Even when someone has a guardian to make decisions for them, their preferences are still important and they should still participate in decision making, to the extent of their ability.

A guardian must follow an adult ward's current preferences when making decisions, to the extent possible. This means that the guardian must follow the ward's current wishes if the decision: 

• Does not cause substantial harm, and
• Is consistent enough with what the ward would have wanted under the circumstances, if they were competent.

The guardian may use evidence of what the person would choose. For example, the person's:

• Previously expressed preferences,
• Personal beliefs,
• Philosophical beliefs,
• Religious and moral beliefs, and
• Ethical values.

In some cases, the guardian doesn't have information or evidence about the ward's wishes and cannot reasonably determine what the ward would want. In other cases, what the ward wants would cause substantial harm. In such cases, the guardian should make a decision based on the ward's best interests. The guardian determines the best interests by considering:

• The reason and nature of the decision or action at issue,
• The benefit or necessity of the decision or action,
• The risks and consequences, and
• Any alternatives and their risks, consequences, and benefits.

The guardian should consider any available information the guardian believes the ward would want to use to make a decision, like the views of family or friends.

[no-lexicon]Guardianship[/no-lexicon] of the person

This means that the guardian makes decisions for the person's care and day-to-day needs. This includes decisions about their:

• Medical treatment,
• Living arrangement,
• Education, and
• Services from lawyers or accountants.

Guardianship of the [no-lexicon]estate[/no-lexicon]

This means that the guardian makes decisions about the person's money and property. The guardian must use the estate for the comfort, support, and education of the person and their dependents. A guardian of the estate must manage the estate frugally.

Representative Payeeship

This lets the Social Security Administration choose a payee to handle a person with a disability's:

• Social Security payments, and
• Supplemental Security income.

There are rules for how a payee must use the benefits. A payee must use the benefits for the best interests of the person. A payee must use their best judgment.

In spending the money, first use the benefits to meet current day-to-day needs for food and shelter. Then, the benefits can be used to cover medical and dental care and personal needs, like clothing and recreation. After all needs are met, all leftover money should be saved. For further guidance, including guidance for when someone is in nursing home care, you can consult A Guide for Representative Payees.

Visit the SSA's website for more information.