Guardianship, Conservatorship and Alternatives

Guardianship and Conservatorship are two separate processes under Massachusetts Law.

Here is some partial information and commonly asked questions regarding Guardianship and Conservatorship, and alternatives and supports to consider. This webpage is for informational purposes only; it is not legal advice. Always look to Massachusetts law to understand the full Guardianship process and Conservatorship process, and to carefully employ less restrictive alternatives and interventions whenever possible.

What is Guardianship of an Adult?

The court can appoint a Guardian to make health care decisions for a person with an incapacity.

Guardianship of an adult is a legal process for individual's who have a clinically diagnosed medical condition and are unable to make or communicate effective decisions about their everyday self-care, health, and safety. The Massachusetts court can appoint a person or entity as a Guardian to make some or all health care decisions on the adult’s behalf. Before appointing a guardian, the court must find that the adult's needs can not be met by a less restrictive alternative, including the use of appropriate technological assistance. A guardianship protects the adult’s right to make decisions where they are able, and limits the guardian's decision making authority to areas where the adult lacks capacity.

To avoid Guardianship, a competent adult can complete a Health Care Proxy to appoint a Health Care Agent to make health care decisions.
If considering a guardianship, first explore the alternatives to guardianship below.

What is Conservatorship of an Adult?

The court can appoint a Conservator to make financial decisions and manage the money, property and financial affairs of a person with a disability or incapacity.

Conservatorship is a legal process for adults who have a disability or an incapacity, called a protected person, and are unable to make or communicate decisions about their money, property or business affairs. The Massachusetts court can appoint a person or entity as a Conservator to help manage the person's money and estate, to ensure the adult's health care and personal services can be contracted and paid for and to protect the property and other financial matters from being wasted. Before appointing a Conservator, the court must find that the adult's needs can not be met by a less restrictive alternative, including the use of appropriate technological assistance. A conservatorship protects the adult’s right to make their own financial decisions as they are able, and limits the conservator's decision making authority to only areas where the adult's ability is impaired.

To avoid Conservatorship, compete a Durable Power of Attorney to appoint a person called an "attorney-in-fact" to make decisions about your money, property and financial affairs.
If considering a Conservatorship, first explore the alternatives to conservatorship below.

Guardianship and Alternatives

First, Consider the Alternatives and Supports

Guardianship of an adult is an important protective intervention, but it also can be the most restrictive of a person's independence and ability to make personal and health care choices.

Before considering a guardianship or at ANYTIME during a guardianship, it is important to assess the adult's current decision making ability, and consider whether there are less restrictive alternatives which will provide the protection and assistance the person needs.

Here's a 5 Question Checklist below to start to consider alternatives, supports and intervention to avoid, modify or terminate a guardianship.

If guardianship is needed, the Checklist can provide important information about the adult's decision making abilities, health care and personal preferences, and needed supports.

This partial checklist briefly explains some alternatives; check the Resources section for more information.

5 Question Checklist to Consider Alternatives to Guardianship

1. Does the adult have the ability to make health care decisions?

All adults are presumed to be competent or have the ability or capacity to make their own health care and personal decisions. Too often we assume a person lacks the ability or capacity to make decisions based on a medical diagnosis, health condition or perhaps an unconscious bias. Having the ability to make your own decisions can avoid guardianship and is an important personal right to fully consider.

Explore the following:

Is there a medical determination of incapacity by an attending physician written into the medical record, or a legal determination of incapacity by a court?
- If NO, then an adult is presumed competent and can make their own decisions. Read more in Top 5 Rights.
Does the adult want to make their own decisions with the help of a supportive person?
- Consider Supported Decision-Making. It empowers adults, with a range of abilities, to make decisions about their own life and health care with the help of one or more support persons. The adult chooses supporters who can offer advice and assistance. Supported Decision-Making can avoid the need for guardianship. Read more here.

2. Does the adult have a valid Health Care Proxy and other planning documents?

A Health Care Proxy is a legal document where you appoint a trusted person, called a Health Care Agent, to make health care decisions on your behalf if you are not able to make decisions yourself. Assess whether an adult has a Health Care Proxy document or can complete one. Having a valid Health Care Proxy can avoid the need for Guardianship. Also explore other planning documents to understand and honor an adult's care goals and choices, and perhaps avoid or limit a guardianship.

