Code

§ 633.551(1), (2). Clear and convincing evidence “means there must be no serious

or substantial doubt about the correctness of a particular conclusion drawn from

the evidence.” In re M.S., 889 N.W.2d 675, 679 (Iowa Ct. App. 2016). The district

court may establish a guardianship for an adult when “the decision-making

capacity of the respondent is so impaired that the respondent is unable to care for
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the respondent’s safety, or to provide for necessities such as food, shelter,

clothing, or medical care without which physical injury or illness may occur.” Iowa

Code § 633.552. This requires proof

showing that the ward or proposed ward is unable to think or act for
himself or herself as to matters concerning the ward’s personal
health, safety, and general welfare. In addition, the district court’s
findings of fact based upon this evidence should support the powers
conferred on the guardian. These powers should be articulated as
clearly as each case permits.

In re Guardianship of Hedin, 528 N.W.2d 567, 579 (Iowa 1995) (cleaned up)

(internal citations omitted). In determining whether a guardianship should be

established, the district court is required to also consider the appropriateness of a

limited guardianship. In re Guardianship of Evans, No. 16-2192, 2017 WL

4570438, at *4 (Iowa Ct. App. Oct. 11, 2017).

Applying these principles, we conclude substantial evidence supports the

district court’s determination that establishing a limited guardianship was

necessary for three reasons. First, there is evidence in the record that suggests

the protected person does not appreciate the severity of his mental-health issues.

In the nurse practitioner’s psychiatric evaluation—written during his involuntary

commitment one month prior to the hearing on his mother’s petition—she indicated

her belief that he was incapable of making responsible medical decisions for

himself due to “poor judgement and insight.” Additionally, in a psychiatric progress

report—the second report admitted into evidence and written during the same

commitment—the protected person is documented to have been “minimizing” and

“superficially cooperative.”
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We understand these observations to mean that the protected person does

not fully understand or acknowledge how serious his mental-health issues are.

And we have previously found that an individual’s failure to appreciate the severity

of their mental illness constitutes substantial evidence in support of a guardianship.

See In re Guardianship of B.Z., No. 19-1761, 2020 WL 4499037, at *3 (Iowa Ct.

App. Aug. 5, 2020) (concluding the respondent’s failure to appreciate the

seriousness of her mental illness constituted substantial evidence that “her

capacity for decision making is severely impaired”).

Second, the evidence shows the protected person has a history of being

involuntarily committed for failure to take his prescribed mental-health

medications. In her evaluation, the nurse practitioner noted the protected person

has a history of “several hospitalizations due to nonadherence to medications.”

Further, in the same evaluation, she wrote that he “will require ongoing

supervision, and oversight of medication administration.” Both of these facts are

relevant considerations and add support to our conclusion that establishing a

limited guardianship is supported by substantial evidence. See In re R.H.,

No. 19-0007, 2019 WL 4297878, at *2 (Iowa Ct. App. Sept. 11, 2019) (concluding

a guardianship for a proposed ward was necessary, in part, due to his failure to

take his mental health medications); see also See In re Guardianship of S.M.P.,

No. 20-0946, 2021 WL 5105869, at *2 (Iowa Ct. App. Nov. 3, 2021) (concluding a

guardianship was supported by substantial evidence where a neuropsychologist

recommended that the proposed ward would require “someone else [to] oversee

all medications to ensure they are being taken as prescribed”).
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Third, while it is undisputed that the protected person can perform some

basic functions by himself, we note that he is reliant on his mother for shelter,

financial support, and numerous daily tasks.3 He is currently unemployed and has

lived with his mother for the past eight years. Additionally, he is reliant on his

mother for tracking his medical appointments as well as transportation to such

appointments. And his mother testified that she believed he was unlikely to get to

a point where he would not need “someone there for him.” These facts bolster our

conclusion that substantial evidence supports the establishment of a limited

guardianship. Cf. In re Guardianship of Feistner, No. 17-2108, 2018 WL

49113669, at *2 (Iowa Ct. App. Oct. 10, 2018) (concluding insufficient evidence

supported the establishment of a guardianship where a woman “could provide for

herself and live on her own,” had a full-time job, and her brother testified that “[s]he

could function on her own”).

For these reasons, we conclude substantial evidence supports the district

court’s finding that establishment of a limited guardianship was necessary.

IV. Conclusion

Because we find substantial evidence supports the district court’s finding

that a limited guardianship was necessary, we affirm.

AFFIRMED.

3 Additionally, while the protected person claims that he can perform many
functions when he is not experiencing a “psych event,” we find his mother’s
testimony that his “baseline” level of functioning continues to decline following such
events significant.