700 Children's® – A Blog by Pediatric Experts

Balancing Independence and Support for Young Adults

May 31, 2022
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When your child turns 18, they become a legal adult. This means that they are now fully responsible for their medical care decisions, and their doctors and nurses can talk only to them. Their healthcare records (and their myChart access) also become private that that time. This right is protected by the Health Insurance Portability and Accessibility Act (HIPAA)

This may seem like a lot of responsibility for a young adult, especially for teens with developmental disabilities or health care needs. This change can also be stressful for parents and caregivers. It is important to remember that adults still get advice from family and friends when they make important decisions.

Creating a Supportive Team

Before your teen turns 18, start to think about how much help they need making decisions.  Here are some simple steps your teen can take if they would like to have support people in their lives.

  • Sign a Release of Information – This gives another adult, like a parent or support person, access to your teen’s medical information and allows them to come along to appointments.
  • Supported Decision Making – Young adults choose trusted family or friends to be their supporters and help discuss important issues or decisions.
  • Chosen Representative – Young adults can choose someone to make decisions about developmental disabilities (DD) programs if they receive these services.

There are legal ways to make sure young adults have the help they need for important decisions. This process should start about 6 months before your teen’s 18th birthday.

Powers of Attorney

Powers of Attorney (POA) are documents that give another individual the legal ability to make specific kinds of decisions.

  • Financial Power of Attorney - makes decisions about money 
  • Education Power of Attorney - makes decisions about education
  • General Power of Attorney - makes decisions about everyday life, such as where the young adult lives, works or goes to school
  • Healthcare Power of Attorney (Health Care Proxy)- makes decisions about medical care if the young adult cannot make decisions for themselves
    • talk with your young adult about making an Advance Directive or Living Will to share their health care and end of life choices


In some cases, if a young adult cannot make decisions for themselves, they are evaluated by the court and found to be “not competent”. This is a legal term meaning that they are unable to care for themselves. In this case, the court appoints a Guardian to make all of their decisions for them.   

There are also different kinds of guardianship, so that young adults can still make some choices on their own.

  • Limited Guardianship – Guardians can make certain decisions, such as medical, financial or housing decisions.
  • Guardianship of the Person- Guardian makes day-to-day decisions about food, clothes, education, or a place to live or a work, but do not make decisions about money.
  • Guardianship of the Estate - Guardian makes decisions related to money.
  • Emergency Guardian – Guardian makes decisions only in emergencies, usually starting with a 72-hour period.

Getting “Ready to Adult”

Talk with your teen to decide what amount of decision-making independence is right for them. Working with your medical team, the social workers and legal services will make sure your young adult has the support they need when they turn 18.  

Resources in Ohio to help guide your decisions about the kind of decision-making support that works best for your young adult and family include the following:

Residents in other states can refer to their state government’s website for direction.

Featured Expert

Nationwide Children's Hospital Medical Professional
Jaime-Dawn Twanow, MD

Jaime Twanow, MD is an attending pediatric neurologist at Nationwide Children’s Hospital and an assistant professor of Clinical Pediatrics and Neurology at The Ohio State University College of Medicine.

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Pediatric News You Can Use From America’s Largest Pediatric Hospital and Research Center

700 Children’s® features the most current pediatric health care information and research from our pediatric experts – physicians and specialists who have seen it all. Many of them are parents and bring a special understanding to what our patients and families experience. If you have a child – or care for a child – 700 Children’s was created especially for you.