If dementia comes, who decides for me? Guardianship orders and a financial safety net for later life

When the dispute over the Ma Ying-jeou Foundation and a family petition for an assistantship order made the news, many people realised for the first time that relatives can indeed ask a court for such an order once an elder begins to show cognitive decline.

That raises an uncomfortable question. If one day I grow old, fall ill, develop dementia — who decides my life for me? And how do I make sure the assets of a lifetime do not end up with fraudsters?

This episode of Sick Needs Money welcomes lawyer Cheng Chia-hsin, legal adviser to the Taiwan Alzheimer's Disease Association. A former prosecutor, she moved into dementia rights and legislative work after her mother was diagnosed. Drawing on caring for her mother and years of casework, she unpacks the legal and financial tools every older adult and caregiver should understand.

1. The quiet warning signs

'You open the fridge and find three chickens frozen solid under frost; watches and keys always turn up in the fridge; the rice cooker runs dry with no water in it.' Cheng recalls the string of confused behaviours her mother began to show.

No one recognised it at the time. Family medicine and endocrinology found nothing, until the association helped them reach a neurology diagnosis. In the cognitive screening test, her mother — who had worked with numbers all her life at the tax office — managed '100 minus 7', then fell into a long silence at the next subtraction.

Cheng notes that care and living costs for an elder with dementia average NT$60,000 to NT$100,000 a month. Alongside medical care, she moved immediately to build a social and family safety net:

• Fingerprint registration: registering her mother's fingerprints at the police station in case she went missing.
• A friendly neighbourhood: leaving NT$5,000 at the nearby convenience store and supermarket and speaking to the managers, agreeing that if her mother forgot to pay they should simply deduct it rather than report a theft.
• Consolidated, capped finances: entrusting the bank cards, title deeds and seals to a trusted family member, while leaving her mother one card with a NT$5,000 limit — preserving the dignity of still controlling her own money.

2. Guardianship orders vs. assistantship orders

When an elder's cognition and judgement are impaired, the court can be asked for an assistantship order or a guardianship order to protect their finances and the safety of their transactions. The difference is one of degree:

• Assistantship order: for the mild-to-moderate stage, where judgement is weakened but not lost. The person keeps most of their legal capacity but needs the assistant's consent for major acts such as selling property, borrowing or litigating. The system cuts both ways — protecting the person from financial exploitation while preserving certainty for everyone transacting with them.
• Guardianship order: for the severe stage, where judgement is entirely lost. The court's order works like a one-way door: the person passes from being an adult with full legal capacity to one without, whose life and finances are represented in full by a guardian.

Every order requires a psychiatric assessment by a specialist. Under Article 1111-1 of the Civil Code, the judge weighs home visits by family court investigators and social workers to decide who genuinely serves the person's best interests.

3. Appointing your own future voice: voluntary guardianship

Under traditional statutory guardianship the court selects from spouse and relatives within four degrees of kinship — which often triggers family litigation once an elder loses capacity. Taiwan's recent reform introduced voluntary guardianship to address exactly this.

The idea is simple: while my mind is clear, I choose the person I trust most to speak for me later. That person need not be a relative — a partner, a close friend, a long-standing colleague. The two sides sign a voluntary guardianship contract and have it notarised; the notary uploads it to the court system within seven days. If dementia, brain injury or stroke later takes your capacity, the guardian you chose can petition the court directly, sparing the family fight and honouring the intention you expressed while competent.

Cheng also warns that the arrangement carries risk. In one real case, a person in the early stages of dementia appointed a relative, who — once the order was granted — sold the two properties the person had earmarked as a museum and an office and moved the proceeds into their own name. The court eventually found the guardian plainly unfit and removed them. Finding the right person remains the hardest task of all.

4. A care trust: the second lock on later-life assets

'The best financial protection is to set up a care trust,' Cheng says — and trusts are not only for the wealthy. If you hold insurance, an insurance proceeds trust is possible; retirees can place pensions and property into trust, with the trustee bank disbursing a fixed sum each month directly to the care facility under the contract.

That way, even in severe dementia — even if the chosen guardian turns out badly — the money cannot easily be withdrawn, diverted or defrauded, and the quality of every future day of care is protected.

'Do not assume this is something that only happens far in the future.' Preparing legally and financially in advance is the most dignified gift you can give yourself and your family, while your mind is still clear.

Sick Needs Money unpacks the real problems that begin after diagnosis, every week.