Child, Handicapped, Senescent--all states of being limited in ability, all states in which guardianship must be exercised, but so different in anticipated outcomes and in caretakers' attitudes.

A child is expected to grow and learn. Repeated lessons, exercises in logic and understanding, experiences in feelings and compassion--all are undertaken in the belief that the child will learn not only the skills for modern life, but the social attitudes appropriate for adulthood. So we counsel, as patiently as we can, with hope for the future.

Some children or other members of the family are found to be limited in their abilities, either physically, emotionally or mentally--or some combination of all three. It's harder to be the caretaker, knowing that the limits reached will be more restrictive than the limits usually experienced by an adult. Many need guidance or even constant care all of their lives.

The hardest, I think, are those who are grown senescent. In glorious youth, in vigorous middle age, who would ever have thought to see eventually the shaking hands, the unkempt appearance, the unexplained rages, the irrational and senseless actions (even to the point of self harm)? The most heart-breaking part is convincing the person (to the level of their understanding) that they are not the person they once were and they have to accept the new situation as it is.

Little by little, their autonomy is stripped away, and with it their self-respect, if it was built on intellectual dominance and control of their world at home and at work. It's so hard to set the boundaries, gently, and enforce them when the person is fulminating with the impotent anger of old age. Worst of all would be to gather legal evidence and appear in court to state to the world that this person is no longer a person, but a ward needing a guardian.

And, unlike a child, there is no hope for recovery, no expectation of a summer coming after a wintry spring. No, it will be winter for them always from now on.