Explore the following:

Does the adult have a valid Health Care Proxy (HCP) or did the adult complete a HCP at a prior time?
- Can you locate the document? If not, ask family, friends, primary care physicians, the local hospital and facility where the adult last resided or was treated if they have a copy.
- If no document, assess if the adult can complete a Health Care Proxy now.
  - Download a free Health Care Proxy available in 15 languages here.

Can the adult complete a Personal Directive (Living Will) and document their care choices?
- A Personal Directive (Living Will) is a personal document where you write down what's important to you, and gives your Health Care Agent, family and care providers information about the care you want and do not want.
- If an adult is unable to complete a Health Care Proxy due to a lack of ability, or cultural traditions present a conflict, or does not have a person to choose as their Agent, it is especially important to consider completing a Personal Directive to understand and honor an adult's personal and health care choices.
- Most adults with a range of decision making abilities can use the Personal Directive to document their likes and dislikes and give instructions on how they want to be cared for today and for future care.
  - Download a free Personal Directive(Living Will) available in 5 languages.

Did the adult complete other planning documents such as a Durable Power of Attorney, Medical Orders for Life-Sustaining Treatment (MOLST), or a Comfort Care/Do Not Resuscitate Order(CC/DNR).
- These documents can be very instructive to understand and honor an adult’s medical and financial goals, priorities and choices.
  - Download fact sheets on the Resource webpage.

3. What is the person's current decision making ability and needed supports?

Everyone is different. Our health needs and care preferences typically will change over time. It’s important to regularly assess an adult’s current decision making ability, as well as their preferences for care and services, psycho-social abilities and appropriate supports and accommodations. Taking a holistic approach can help safeguard an adult’s autonomy and tailor appropriate interventions and supports to avoid or modify a guardianship.

Assess the following:

What decision making abilities has the adult retained or kept?
- A person may be able to make decisions is some areas but not in others. Identify and safeguard retained abilities.
Has the person regained some or all decision making powers?
- A person’s ability to make decisions can be lost and then regained. You can request a medical assessment at anytime to access capacity.
  - If regained, can the adult complete a Health Care Proxy?
- If the adult is under guardianship, it is the role of the guardian to advocate for the adult's re-gained abilities. Guardians can request a medical assessment.
What’s the adult's current psycho-social abilities and need for appropriate supports and accommodations?
- Consider a holistic assessment. A care manager or aging life care advocate can help assess and tailor appropriate interventions and supports.
- If the adult is under guardianship, the guardian can consider petitioning the court to allow payment to bring in a professional care manager or aging life care advocate.
Has the adult’s goals and care preferences changed overtime?
- Re-assess regularly to ensure treatments and interventions are meeting the adult’s current care goals and choices.
- Update or add care planning forms to document a person's choice in a Personal Directive, or in considering a MOLST form for adults with serious illness.

4. Would the adult benefit from a Supported Decision–Making Model?

When first assessing an adult's decision-making ability, and at ANYTIME during this process, evaluate if Supported Decision-Making is right for the adult as an alternative to guardianship. Supported decision-making allows adults to retain their decision-making rights about their personal affairs. The adults chooses one or more support persons who can offer advice, help adult's understand their options and communicate their preferences to others, and assist with needed health care, living arrangements, financial matters and in other areas.

8 Things to Know About Guardianship

Here are some commonly asked questions about the guardianship process and links to resources. Guardianship can be a complex process with many steps to follow and forms to complete. Below is a partial summary of some of the key steps. Consult Massachusetts law or contact a Guardianship attorney for more complete information. The following is for informational purposes only and not legal advice.

1. What is guardianship and when is it appropriate to consider?

Guardianship of a person is a legal process, where the court can appoint a guardian for an incapacitated person, who has a clinically diagnosed condition causing an inability or incapacity to receive and evaluate information or make or communicate decisions about the adult’s health, safety and well-being.

In a court hearing, the court grants certain authority to the guardian to make health care and personal decisions on the adults’ behalf, coordinate needed support and assistance, and advocate for the adult’s autonomy.

