How to get help for an adult who can't manage alone.

If an adult becomes unable to handle day-to-day financial or medical affairs affairs, someone else must step in to take care of things. If the incapacitated person planned ahead and signed durable powers of attorney for finances and health care, the person named in those documents can take charge.

However, if no planning has been done -- a common situation -- then family members must ask a court to appoint a conservator or guardian. This person will have the court-ordered authority and responsibility to manage the incapacitated person's affairs.

If a court appoints someone to take care of financial matters, that person is usually called a "conservator of the estate," while a person in charge of medical and personal decisions is a "conservator of the person." An incapacitated person may need just one type of representative, or both. The same person can be appointed to take both jobs. Both types of conservators are supervised by and held accountable to a court.

Generally, conservatorships are established for people who are in comas, suffer from advanced Alzheimer's disease, or have other serious illnesses or injuries.

Pros and Cons of a Conservatorship

Conservatorships are time-consuming and expensive; they often require court hearings and the ongoing assistance of a lawyer. The paperwork can also be a hassle, because the conservator must keep detailed records and file court papers on a regular basis.

All court proceedings and documents are a matter of public record, which can be an unwelcome intrusion for someone who values independence and privacy.

Conservators are subject to court supervision, which provides a powerful safeguard for an incapacitated adult's property. To prevent conservators from mismanaging the property or otherwise taking advantage of the people they are helping, most courts require conservators to provide periodic reports detailing their actions. Many courts also require the conservator to seek permission before making major decisions, such as selling real estate (for a financial conservator) or terminating life-support (for a conservator in charge of health care decisions).

In addition, a financial conservator must often post a bond (a kind of insurance policy that protects the conservatee's estate from mishandling). The bond premiums are paid from the conservatee's assets -- and are an unnecessary expense if the conservator is competent and trustworthy.

Occasionally, however, a conservator will mismanage a conservatee's assets or make poor choices about the conservatee's health care. Although each state has rules and procedures designed to prevent such abuses, few have the resources to keep an eye on conservators and follow through if they spot trouble. Many cases of incompetence or mistreatment go unnoticed.

The Court Process

Anyone -- including the proposed conservatee, family members, and friends -- may object to the conservatorship in general, or to the specific choice of conservator. Someone who wants to block a conservatorship must file papers with the court, inform all interested parties (the proposed conservatee, family members, and possibly close friends), and attend a legal hearing.

When someone begins a conservatorship proceeding, a judge must hear evidence on the person's mental capacity. If the judge concludes that a conservator is necessary, he or she will appoint one -- commonly, the spouse or adult child.

It's rare, but sometimes several family members or friends may vie for the job. If that happens, the judge follows preferences established by state law. Most states give preference to the conservatee's spouse, registered domestic partner, adult children, adult siblings, or other blood relatives. But a judge who thinks someone else is best for the job may pick that person.