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Supported Decision Making & Alternatives to Guardianship

For decades, guardianship was considered the best way to support people with intellectual and developmental disabilities (IDD) as they transitioned into adulthood. Under guardianship, a court grants another person the legal authority to make decisions—about healthcare, finances, and daily life—on behalf of someone deemed unable to do so independently. Although designed to protect, this approach can unintentionally limit essential rights—such as choosing where to live, choosing where to work, and making personal or medical decisions. Many families were, and still are, encouraged by trusted people in their lives to pursue guardianship as their loved one turns 18.

While guardianship is appropriate for some, research and lived experience show that loss of autonomy under guardianship can lead to decreased independence and reduced quality of life. Today, it is recognized more and more that most people with IDD can make their own decisions when provided with the right support. Guardianship should be a last resort, used only when less restrictive options cannot meet the person’s needs. (Read The Arc’s position statement on guardianship here.)

The good news is, there are a variety of supportive options that address concerns while also honoring independence.

Alternatives That Preserve Self-Determination & Foster Greater Independence

Modern alternatives to guardianship emphasize providing support rather than replacing decision-making. Here are some widely recognized approaches:

Supported Decision-Making (SDM):

SDM allows individuals to choose trusted supporters—family, friends, or professionals—who help them understand options and communicate decisions. The individual remains the decision-maker, promoting dignity and self-determination. SDM recognizes that everyone needs help making decisions sometimes and that needing support doesn’t mean someone should lose their right to choose. Instead of replacing a person’s decision-making authority, SDM provides tools and relationships that help the person understand options and make informed choices.

Family, friends, professionals, and other identified supporters might:

  • Explain information in plain language
  • Help list pros and cons and weigh options
  • Role-play various scenarios and understand consequences
  • Attend appointments to take notes or clarify options
  • Communicate decisions

Many states now recognize SDM agreements as a legal alternative to guardianship, including Colorado. In 2021, the Colorado legislature passed Senate Bill 21-075, the Supported Decision-Making Agreement for Adults with a Disability, C.R.S. 15-14-801. The statute describes a supported decision-making agreement as the voluntary method of decision-making where an adult with a disability makes decisions by entering into an agreement with friends, family members, professionals, or other people that the adult with a disability trusts to be a part of a supportive community.

For more information on Supported Decision-Making, please visit:

Medical Power of Attorney / Advance Directives:

Medical Durable Power of Attorney (MDPOA) is a legal document that allows a person to name someone they trust to make medical decisions for them if they become unable to do so. It must be completed in advance, while the person still has decision-making capacity. Support can be provided to help the person understand and complete the form. The MDPOA can also include specific instructions about when and how the person wants support with their medical care. Unlike a full guardianship, an MDPOA does not strip away rights—it simply shares decision-making authority when needed. Many free, easy-to-use MDPOA forms are available online. A sample can be found here: Colorado Medical Power of Attorney Form.

More information on advance care planning can be found here: Advance care planning for patients and families | Colorado Department of Public Health and Environment

Financial Supports & Asset Management
  • Representative Payee: For those receiving Social Security or similar benefits, a representative payee can manage benefit payments without broader decision making over other life decisions. The representative payee receives the funds and makes sure bills and basic needs are paid for. Learn more about SSA’s Representative Payment Program here.
  • ABLE Accounts: ABLE Accounts in Colorado help people with disabilities save money for things like housing, education, and healthcare without losing their SSI or Medicaid benefits. These accounts are tax-free. Click here to learn more about Colorado ABLE Accounts.
  • Financial Power of Attorney & Trust Accounts: Individuals can authorize someone to assist with financial matters without losing overall control. This can be tailored to specific needs and timeframes. Special types of trust accounts allow a person with a disability to save money without affecting their benefits. Each trust has its own rules. Make sure to understand how the money can be used and what happens to any remaining funds.
  • Other Financial Supports: A person with IDD can name a trusted co-signer on a bank account or debit card to help manage money day to day.

Why This Matters

Every person can make choices and deserves the right to direct their own life to the greatest extent possible. By exploring alternatives to guardianship, families and professionals can ensure support systems are in place that respect autonomy, foster independence, and uphold civil rights.

“Alternatives to guardianship, including supported decision making, should always be identified and considered whenever possible prior to the commencement of guardianship proceedings.” -National Guardianship Association Position Statement on Guardianship, Surrogate Decision Making and Supported Decision Making, 2015

With the right tools and guidance, teens and young adults with IDD can grow into confident, independent adults—while still having the support they need. You don’t have to do this alone; there are proven strategies to help your loved one thrive and live a self-determined life.

Our advocacy team is here to help you and your loved one explore options and connect you to additional resources if needed. Click here to submit a request for Individual & Family Advocacy.