Guardianship is a highly protective intervention but it can be quite restrictive on an adult’s personal liberties. It’s important to assess a person’s decision-making abilities and explore supports and alternatives before considering a guardianship. For many adults it may be very possible to avoid or limit a guardianship with needed supports and accommodations.

Read more about guardianship here.

2. What are the rights of an incapacitated person in a guardianship hearing?

An incapacitated person is defined as someone has a clinically diagnosed condition that results in an inability or incapacity to receive and evaluate information or to make or communicate decisions about one’s physical health, safety, or self-care, even with the appropriate technological assistance.

In a guardianship hearing, the incapacitated person is at risk of losing their independence and decision-making powers. The incapacitated person, called the respondent in a court hearing, has some important protections under the law to ensure fair treatment. Those rights include:

The right to have an attorney. If the person can not afford an attorney, one will be appointed by the court;
The right to have notice of the hearing and be present at the hearing;
The right to object to who wants to be named as a guardian or to the appointment of a guardian;
The right to present evidence and witnesses and cross examine witnesses.

3. Who can be a guardian?

A guardian is a person or an entity who is appointed by the court to make health care and personal decisions on behalf of an incapacitated person. Guardians can be family members, friends or others who know the incapacitated person. Guardians can also be professionals, like attorneys or health care providers, or an entity such as a hospital, a facility or state agency. The person/ entity typically files a petition to request to be appointed as guardian.

Before becoming a guardian it’s important to consider the type of guardianship that best fits the circumstances and is least restrictive for the incapacitated person. Read more on who can be a guardian here.

4. What are the types of guardianship to consider?

When petitioning the court to become a guardian it’s important to first decide what type guardianship is best for the incapacitated person. Here’s a brief summary of the common types of guardianships to consider-

Limited

A Limited Guardianship is preferred under Massachusetts law. In the court hearing, a limited guardianship will be constructed based on what decision making ability the person can retain or keep to maximize their independence, and what limited powers the guardian will have to support the person in areas where they do not have decision-making ability require assistance. The court will issue a court order or decree that outlines the guardian’s decision-making powers. See examples of specific rights a person may be able to retain here.

Plenary

In a Plenary or Full Guardianship, the court authorizes the guardian to make most or all ordinary health care and personal decisions for the incapacitated person.

Temporary

A temporary guardianship is intended for an emergency situation or to provide a guardian with limited authority to address an imminent harm, and is timed limited for up to 90 days. At that time, the temporary guardianship can be extended or a permanent guardianship be considered.

A Rogers Guardianship is a type of hearing where the guardian is requesting specific authority to administer antipsychotic medications or other intrusive medical treatments and procedures, for individuals who are unable to consent to treatment themselves. The court must authorize a treatment plan and appoint a monitor to oversee the plan. Read more here.

Read more here about types of guardianships here.

5. What happens in a guardianship hearing process?

Here’s a brief overview of what to expect in a guardianship hearing and some of the terms used in the process. There are many more important steps and forms to file with the court than listed below. If you are pursuing a guardianship, please read a fuller explanation on the mass.gov website.

Here’s how it works-

The MA Probate and Family Court supervises an adult guardianship.
A petition is usually filed by the person asking to be appointed guardian at the Probate and Family Court in the county in which the incapacitated person lives.
The person filing the petition is called the petitioner. There are other forms to obtain and file, including a Medical Certificate or Clinical Team Report, and specific steps to follow in this process. Read more here.
The incapacitated person, called the respondent, has some important protections under the law to ensure fair treatment during the hearing process, which include the right to have an attorney, the right to be given notice of the hearing, the right to object to the appointment of an guardian and the person who wants to be guardian, and the right to present evidence and witnesses.
Once the petitioner has completed all the necessary steps, the court will schedule a hearing. Notice of the hearing must be given to the incapacitated person.
At the hearing, the Court will determine whether to grant the guardianship and appoint the guardian. Before appointing a guardian, a court must find that the person's needs cannot be met by less restrictive means, including use of appropriate technological assistance. See the Checklist on this webpage .
If the guardianship is granted, the court will issue a court order or decree which details the specific authority and responsibilities of the guardian. Always look to the court order or decree to understand what a guardian can do and can not do.
Guardians have may duties and responsibilities which include informing the court annually of progress, whether the adult has regained some or all capacity, to make a request to modify or terminate the guardianship or to seek extended authority hearings.

