When planning how legal decisions and other important choices will be made in the future, the goal is to support the person with IDD’s voice using the least restrictive option that still meets safety needs. Many people use a mix of approaches over time.
Supported Decision-Making (SDM)
Supported Decision-Making helps the person make decisions with support (trusted people, plain-language information, visuals, extra time) while keeping their legal rights. Learn more about Supported Decision-Making here.
Information sharing and powers of attorney
Depending on the person’s wishes and needs, families may consider:
- HIPAA releases (so providers can share information with named supporters)
- Health care power of attorney (support with medical decisions)
- Financial power of attorney (support with finances; use carefully and transparently)
Representative payee
A representative payee can help manage Social Security benefits to make sure basic needs are paid for. This is not the same as guardianship. Learn more about SSA’s Representative Payment Program here.
Guardianship or conservatorship
Guardianship can provide legal authority in high-risk situations, but it can also reduce autonomy. If considered, many families explore:
- Alternatives first (including SDM)
- Limited/partial options when appropriate
- Regular review to ensure it remains necessary and proportional
Advance directives (when appropriate)
If the person can express preferences about medical care, advance directives may document values and choices using accessible supports.
