Public Guardianship

Protecting Maryland's Vulnerable Older Adults

The Maryland Department of Aging Public Guardianship Program serves individuals 65 years of age and older, who have been deemed by a court of law to lack the capacity to make or communicate responsible decisions concerning their daily living needs. The la​​​w authorizes, as a last resort, appointing the Secretary of the State Department of Aging or the Director of a local Area Agency on Aging (AAA) as a "guardian of person" when no other person or organization is willing and appropriate to take on the responsibility. 

Service providers who are interested in initiating a guardianship review should contact MAP or their local AAA.

Prioritizing Autonomy

Before pursuing guardianship, AAA service providers actively explore less restrictive decision-making options. When a Public Guardian is appointed, they are committed to developing tailored plans to meet specific needs of the older adult; prioritizing settings that maximize independence while ensuring safety, and evaluating if a more autonomous arrangement can be restored. 

Surrogate Decision-Making

Under the Maryland Health Care Decisions Act, relatives or close friends may act as surrogates to make critical medical decisions without a formal guardianship. Surrogates can consent to medical procedures or the withholding/withdrawal of life-sustaining treatment in specific circumstances (e.g., terminal illness, end-stage conditions, or a persistent vegetative state). All decisions must be based first on the known wishes of the patient. If those wishes are unclear, the surrogate must act in the patient’s best interest.

For more information, download Public Guardianship for Adults Age 65+ - PDF - 886.87 KB.