There are many steps to consider in the guardianship process. you can learn more here for a full explanation of the process.

6. What is a guardian's decision making authority and other responsibilities?

A Guardian makes personal and ordinary health care decisions for an incapacitated adult only as necessary to protect the adult from harm, and according to the decision-making powers stated in the court’s decree and order. A Guardian’s duties and responsibilities can vary depending on the type of guardianship, but generally are as follows-

Ensure proper care for everyday basic needs and safety, arrange for social, educational and recreational needs;
Arrange for a safe and appropriate (least restrictive) living situation;
Make ordinary or routine medical treatment and health care decisions;
Encourage the adult to participate in decision-making whenever possible,
Consider the adult’s expressed desires and personal values in decision making and their care planning documents;
Wherever possible, help the adult develop or regain the ability or capacity to manage his or her own personal affairs.

The guardian can not make extraordinary health care decisions about intrusive or advanced treatments without specific authority from the court. The list of treatments and decisions that are generally considered to be extraordinary and require a court hearing include long term admission to a nursing facility, antipsychotic medication, sterilization, withholding life sustaining treatment and stopping kidney dialysis, and other medical interventions. Additionally, a guardian does not have the power to revoke a valid Health Care Proxy.

7. What is substituted judgement in a guardianship hearing?

Under Massachusetts law, a guardian can not make extraordinary health decisions involving intrusive or non-routine treatments without the court's expressed permission. Extraordinary health care decisions generally include long term admission to a nursing facility, antipsychotic medication treatment plan, sterilization, withholding life sustaining treatment and stopping kidney dialysis and more. These treatment decisions require the court to apply a substituted judgment standard. A substituted judgment standard is where the court puts themselves in the shoes of the incapacitated person to determine what treatment or decision the person would consent to if she or he were competent. The Court considers the following factors in making a determination:

the person’s expressed preferences, including preferences documented in care planning documents that may include preferences about medications;
the person’s religious beliefs and convictions;
the impact of the decisions on the incapacitated person’s family;
the negative or adverse side effects;
the consequences and possible outcomes if treatment is refused;
the prognosis and possible outcomes with the treatment.

The court weights these factors against the interests the state might have in implementing a treatment plan. The court will authorize such treatment when “it specifically finds using the substituted judgment standard that the person, if not incapacitated, would consent to such treatment and specifically approves and authorizes a treatment plan and endorses said plan in its order or decree”. Read more here.

8. Where can I learn more about the guardianship process and access the forms to file?

Conservatorship and Alternatives

First, Consider the Alternatives and Supports

Conservatorship of a protected person’s property is an important intervention, but it also can be the most restrictive of an adult's independence and their ability to make decisions about their money, property and financial matters.

Before considering conservatorship or at ANYTIME during a conservatorship, it's important to assess an adult's current decision making and financial management ability, and to consider whether there are less restrictive alternatives to provide the protection and support the person needs.

Here's a 5 Question Checklist below to start to consider alternatives, supports and interventions to avoid, modify or terminate a conservatorship.

If conservatorship is needed, the Checklist can provide important information about the adult's decision making abilities, personal preferences about managing property and financial matters, and needed supports.

This partial checklist briefly explains some alternatives; also check Resources for more information.

5 Question Checklist to Consider Alternatives to Conservatorship

1. Does the adult have the ability to manage their money, property and financial matters?

All adults are considered competent to have the ability to make their own decisions about their money, property and financial matters. Too often we assume an adult lacks the ability to make decisions based on a medical diagnosis, a health condition or perhaps an unconscious bias. Having the ability to make your own financial decisions and manage your money and property can avoid a conservatorship, and is an important personal right to fully consider.

