What Is a Medical Guardianship?

Medically Reviewed by Nayana Ambardekar, MD on June 04, 2024
5 min read

If you care for an older loved one, you may wonder what to do when your loved one can no longer make their own decisions concerning their health and well-being. A medical guardianship places another person — usually a family member or another person close to the family — in charge of the older loved one’s decisions.

These decisions can be purely medical, but they can also involve real estate, finances, and any other life decisions. What is right for one person may be wrong for another. Learn more about the medical guardianship definition and gain an understanding of when it’s time to get help for your loved one.

Guardianships aren’t just for the elderly. They can apply to people with mental and physical disabilities as well as older adults who need help making life decisions that involve their medical care. 

If you want to learn how to get medical guardianship of an adult loved one, you'll first need to decide whether your loved one needs guardianship and how long it should last. For example, if your loved one is incapacitated after a stroke but is expected to recover, you may need to make medical decisions until they feel better. If they are in a coma and their physicians do not expect them to wake up, you might need to make decisions for them for the rest of their life. 

Sometimes, both permanent and temporary medical guardianships are based on the loved one's poor psychiatric health. Some states restrict the guardian's ability to sign off on mental health treatment for the loved one, while others allow it. Your loved one's physician or psychiatrist will be able to advise you further on this matter. 

While filing for medical guardianship is not as easy as moving into your loved one's home and acting as their physical caregiver, it's a pretty straightforward process. Consider the following steps to take:

  • Decide whether or not you're the best person to act as your loved one's guardian.
  • Hire a lawyer who has experience in this area and can advise you through the process. It's possible to file for guardianship without a lawyer, but if you don't follow the instructions and rules correctly, your case might be overlooked.
  • Locate and fill out the necessary medical guardianship forms to petition for guardianship. These usually include a petition for guardianship, a family court sheet, an information sheet about the loved one you're requesting guardianship of, and a citation to appear in court to request a court date.
  • Ask your loved one's physician to fill out a physician certificate that explains your loved one's condition and their current state of mental and physical health.
  • Serve the forms to the adult you're requesting guardianship of (and anyone else who is involved in the case).

These terms may differ slightly between states, but if someone is talking about a “guardianship,” they usually mean a medical guardianship or the state of being legally responsible for a child. Some states define guardianship and conservatorship differently, so always be sure to ask for clarification between these terms if you need it to understand your loved one's case.

Conservatorships mainly focus on managing another person’s financial affairs. One person may be the conservator for their sibling with a history of traumatic brain injury because the sibling has trouble making financial decisions but can make their own medical decisions without a problem. 

Someone else might be the guardian, but not the conservator, of a niece or nephew who just lost both of their parents. Another person may be both the guardian and conservator of their elderly parent, which gives them the right to make most decisions (those that involve medical, financial, and personal affairs) for their parent.

No. A caregiver can be anyone who takes care of or manages the affairs of an elderly loved one. This person usually performs acts of care such as bathing, cooking, cleaning, sorting mail, and administering medication. A caregiver might also be a guardian, but these two terms refer to two different legal roles.

A caregiver does not have the legal right to make choices for the loved one unless they are also a guardian. A guardianship is a legal term that gives the guardian the legal right of making certain decisions for the loved one.

Pros. The benefits of guardianship are fairly straightforward. The person in the guardianship no longer has the responsibility of managing their medical decisions, and they can rest assured that a trusted family member or friend is taking care of these needs for the rest of their life or while they are incapacitated. 

Cons. Sometimes there isn't a family member or close friend available to become a guardian. In this case, the court appoints a guardian to the elderly person or person with a disability. This can be a neutral situation, but it can often put the court-appointed guardian in a tricky and powerful position where they have to make decisions for someone they don't know. 

The guardianship can take away several rights from the person under it, including making medical decisions, voting, owning firearms, and driving a car. It's important to only use guardianship when necessary and as a last resort when caring for a loved one.

Use empathy and try to understand that, while the guardianship might be in your loved one’s best interest, the fact that they need guardianship at all probably means they’re not in the best state of mind. This can affect how your loved one perceives your words.  

If you're speaking to an aging parent, you might feel at times that you are parenting your elderly loved one, and this can cause resentment on both sides. You also run the risk of misunderstanding each other if your loved one feels pushed into something they don’t want and you feel like you’re only trying to help. While you may assume that you know exactly what your loved one needs, it's important to consider their thoughts and feelings as well, if possible. 

With time, your loved one may see that medical guardianship is in their best interest and that it frees them of the burden of scheduling and medical decision-making for themselves. If your loved one is resistant to the idea, you might consider talking to them with a mental health counselor present. Try to use active listening and work toward a mutual understanding of the situation.