Guidelines for Guardians of Adults with Intellectual Disabilities

Categories: ASD and DD, Adult-focused

By Margaret Walsh, M.A., BCBA                                                                                                                                                                 

[This column was published in the West Springfield Republican on January 20, 2022.]

Being a guardian for an adult with Intellectual Disabilities (ID) is an important and dynamic role. When a guardian is appointed to support someone, their most important responsibility is to ensure they understand and can communicate the needs and desires of the individual to the best of their ability. 

Massachusetts requires that adults who receive services from the Department of Developmental Services (DDS) have support plans that are person-centered. A guardian needs to ensure that the supported individual is at the center of the decision-making process and is the most important member of the team of people providing services and care.

A guardian will work with the individual and the supporting team by providing an objective and fair perspective about the needs and desires of the individual as they arise. A guardian’s authority to make decisions for a person can be limited and depends upon the individual’s needs and ability to make decisions.

Courts in Massachusetts recognize two different kinds of guardianships: 1) A plenary guardianship that is established because the person cannot make any decisions themselves. 2) A limited guardianship that gives a guardian the authority to make decisions in very specific areas where the person who needs support struggles to make sound decisions. For example, the individual may be able to make good decisions about money but might struggle to make decisions about medical care. Everyone providing support to the individual should know what decisions the guardian can and cannot make. It is also important that the team advocates for the individual to make decisions for themselves when appropriate. 

In some cases, teams should work with individuals to help them regain their own autonomy and petition the court for a less restrictive means of providing support that makes sense to the individual. Even if someone will always need a guardian, those providing support should encourage the person to make choices and should teach him or her the necessary skills to lead a life that is meaningful and fulfilling. 

Guardians are required to communicate to the court on an ongoing basis and provide the court with any necessary documentation. They must file an Initial Care Plan Report 60 days after being appointed guardian, and an Annual Care Plan Report every year after the appointment until the guardianship ends. Both plans are similar and include the following details:

  • the health status of the individual,

  • what services they have or need,

  • their current living situation,

  • plans for future care,

  • any abuse allegations,

  • when the guardian visited the individual, and

  • if the guardianship is still needed.

Failure to provide to this document on time can result in a hearing where the guardian is required to be interviewed by the court.

In addition to filing these reports, the guardian must keep the court informed of other changes. For example, if the guardian or the person being supported moves, the guardian must make sure the court has current addresses. If the individual passes away, the guardian must file a death certificate with the court. If a person no longer needs a guardian because they are no longer incapacitated, the guardian must file a petition with a medical certificate that states that the person is no longer incapacitated. Guardians must let the court know when they are resigning from their position as guardian. All forms required for filing are available at each division or on the Probate and Family Court website.

Being a guardian can be a challenging job. Helping adults with ID and their teams make informed decisions requires an understanding of complex issues and the ability to advocate for the individual’s best interests. Guardians are not just the people who sign off on documents and attend meetings. They are committed and caring people who help the individuals they serve have a strong voice in determining how they will reach their highest potential and live their best lives.

Margaret Walsh, M.A., BCBA, is the Director of Clinical Services for the May Center for Adults Services in Western Massachusetts. She can be contacted in West Springfield at 413-734-0300 (ext. 262) or at

May Institute is a nonprofit organization that is a national leader in the field of applied behavior analysis, serving individuals with autism spectrum disorder and other developmental disabilities, brain injury and neurobehavioral disorders, and other special needs. Founded more than 65 years ago, we provide a wide range of exceptional educational and rehabilitative services across the lifespan. For more information, call 800.778.7601 or visit