Explore the following:

Is the adult unable to manage their money, property and business affairs effectively because of a clinically diagnosed impairment in the ability to receive and evaluate information or make or communicate decisions, even with appropriate technological assistance, and, 1). the adult has property that will be wasted or dissipated unless management is provided, or 2). money is needed for the support, care, and welfare of the person or those entitled to the person’s support and that protection is necessary or desirable to obtain or provide money?
- If NO, the person is considered to have the ability to make financial decisions and manage their money, property and business affairs.
- If the person has the ability to make their own decisions with the help of a supportive person, consider a Supported Decision-Making model.
  - Supported Decision-Making empowers adults, with a range of abilities, to make decisions about their life, health and financial decisions with the help of one or more support persons. The adult chooses supporters who can offer advice and assistance. Supported Decision-Making can avoid the need for conservatorship. Read more here.

- If YES, a conservatorship may be appropriate after fully considering less restrictive alternatives and support.

2. Does the adult have a valid Durable Power of Attorney and other planning documents?

A Durable Power of Attorney is a legal document in which you appoint a person you trust, called an "Attorney-in-fact", to manage your money, property and financial matters if you become disabled or incapacitated and are unable to effectively manage your financial matters yourself.

This legal document specifies the "powers" or authority you give to a trusted person to manage your financial matters. “Durable” means the document is valid if the person becomes incapacitated. A Durable Power of Attorney can avoid the need for a conservatorship. Also explore other planning documents to understand and honor an adult's goals and choices, and perhaps avoid or limit a conservatorship.

Explore the following:

Does the adult have a valid Durable Power of Attorney?
- Can you locate the document? What powers were given to the "attorney in fact"?
  - To locate, ask family, friends, attorneys, primary care physicians, the local hospital and facility where the adult last resided or was treated if they have a copy.
- If no document, assess if the adult can complete a Durable Power of Attorney now.
  - Download a Durable Power of Attorney fact sheet here.

Explore other planning documents:

Does the adult have a valid Health Care Proxy? If not, can the adult complete one now?
- Download a free Health Care Proxy available in 15 languages here.

Can the adult complete a Personal Directive (Living Will) to document their care choices and preferences?

- A Personal Directive (Living Will) is a personal document where you write down what's important to you, and give your Health Care Agent, family and care providers information about the kind of care you want and do not want.
- If an adult is unable to complete a Health Care Proxy due to a lack of ability, or cultural traditions present a conflict, or does not have a person to choose as their Agent, it is especially important to consider completing a Personal Directive to understand and honor an adult's personal and health care choices.
- Most adults with a range of decision making abilities can use the Personal Directive to document their likes and dislikes and give instructions on how they want to be cared for today and for future care.
  - Download a free Personal Directive(Living Will) available in 5 languages.

Did the adult complete a Medical Orders for Life-Sustaining Treatment (MOLST), or a Comfort Care/Do Not Resuscitate Order(CC/DNR)?
- These documents are designed for adults with serious illness and can be very instructive to understand and honor an adult’s medical and financial goals, priorities and choices.
  - Download fact sheets on the Resource webpage.

3. What is the adult's current decision making and financial management ability?

Everyone is different. Our ability to understand and make decisions to manage our money, property and financial matters can change overtime. It’s important to regularly assess an adult’s current decision making ability regarding financial matters to protect their estate, and importantly ensure the adult's health care and personal services can be contracted and paid for. Taking a holistic approach can help safeguard an adult’s autonomy and tailor interventions and supports to avoid or modify a conservatorship.

Assess the following:

What decision making abilities has the adult retained or kept?
- A person may be able to make decisions is some areas but not in others. Identify and safeguard retained abilities.
Has the person regained some or all decision making powers?
- A person’s ability to make decisions can be lost and then regained. You can request a medical assessment at any time to access decisions making and management capability.
  - If regained, can the adult complete a Durable Power of Attorney and other planning documents?
- If the adult is under conservatorship, it is the role of the conservator to advocate for the adult's re-gained abilities and support their goals and priorities
What’s the adult's current psycho-social abilities and need for appropriate supports and accommodations?
- Consider a holistic assessment. A care manager or aging life care advocate can help assess an adults goals, abilities and priorities and tailor appropriate interventions and supports.
- If the adult is under conservatorship, the conservator can consider petitioning the court to allow payment to bring in a professional care manager or aging life care advocate.

Here’s a sample list of rights that can be retained to limit a conservatorship.

