supported decision-making v. guardianshipAs adults, we value our ability to make our own decisions about where we live, who provides our medical care, and how we want our treatment to be managed by our healthcare providers.   However, life circumstances may occur which can interfere with a person being able to make these choices independently. For instance, it may be a physical or mental condition which impairs someone’s cognitive abilities or an accident which severely limits their ability to communicate or express their needs.  One option in this situation is to have a guardian appointed to make decisions on the person’s behalf.  Another choice is to ensure that measures are in place to engender the person’s ability to make their own decisions.   Here are some factors to consider about both supported decision-making and guardianship:

What is Supported Decision-Making?

Supported decision-making is an approach which seeks to utilize multiple appropriate supports for a person with an impairment which interferes with their ability to make fully independent decisions.  The theory behind this model is that by having different mechanisms in place, the individual will be empowered to make as many of their own choices as possible.  These supporting factors can be family and friends, community programs, and other resources and professionals who can assist the person in understanding their options.

What is Guardianship?

Guardianship, on the other hand, is a legal process wherein a court evaluates a person’s competency and decides whether or not to appoint a guardian to make decisions on their behalf.  A court-appointed guardian would be responsible for making decisions about their person’s living environment, medical care, and in some situations even end of life decisions.  The guardian is also responsible for reporting to the court and has specific responsibilities and duties in relation to the person.  This relationship allows the guardian to have complete decision-making authority over particular aspects of the person’s life.

Alternatives to Guardianship

It may be possible to avoid guardianship by employing certain legal mechanisms.  For instance, a durable power of attorney for health care allows a person to name someone to make health care decisions for them if they become incapacitated.  There are also powers of attorney which will let the person give someone else the authority to oversee their financial matters in the same circumstance.  Another option is to create a type of trust which provides for the individual’s care. Depending on the person’s degree of impairment, with these type of legal devices in place, it may not be necessary that they are appointed a guardian.

Which is a Better Choice?

While guardianship may seem severe in comparison to supported-decision making, in some instances such as advanced Alzheimer’s or total incapacitation, the person may not be able to make any decisions regarding their care.  However, where someone has a cognitive limitation but can make some choices, utilizing resources to support their autonomy may be the best course of action.  It may also be that a combination of supported-decision making measures and legal devices may provide enough guidance and protection to make guardianship unnecessary.  Deciding between the two options will largely depend on your circumstances and the person’s abilities and condition.

Determining the ideal way to ensure someone has adequate care while maintaining some decision-making can be complicated.  We have experience and knowledge which can help as you explore these and other option for your loved one.  Please contact us online or by phone if we may be of assistance.

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