When OT Meets the Courtroom

Guardianship’s Missing Link? It Might Just Be Us.

Occupational therapists don’t often show up in conversations about guardianship. But we should.

In 2013, the American Bar Association published an article titled Still a Best-Kept Secret in Adult Guardianship: Using the Skills of Occupational Therapists, and more than a decade later, its message is still ahead of its time. The piece outlines exactly how OTs bring value to decision-making assessments, court processes, and person-centered guardianship. It names roles we’re capable of such as visitor, expert witness, capacity evaluator, support to families and public programs and tools we already use daily, like environmental modifications, functional assessments, and collaborative planning.

What struck me most about the article? I’ve done all of these things.

I’ve assessed functional cognition to advise on capacity before a guardianship filing. I’ve served as a guardian in a nonprofit guardianship program. I’ve testified as an expert witness to protect dignity, clarify cognitive function, and guide courts toward decisions that balance oversight with autonomy. This isn’t hypothetical: it’s what occupational therapy looks like at its most essential.

Here’s what that looks like in real life:

• Temporary Guardianship to Restore Autonomy

  A woman under full guardianship wanted to regain her rights. Rather than default to a permanent order, we worked with her and the court to implement a temporary guardianship in a effort to eventually restore her rights in a gentle and proactive way. I provided a functional assessment, created a care plan with supports, and laid out practical ways to rebuild independence over time. It gave her the safeguards she needed without closing the door to future independence.

• Financial Exploitation & Expert Testimony

  An older adult had been gifting large sums to a caregiver, who was using the money for homes, vacations, and luxury goods. The family suspected exploitation. I conducted functional cognitive testing and real-world money management tasks, which revealed impaired executive functioning and poor judgment. My expert testimony supported the appointment of a guardian of the older adult and his estate, ensuring the elder’s protection going forward.

• Dispute Involving an Adult Son with a Brain Injury

  In a case involving an adult son with a brain injury, both parents were co-guardians. As they aged, the mother wished to relocate closer to her daughter, who was the intended future guardian. The father opposed the move, citing his son’s intensive needs. I conducted an in-depth functional evaluation, clinical chart review, outlined environmental and caregiver needs, and testified in court. My care plan gave the court confidence in supporting the mother’s petition, ensuring continuity, safety, and a sustainable plan for future guardianship.

At Continuum Care Strategies, we believe the best guardianship outcomes happen when clinical insight, ethical reflection, and systems-level strategy come together. That’s what OTs do best.

If you’ve never considered how occupational therapy fits into the world of adult guardianship, this article is a powerful place to start. Read about it here:

⚖️ 🔗 Still a Best-Kept Secret in Adult Guardianship: Using the Skills of Occupational Therapists

It’s time for the secret to be out.