4. What are the alternatives and supports to consider prior to a conservatorship?

Always assess the adult's current abilities and consider what alternatives and supports make be right for the adult. Here are just some of possible alternatives and supports to consider that can help avoid or modify a conservatorship.

Representative Payee for Social Security and SSI Benefits.
- A representative payee is person who can receive Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) for another person who is not capable of managing their own benefits. Read more about the Social Security's Representative Payment Program here.
- Read more about the role and appointment of a Representative Payee, from the Mental Health Legal Advisors Committee, here.
Joint Bank Accounts and ABLE Savings Plan.
- A joint bank account is a shared account between two people. Either person named on the account has equal access to the bank account and can deposit or withdraw funds or use a joint checking account to manage shared bills, and pay for needed care and services. Two typical joint accounts are survivorship accounts and convenience accounts which your local bank can help you set up. Please note that a joint account may have implications for collecting Supplemental Security Income SSI benefits- read more here to see if this applies to you.
- ABLE savings accounts can be set up for the health care and personal expenses of persons with disabilities, without interfering with their access to other benefits. Read more here
Trust
- A trust is a legal arrangement through which a person or an organization, called the trustee, holds assets for another person, called the beneficiary, according to the terms written into the trust document. There are several kinds of trusts, including a Special or Supplemental Needs trust for individuals receiving disability and other benefits. Creating a trust and trust law can be complicated; it is commonly recommended the trust be created by an experienced attorney. Read more about MA Law and Trusts here.
Supported Decision–Making Model
- When first assessing an adult's decisions-making ability, and at ANYTIME during this process, evaluate if a Supported Decision-Making model is right for the adult as an alternative to conservatorship. Supported decision-making allows an adult to make decisions about their own life with the help of one or more support persons, called supporters. The adult chooses their supporters who can offer advice, help adults understand their options and communicate the adult's preferences to others, and assist with financial matters, needed health care, living arrangements ,etc.
  - Read more here.
  - Download a fact sheet here.

Learn more about Alternatives to Conservatorship in Massachusetts, from the Mental Health Legal Advisors Committee, here.

5. If all supports and alternatives have been considered and are not possible, what type of conservatorship is right for an adult?

If a conservatorship is needed, first assess which type of conservatorship will best address the circumstance, maximize an individual’s autonomy and provide needed supports.

Explore the types of conservatorship. Here's a brief summary:

Limited Conservatorship
- In a Limited Conservatorship, the court can appoint a conservator with limited, specific powers only where necessary to protect a person’s assets and property. The adult retains the right to make financial decisions and manage financial matters is all other areas.
Temporary Conservatorship
- In a Temporary Conservatorship, the court can authorize a conservatorship for up to 90 days and grant the conservator limited authority to address an imminent harm or emergency situation.
Plenary or Full Conservatorship
- In a Plenary Conservatorship, the court authorizes the conservator to control most or all of the protected person’s assets and property, preserving any rights for the individual where possible.
Special Conservatorship
- This is a protective arrangement, where the court can authorize a single transaction or narrowly tailored arrangement to protect the individual’s assets or property, where appointing a conservator is not necessary.

5 Things to Know about Conservatorship

Here are some commonly asked questions about conservatorship with links to informational resources. Conservatorship can be a complex legal process with many steps to follow and forms to complete. Below is a partial summary of some of the important information. Consult Massachusetts law or contact a Conservatorship attorney for more complete information. The following is for informational purposes only and not legal advice.

1. What is conservatorship and when is it appropriate to consider?

Conservatorship is a legal process for adults and minors, called protected persons, who have a disability, impairment or an incapacity, and are unable to evaluate information or make or communicate decisions to manage their assets(money), property and business affairs, even with the use of appropriate technical assistance. The Massachusetts court can appoint a Conservator for a protected person in order to-

help manage the protected person's assets and property;
ensure the protected person’s health care and personal services can be contracted and paid for; and,
protect the property and other financial matters from being wasted.

A conservatorship protects the adult’s right to make their own financial decisions as they are able, and limits the conservator's decision making authority to only areas where the adult's ability is impaired.

