Guardianship and Its Alternatives: What Families Should Know First

Start with the question, not the answer

When a child with a disability approaches 18, families are often told — by a school, a doctor, sometimes another parent — that they “need to get guardianship.” Sometimes that is true. Often it is not, and there are less restrictive options that protect a young adult while leaving their rights intact. The right question is not “how do I get guardianship?” but “what decisions does my adult child need help with, and what is the least restrictive way to provide that help?”

What guardianship actually is

Guardianship is a court order that transfers some or all of an adult’s legal decision-making rights to another person. A plenary (full) guardianship removes nearly all of those rights — where to live, medical care, money, contracts. A limited guardianship covers only the specific areas the court finds the person cannot manage. Because it removes rights, courts are supposed to treat it as a last resort and to prefer limited over full guardianship whenever possible.

What the process generally looks like

The details vary by state, and this is not legal advice — but the shape is usually similar:

1. A petition is filed with the court, usually by a parent.
2. An evaluation from a doctor or psychologist describes the person’s abilities and needs.
3. The person is notified and is entitled to be at the hearing, and to their own lawyer. In Pennsylvania the court must appoint one for them, and the family does not pay for it.
4. A judge decides whether guardianship is warranted, and how broad it should be (limited or full).
5. The guardian reports back to the court on an ongoing basis.

In Pennsylvania this happens in the Orphans’ Court division of the county Court of Common Pleas. Many families work with an attorney; some counties have lower-cost legal clinics.

When it can genuinely be needed

Guardianship exists for situations where a person cannot understand or communicate decisions about their own safety, health, or finances even with support — and where informal help and the alternatives below are not enough to keep them safe. A significant medical decision that the person cannot weigh, or serious financial exploitation, are the kinds of situations where families and courts land on it.

Alternatives to consider first

• Supported decision-making (SDM). The adult chooses trusted supporters who help them understand options and communicate choices — the adult still decides. Some states recognize written SDM agreements; Pennsylvania families use them informally and with providers.
• Powers of attorney. A health care power of attorney and a financial power of attorney let the adult name someone to act for them, without a court and without losing rights. The adult must understand what they are signing.
• Health care proxy / advance directive for medical decisions specifically.
• Representative payee. If the adult receives Social Security (SSI/SSDI), a payee can manage those benefits — no court involved.
• Special needs trust and ABLE account. Ways to hold money for the adult without affecting benefit eligibility, and without guardianship.
• Releases and shared access. Signed releases with doctors, the school, or the county let family stay in the loop.

What it costs, and who pays

Cost is the part that stops many families, so here is how it breaks down in Pennsylvania. Amounts vary by county and by lawyer.

• The adult’s own lawyer: not the family’s cost. Since Act 61 took effect in June 2024, the court must appoint a lawyer for the adult the petition is about, whether or not they can pay. That lawyer represents the adult’s own wishes. The fees are paid from the adult’s funds or by the county.
• The petitioner’s lawyer: the main expense. The person asking to be guardian usually pays their own lawyer. Ask about limited-scope help, where a lawyer reviews your paperwork or coaches you through one step instead of handling the whole case. It costs much less than full representation.
• Court filing fees: can be waived. A Petition to Proceed In Forma Pauperis asks the court to waive fees and costs when you cannot afford them. The Clerk of the Orphans’ Court in your county has the form.
• The doctor’s evaluation. Written evidence from a doctor or psychologist is required. Start with the adult’s own doctor or treatment team. If the court wants an independent evaluation and the adult cannot afford it, the judge can allow it to be paid from public funds.
• After appointment. Guardians file reports with the court every year. A guardian can ask the court to approve reasonable pay for their time from the adult’s own money, which only helps when the adult has income or savings beyond their basic needs.

Someone ready to be guardian, but can’t afford a lawyer? Read Guardianship When Money Is Tight for how to ask for the fee waiver, free and low-cost legal help, and filing without a lawyer.

Find help in your county

Choose your county to see where guardianship petitions are filed, the free legal aid program that serves it, lawyer referral, and the county MH/IDD office.

Questions to bring to a lawyer or advocate

• Which specific decisions is my adult child unable to make, even with support?
• Would a limited guardianship or an alternative cover those?
• What does the process cost here, and is there a legal clinic?
• How can it be changed later if my child’s abilities grow?

This guide is general information, not legal advice. Laws and procedures differ by state and county. The attorneys below are listed in the ND Collab Business Directory and work with families on these decisions.