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As his wife, why can't I just make decisions on his behalf if I have a Will, Power of Attorney (for health and financial decisions) plus physicians directive in place? Why would I need guardianship over my own husband?

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I might meet with your attorney and confirm that everything is in order with your existing documents and that the Power of Attorney is DURABLE. So, it stays in place even after incompetency.
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The only reason you would need guardianship is to force a course of action that he is resistant to such as placing him in a facility. It is impossible to predict how he will change over the course of his disease, but I wouldn't try for guardianship except as a last resort, the documents you already have in place as well as his formal diagnosis should be all that you ever need.
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I wouldn't think it's necessary particularly if he is in the early stages. He would have to be incompetent for anyone to be awarded guardianship. If you have medical and financial power of attorney now I don't know why you would need to pursue guardianship even in the future. The only scenerio I can imagine would be if he becomes totally unmanageable for you and has to be forced into a facility. Guardianship nay be needed at that point. But let's hope not. It's a hassle.
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