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Guardianship can be appropriate in a number of circumstances.

If the person hasn't designated POA to someone. If the person hasn't signed an Advanced Healthcare Directive. Or if the person has designated someone to just one of these positions but not the other.

Guardianship might also be appropriate if the person has dementia and can't make decisions on their own.

If the person has dementia and refuses to go into a nursing home. If the person is very ill and refuses to go into a nursing home.

If there is no POA and the person is being taken advantage of by a friend or family member.

There are many circumstances in which a person might need a guardian.
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Guardianship is appropriate when, for example, mom wants to move back to her house, convinced that she will be happier and safer there. When she hates living in a facility and claims you put her away, that is when you start the petition. The head nurse and the court evaluator will be on your side.
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Guardianship was recommended to me for my brother in light of my having POA and his ability to make decisions- where diminished capacity cannot be denied even intermittently, and there is no Estate to speak of a POA was suffice. Sometimes it is a tool to request a family etc. to obtain Guardianship while a care center or facility can encourage a senior to authorize something as an open loophole with an incentive to a party requesting it. i.e. case manager wants his/her favorite Hospice or Physical Therapist to get the referral to care for senior versus individual or family preference.
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