Conservatorship can be a highly protective intervention but it can be quite restrictive on an adult’s personal liberties. It’s important to assess the adult's decision-making abilities and explore supports and alternatives before considering a conservatorship. For many adults it may be quite possible to avoid or limit a conservatorship with needed supports and accommodations.

2. Who can be a conservator?

Any person or entity interested in the estate, affairs or welfare of an individual may petition the court to become a conservator. Conservators can be family members, friends or professionals, or a corporation nominated by the protected person, or an agent appointed under a Durable Power of Attorney.

An interested individual or entity typically files a petition with the court to be appointed as conservator or seek a protective order for a protected person. There is an order of priority the court will consider to act as conservator Read more here. Section 5-409a.

After a court hearing to determine the basis for an appointment or other protective order, the court can appoint a conservator and specify the conservator’s authority and duties in a court decree or order.

Before becoming a conservator it’s important to consider the type of conservatorship that best fits the circumstances and is least restrictive for the protected person.

3. What are the types of conservatorship or protective arrangements to consider?

If alternatives and supports have been considered and are not possible, and conservatorship is needed, assess which type of conservatorship best addresses the circumstances, maximizes an individual’s autonomy, and protects a person’s assets and property. Here are the types of conservatorships the court can consider.

Limited Conservatorship.
- In a Limited Conservatorship, the court can appoint a conservator with limited, specific powers only where necessary to protect a person’s assets and property. The person retains the right to make financial decisions and manage financial matters is all other areas.
Temporary Conservatorship.
- In a Temporary Conservatorship, the court can authorize a conservatorship for up to 90 days and grant the conservator limited authority to address an imminent harm or emergency situation.
Plenary or Full Conservatorship.
- In a Plenary Conservatorship, the court authorizes the conservator to control most or all of the protected person’s assets and property, preserving any rights for the individual where possible.
Special Conservatorship
- This is a protective arrangement, where the court can authorize a single transaction or narrowly tailor arrangement to protect the individual’s assets or property, where appointing a conservator is not necessary.

Resources

Here are some resources to help adults, families, medical and legal professionals, health care agents, supportive persons, guardians and conservators. Working together, we can protect the rights of all adults and ensure each individual gets the best possible medical treatment and needed services throughout their lifetime.

Everyone can start by making a plan to know and honor an individual's care goals and preferences.

Honoring Choices Massachusetts- Multilingual Planning Documents: Download and print no cost documents, information and tools to make a personal care plan. Your care plan can include the 5 Massachusetts planning documents:
- Health Care Proxy- appoint a trusted person, called a Health Care Agent, to make health care decisions on your behalf.
- Personal Directive (Living Will) - every adult should be given health information in a way they can understand, and express and document their care preferences.
- Durable Power of Attorney- appoint a trusted person, called an attorney in fact, to make decisions about money, property and financial matters on your behalf.
- MOLST- Medical Orders for Life Sustaining Treatment informational fact sheet and sample form for adults with serious illness or advancing frailty.
Resources webpage- free downloaded fact sheets, tool kits and conversations guides, for consumers and professionals.

Consider a Holistic Assessment for Appropriate Care

National Aging Life Care Association, New England Chapter.
- Locate a certified care manager or life care advocate for help with a holistic assessment and navigating appropriate interventions and resources.

Guardianship Information

Conservatorship Information

General information Mass. General Law c. 190, Article V of the MA Uniform Probate Code here.
Conservatorship and links to the forms

Guardian Support and Training

The Massachusetts Guardianship Association (MGA)
- Provides information & resources for adults, families and professionals; sponsors educational events and supports public policy.
The Center for Guardianship Excellence
- Networking and training for family and professional guardians;
- Monthly support groups for guardians to make connections and offer insights into challenging cases;
- Offers live and on-demand training
The National Guardianship Association (NGA)
- Become a member;
- Offers resources to support guardians and people in their care;
- NGA has approved Standards of Practice and Ethical Principles;
- New: Bill of Rights for Persons with Guardians.

We welcome your feedback!

Adults who are subject to or under guardianship face a complex process that has become increasing difficult to navigate. Highly collaborative solutions and new pathways are needed. Let us know what would help improve this process. Please share a comment below or lend you expertise and lived experience to our Guardianship workgroup. We'd welcome hearing from you.