Supported Decision Making: Alternatives to Guardianship

Formal and informal sources of support to understand choices and make decisions without the need for guardianship.

Medical, Legal, Financial, Life puzzle pieces held up by three stick people.

Supported decision-making refers to ways of helping individuals of any age or ability understand information and make decisions that affect important areas of their life, such as legal, financial, medical, housing, education, and relationships.

It’s not a one-size-fits-all process, but a self-determined approach to helping people understand their choices and have their voice heard and respected.

Supported decision-making offers effective alternatives to guardianship without removing an individual’s right to vote, marry, and make important life decisions (including the ability to make and learn from mistakes).

“The decision process is part of being whole… If I try to force Ryan to do something, I am destroying his selfness and being whole. He is a whole person and he is making decisions and I encourage him.” –Herbert King


  • Understand information, issues, and choices;
  • Focus attention in decision-making;
  • Weigh options;
  • Ensure that decisions are based on their own preferences; Interpret and/or communicate decisions to other parties.

(Salzman, 2011)

Supported Decision-Making Options

Representative Payee

Assigned to manage Social Security benefits, such as SSI. A payee makes sure that financial benefits are used to pay for living expenses.

Power of Attorney (aka Attorney in Fact)

Appointed by the person to have medical and/or financial authority to make decisions and act on behalf of the individual.

Special Needs Trust

A pooled special needs trust manages the person’s financial assets without risking the loss of benefits that have resource limits. It’s a way to protect the person’s money and ensure that it benefits only the individual with the disability.

Informed Consent

If a person over age 18 does not have the mental capacity to understand choices and make medical decisions, Washington State law provides a way for the following individuals to make health care decisions on his or her behalf in the following order: a guardian; an individual to whom the person has given a durable power of attorney, including the authority to decide health care issues; spouse; adult children (over age 18); parents; adult brothers and sisters.

Learn More

Alternatives to Guardianship (Informing Families)

Disability Rights Washington

Missouri Family to Family: Partnering Together in Supported Decision Making

National Resource Center for Supported Decision-Making

Stories of Supported Decision-Making


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  • Informing Families is a partnership for better communication, provided by the Washington State Developmental Disabilities Council in collaboration with the Washington State Developmental Disabilities Administration and other partners throughout the state.