Different types of decisions

There are many kinds of decisions that adults must make.

Think about how your child might be able to manage these types of decisions.


image of a woman thinking and five thought bubbes: education, health care, insurance, housing, managing money.

Once a child turns 18, parents will not be able to do the following: (image of four rectangles with text in each) Money: manage bank accounts, authorize a credit card. Healthcare: see their medical records, make decisions about medical care and treatment, give permission for procedures, even in emergencies, talk with insurance companies about their coverage. Education: decide on their special education services (sign the IEP), decide if they stay in school until 22. Housing: decide where their child will live, decide who their child will live with, apply for section 8 housing or other benefits, sign a lease.

People with disabilities often need help making these decisions in order to protect themselves from harm, and get the most out of life.

  • There is a range of options in Massachusetts to help support your child's decision-making once they turn 18.

  • There are ways to get permission to make some of these decisions for your child, but let them make others themselves.

  • We'll go through the options with you!

Click the box below to learn more about the decisions:

Before you start this process, take some time to assess your family member's specific needs:

  • Review the list below. It is adapted from Barbara Jackins' book Legal Planning for Special Needs in Massachusetts.

  • For each area, think and talk about how well your family member can do these things on their own.

  • Involve your family member if possible.

Graphic of parent who wonders, 'Can my family member do these things?'


  • Seek medical care when they are sick or injured

  • Weigh the risks and benefits of medical procedures

  • Understand the need for routine medical care

  • Understand that they may still need a medical procedure, even if it is painful or unpleasant

  • Assess whether taking a certain medicine is important, even though it may have unpleasant side effects

  • Provide accurate information about their medical condition

  • Follow medical advice and treatment plans


  • Understand their learning issues

  • Understand the services they need at school

  • Advocate to get the services they need at school


  • Count money

  • Make change

  • Keep their money safe so it's not lost or stolen

  • Keep a monthly spending budget

  • Pay for expenses

Vocational / adult services

  • Apply for services from government agencies [for example: the Department of Disability Services (DDS), Department of Mental Health (DMH), Massachusetts Rehab Commission (MRC)]

  • Access the services they need, like job training, job support, or day programs

  • Advocate for themselves to get the best possible services

Living arrangements

  • Take care of themselves, physically

  • Buy food, clothing, and shelter

  • Live in a group setting and respect others' needs for quiet, privacy, and cleanliness

Legal and decision-making

  • Understand what it means to sign documents

  • Make sound decisions in important life areas like housing, school, and work

Self-care and safety

  • Use basic safety skills: staying away from dangerous areas, locking doors, not talking to strangers, being careful around fires, stoves, candles, etc

  • Get help during emergencies like fires or accidents


  • Communicate effectively (verbally or by other means)

  • Understand that they have choices

  • Express their preferences

Source: Jackins (2010)