children can serve as a cause for personal motivation and empowerment. Pragmatically, clients

should be assisted in preparing their children for the loss of parents in the following areas:

Legal guardianship. Workers should help clients identify significant others or



friendswithin the client system who could serve as legal guardians for their children. By

stressing that children without legal guardianship become wards of the State, clients

sometimes find the motivation to search for and secure guardians for their children.

Workers should understand that the search for guardians for children of clients with

substance abuse and HIV/AIDS-related issues can be difficult because clients often have

exhausted their support system of family and friends well before involvement in formal

treatment systems or programs.

Standby guardianship. A standby guardian is someone who agrees to stand ready to



assume guardianship (legal responsibility) for a minor when the parent of that child dies

or becomes incapacitated. A parent will use the procedure when there is significant risk

that he will die or become incapacitated within a certain period of time (e.g., in New

York, this period is 2 years). The parent must usually petition a court for the appointment

of a specific individual to be the standby guardian. The standby guardian can assume

responsibility when the parent becomes incapacitated and then relinquish it when and if

the parent recovers. The standby guardian's authority is effective when she receives

notification of the parent's incapacity or death.

Leaving a legacy of living memories. An approach often used in agencies is working



with parents to create living legacies for their children. For instance, families may be

encouraged to make videotapes or audiotapes of themselves for their children. The

National Hospice Organization has an excellent library of grief and bereavement

materials, including some very good age-appropriate materials for children.

Dealing with survivor guilt. The issue of survivor guilt is relevant for all family



members but particularly so for the infected parent whose infant dies first. The problem

of guilt must be brought forth, discussed, and processed so that clients can take a more

proactive approach to their other problems.

HIV and Risk of Relapse

Declining health as a result of HIV disease is a recognized risk factor for relapse into substance

abuse. Physical and psychological stresses associated with HIV disease include pain, decreased

functional ability, fatigue, and weakness, as well as fear, anxiety, grief, and possibly increased

isolation and separation from loved ones, all of which increase individuals' risk of resuming

substance abuse.

HIV/AIDS milestones are significant for the client, her significant others, and her support

network. Counselors often can anticipate crisis, upset, or a readiness for change when a client

reaches an HIV/AIDS milestone. Counselors who know and understand these milestones have an

opportunity to prepare clients through the development of coping skills and strategies. It is a time

of great opportunity for change (becoming clean and sober) or for relapsing. Milestones can

create the impetus for a new way and learning new behaviors, or they can serve as an impetus for