Once you turn 18, the law says you can make your own choices. If you would like or need help making decisions after 18, this fact sheet talks about some possibilities besides guardianship.
Supported decision-making (SDM) lets adults with disabilities make their own decisions with the help of people they trust. We all use SDM, whether it is asking a parent for financial advice or a coworker to suggest a repair shop. All types of people use SDM, including individuals with learning disabilities, intellectual disabilities, or mental illness. SDM is also becoming popular with older adults. Unlike other alternatives to guardianship, the decision is always yours. You can make a choice if it doesn’t hurt anyone. You can also ask for help or say “no” any time. Utah finally put SDM into law this year.
A person does not have to use SDM if it hasn’t or won’t work for them. However, studies show a person using SDM is more independent and is less likely to experience abuse. The American Bar Association offers an online toolkit for SDM. Even though the toolkit is designed for lawyers, it can help you, your family, and friends begin to talk about the kinds of decisions you can make for yourself, the times you might want some help, and areas you may feel comfortable leaving to others. To learn even more, visit supporteddecisionmaking.org and supporteddecisions.org.
A power of attorney is a legal document where you give someone you trust the right to make a choice or decisions for you. For example, you can give them the right to make medical or financial decisions. Something to keep in mind when considering a power of attorney is that you don’t have to go to court to make one. However, while a judge can enforce it, they can’t make sure it’s followed all the time.
Health Information Portability and Accountability Act: Through HIPAA, you can give your doctor permission to share information with whomever you’d like, including your family or friends.
Medical Power of Attorney: A family member or friend can make some or all your medical decisions if you create a medical power of attorney.
An Advance Directive tells your doctor and others what to do or who you want to make decisions for you if you can’t. You can change or end it whenever you want.
Beginning in 2026, an advance directive will include a specific section for you to share your wishes around mental health treatment. It allows you to make your own decisions, unless a trained professional or judge decides you can’t. Even then, someone else should follow your instructions or do their best to make the same choice you would, unless it could mean serious harm or death. There’s also something similar called a Declaration for Mental Health Treatment. The declaration can be used if you’re in crisis and can’t express your wishes. However, it only applies to psychoactive medication, electroconvulsive therapy, or a hospital stay of 17 or fewer days.
If you can’t make your own decisions and you don’t have an advance directive or medical power of attorney, certain family members can make those decisions for you, including a spouse, adult child, parent, or adult sibling. Since you are the patient, the doctor must tell you the risks and benefits of a treatment, other available treatments, and what happens if there is no treatment. If you’re unable to decide, a person with legal authority or a close relative can make healthcare decisions.
Financial Decisions: To better manage your money, you can use direct deposit and automatic bill pay. If you want someone to help you, you can open a joint account, create a financial power of attorney, or establish a special needs trust.
Education Decisions: You can invite anyone you want to be part of your Individualized Education Program (IEP) team. You can also create a power of attorney for education, if you’d like someone to make some decisions for you.
Housing: For help choosing where and/or with whom to live, talk about your desires and options/choices with your circle of support, an independent living center, or your case manager/support coordinator. Don’t forget to ask how you can get help with rent or applying for Public Housing Assistance.
Socialization: You can learn about social skills, safety awareness, and healthy relationships with others through self-advocate groups, independent living centers, or community support groups, etc. This can include information on romantic relationships.
Case Management Plan: Learning more about or taking steps to use one or more of these tools can be a goal in your person-centered support plan (PCSP). You have the right to invite people to the meeting who will support you in advocating for the services you need to be independent. You can also write new choices into your PCSP.
Getting Help: While it’s possible for you, your family, or others to do many of the things in this factsheet on your own, it’s a good idea to check with an attorney to make sure they’re done correctly. You can find one by looking for “Guardianship and Conservatorship” under “Estate Planning” at licensedlawyer.org. The Utah State Bar’s Modest Means program may also be able to help if you don’t have much money.