What does a Guardian of an Adult Do?

1. What are a Guardian’s duties and responsibilities to the adult?

A Guardian is appointed by the court to make some or all medical and personal decisions on behalf of the incapacitated adult. The court can tailor the guardianship to limit the guardian’s decision making powers to areas where the adult is impaired. The Guardian’s decision making powers are listed in the Decree and Order issued at the guardianship hearing.

When making medical and personal decisions, a Guardian must consider the adult’s expressed desires and personal values and act in the adult’s best interest, encourage the adult to participate in decision making whenever possible, and help the adult develop or regain the capacity to manage his or her own personal affairs if possible. A Guardian does not manage the financial affairs of an adult unless the Guardian has also been appointed Conservator by the court.

A Guardian’s duties will vary depending on the adult’s abilities and limitations, but generally include the following:

  • Ensure the adult’s living situation is safe and appropriate (least restrictive environment)
  • Provide for the adult’s everyday basic needs and safety
  • Make ordinary medical care decisions and arrange for needed treatment
  • Provide for the social, educational, recreational and future needs of the adult
  • Apply for health insurance and other benefits, if needed
  • Advocate for the adult’s legal rights and independence

2. What are the limits to a Guardian’s decision making powers?

A Guardian can make ordinary medical and personal decisions, limited to what appears in the Decree and Order and Letters of Appointment. If powers are not in stated the court’s Decree and Order, a Guardian must ask for the Court’s approval to:

  • Expand, lessen, or change his or her decision-making powers
  • Admit an adult to a nursing home facility
  • Admit or commit an adult to a mental health or a developmentally disabled facility
  • Authorize the use of anti-psychotic drugs
  • Authorize extraordinary medical treatments
  • Resign or terminate the guardianship while the adult is alive
  • Revoke a Health Care Proxy

3. What are a Guardian’s duties and responsibilities to the court?

After a Guardian is appointed, the court oversees the guardianship and monitors the well-being of the adult. Every Guardian must complete a Guardian’s Care Plan/Report. A Guardian’s Care Plan/Report is a fill-in-the blank court form a Guardian sends into the court to report on the adult’s current condition, living arrangements, financial matters, and future care.

The first Care Plan/Report is called an Initial 60 Day Care Plan and is due within 60 days from the date the Guardian was appointed. The Guardian must also submit an Annual Report, due every year on the anniversary date of the appointment, for as long as one remains Guardian. You can find a blank copy of the Guardian’s Care Plan/Report at the Registry office of the Probate and Family Court, or on-line at http://www.mass.gov/courts/courtsandjudges/courts/probateandfamilycourt/upcforms.html

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