Guardianship and the options to try first
Guardianship is one way to help an adult with IDD make decisions. It is also the most restrictive. Here are the options, from least to most.
Start with the person
Every adult has the right to make their own choices, with help if they want it. Most people with IDD can make many decisions with the right support. Ask three questions:
- What decisions does the person make well today?
- Which decisions are hard, and what help would make them easier?
- Who does the person trust to help?
Many states now require courts to look at less restrictive options before they order guardianship.
Options, least to most restrictive
| Option | What it does | Rights kept |
|---|---|---|
| Informal support | Family and friends help the person think through choices. | All |
| Supported decision-making | The person chooses supporters and signs an agreement about how they help. The person still decides. Many states recognize these agreements in law. | All |
| Release forms | HIPAA and FERPA forms let doctors and schools talk with chosen people. | All |
| Health care power of attorney or proxy | Names someone to make health decisions if the person cannot, or to help them now. | All, and the person can change it |
| Financial power of attorney | Lets a trusted person help with banking and bills. | All, and the person can change it |
| Representative payee | Social Security picks a person or group to manage SSI or Social Security payments. | All, except control of that benefit |
| ABLE account or special needs trust | Holds money for the person without losing SSI or Medicaid. | All |
| Limited guardianship | A court gives a guardian power over some areas only, such as health care. | Some |
| Full guardianship | A court gives a guardian power over most decisions. | Few |
What guardianship means
Guardianship (called conservatorship in some states) is a court order. A judge decides the person cannot make some or all decisions and names a guardian. It can take away the right to choose where to live, to marry, to vote in some states, and to make medical and money decisions.
- It usually costs money for court fees, a lawyer, and sometimes a court visitor.
- It can be hard to end. If things change, you can ask the court to limit it or end it (restoration of rights).
- The person has the right to a lawyer and to go to the hearing.
- Guardians usually must report to the court every year.
Free help
National Resource Center for Supported Decision-Making
Sample agreements, state laws, and stories from people who use supported decision-making.
VisitYour Protection and Advocacy agency
Free legal help when a person's rights are at risk, including guardianship.
Find your state's agencyYour state DD Council
Many councils fund guides and trainings on decision-making.
Find your council
Last reviewed: October 2026. Laws, dollar amounts, and program rules change. Check with the agency named on this page before you make a decision.