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Guardianship & Supported Decision-Making: What’s the Difference?

Guardianship & Supported Decision-Making: What’s the Difference?

When you have a loved one that needs some assistance with making important decisions, whether they be financial or regarding medical care, you may be faced with deciding what type of help he or she needs. Regardless of the reason for the decision-making help – age, illness, developmental disability – you are likely to be faced with two choices regarding your loved one’s care: guardianship or supported decision-making.

These are two completely different terms that come with varying responsibilities for both the person who needs the help and the one offering support. Guardianship and supported decision-making each come with their own challenges and benefits, and what may work well for one individual’s situation may not work well for another.

So, what are guardianship and supported decision-making, and how do you choose between the two?



Guardianship is probably the most familiar of the two terms, as it has been a common practice for many years. With guardianship of adults, a person or entity is legally appointed as the decision maker for the individual. A guardian makes a variety of decisions, from where that individual lives to what sort of medical care he or she receives. Guardians typically are close family members or friends, usually someone who shows he or she has the best interest of the individual at heart.

While many guardians consult with their wards about important decisions, it is not a requirement that the ward has any say in the decision that’s made. A guardian has the final say on what happens with the individual’s property, money, and other issues.

Guardianship is ideal for situations where the ward has no true capacity to make his or her own decisions. In cases of patients with dementia, those with severe mental impairments or those who have proven their decisions can lead to danger are the patients best suited for guardianship.


Supported Decision-Making

In recent years, supported decision-making has become increasingly more popular, especially among those adults that have impairments but are not so severely impaired that they cannot make any decisions for themselves.

With supported decision-making, the individual makes his or her own decisions with the assistance and input of a trusted person or group of people. For many adults, especially those with developmental disabilities or injuries that impair mental capacity, they need assistance making the correct decision for their situation but are fully capable of playing a part in that decision-making process.

Supported decision-making gives the individual more agency and investment in his or her care, which often improves quality of living and treatment outcomes.


How Do I Choose the Right Method?

Choosing between guardianship and supported decision-making comes down, in large part, to the ability of your loved one to contribute to making important decisions. If your loved one is largely able to consider different options, discuss pros and cons, and welcome feedback, supported decision-making is probably the right choice. However, if your loved one has a very severe disability or if previous attempts at supported decision-making haven’t worked, guardianship may be the better course.


Experienced Estate Planning in Frederick County, MD

At the Elder Law Office of David Wingate, we’ve had years of experience helping families decide between guardianship and supported decision-making. We want to help you make the right decision for your family, so we work with all involved to weigh the pros and cons, and put into place the necessary legal safeguards. Schedule your consultation today!

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