In 2021, pop star Britney Spears’ effort to end a court-ordered conservatorship drew widespread attention to a system rarely discussed. While her case was unusual, the questions it highlighted were not. Guardianships and conservatorships are legal arrangements that determine how courts balance protection with individual rights. They affect hundreds of thousands of adults across the United States, most of whom are living with health conditions, disabilities, or injuries that limit decision-making capacity.
As the U.S. population ages, the number of guardianship cases is expected to grow. Between 2020 and 2060, the number of adults aged 65 and older is projected to increase by nearly 70 percent. This demographic shift will place additional pressure on courts, families, and policymakers to ensure that guardianships are used appropriately and monitored effectively.
Guardianships and conservatorships are court-ordered arrangements that transfer certain decision-making powers to a designated individual. While states differ in their terminology and scope, generally:
Guardianship covers personal decisions, such as housing, medical treatment, or daily care.
Conservatorship covers financial decisions, such as managing accounts, paying bills, or overseeing investments
Some states use the terms interchangeably, while others distinguish between them. In practice, a single case may involve both roles.
Courts most often appoint guardians or conservators when an adult is found unable to manage their own affairs because of:
Dementia, Alzheimer’s disease, or other degenerative illnesses.
Intellectual or developmental disabilities.
Psychiatric conditions that impair judgment.
Traumatic brain injury, stroke, or other serious injuries.
In rare cases, severe substance use disorders.
Because guardianship can remove fundamental rights, courts are generally required to consider less restrictive options first. These may include powers of attorney, advance directives, estate planning tools, or supported decision-making agreements, which allow individuals to retain decision-making authority while receiving support.
When guardianship is ordered, it can vary in scope (e.g., full guardianship, covering nearly all decisions, or limited guardianship, covering only specific areas) and duration (e.g., temporary for emergencies, or long-term, which lasts until the court ends it). These distinctions are intended to tailor the intervention to the individual’s circumstances while preserving as much independence as possible.
Many people first hear the word "guardianship" in the context of child protection cases, where a court appoints an adult to care for a child whose parents are unable or unwilling to do so. This is minor guardianship. Adult guardianship is different. It applies to people aged 18 or older who a court finds unable to manage some or all personal, financial, or medical affairs. While minor guardianships often aim to provide a stable environment until a child reaches adulthood, adult guardianships can last for years, or even a lifetime, and can significantly limit a person’s rights.
Guardianship is one of the most far-reaching legal interventions in the civil system. Depending on the scope of the order, it can remove rights such as voting, signing contracts, marrying, or making medical decisions.
Because of this impact, courts are expected to consider less restrictive alternatives, as listed above, before granting guardianship. They are also expected to tailor orders as narrowly as possible and to oversee guardianship cases once they are in place.
Research has documented challenges with these safeguards. Some conditions are temporary or variable, yet guardianships can last for years. Oversight practices vary widely across states and courts. Conflicts of interest can arise when family members are appointed. These concerns underscore the importance of reliable data to evaluate how the system is functioning.
Despite the seriousness of these cases, most courts cannot report how many adults are under guardianship, who their guardians are, how long the cases last, or how they are reviewed.
Available information is often limited to new case filings, leaving fundamental questions unanswered about representation, outcomes, and oversight.
Key questions remain unanswered:
How many adults are under guardianship in the United States?
Who initiates guardianships, and in what settings?
How often do individuals have legal representation?
What proportion of cases involve full versus limited orders?
How long do guardianships last, and how are they ended?
How frequently are guardianships reviewed, modified, or terminated?
The American Bar Association and other experts have identified data collection as a priority for reform. Without better data, courts and policymakers cannot assess whether guardianship is being used appropriately or whether existing oversight practices are effective.
To help fill this gap, the Legal Services Corporation launched the Adult Guardianship Research Project as part of its Civil Court Data Initiative. This project will:
Track guardianship case filings and decisions.
Provide information on who is placed under guardianship and who serves as guardians.
Examine representation rates and case decisions.
Share findings through briefs and reports.
By collecting and analyzing new data, the project will provide a stronger evidence base to understand how guardianship operates nationwide and its impact on the people involved.
The Legal Services Corporation has launched the Adult Guardianship Research Project through its Civil Court Data Initiative, with support from the Administration for Community Living at HHS and other funders. This project tracks filings and decisions over time, examines representation and outcomes, and shares findings through briefs like this one.