Two Passports, One Conservatorship: The Elder Care Dilemma Facing South Asian American Families

The first sign is often small: a missed medication, an unpaid bill, a confusing phone call from a bank. For South Asian American families, the second sign is often legal. An adult child arrives at a hospital or a county courthouse carrying a durable power of attorney signed years earlier, only to learn that the document does not authorize the decision now needed—or that the institution will not honor it without a court order.

As the immigrant generation of the 1970s, 1980s, and 1990s ages, guardianship and conservatorship proceedings are becoming a quiet but growing feature of diaspora life. These cases expose a gap that is both legal and cultural: a patchwork of state laws that assumes families, assets, and decision-makers are all located in one country. For many South Asian American households, they are not.

When Capacity Becomes a Family Argument

Guardianship is a court-supervised process. A judge determines whether an adult lacks capacity to make certain decisions and, if so, appoints someone to act on that person’s behalf. Conservatorship, in states that use the term, typically governs financial affairs. The proceedings are meant to be protective. They can also be adversarial, public, and expensive.

In South Asian American families, the trigger is often a medical crisis. A parent with dementia or a stroke can no longer manage finances or consent to care. Adult children may disagree about what should happen next. A relative in South Asia may hold a different view. Siblings who have lived in different countries for decades may find themselves in a county courtroom, arguing over authority that everyone assumed would be handled informally.

The cultural script can complicate the legal one. Many families expect the eldest son or the daughter living closest to take charge. Others assume that a parent’s wishes, stated years earlier, will be honored without documentation. Still others rely on a relative in the home country to manage property there. None of these expectations substitutes for a legally recognized decision-maker in the United States.

The Power of Attorney Is Not a Guardianship

A power of attorney is a useful tool, not a universal key. A durable power of attorney can authorize financial decisions while the principal has capacity to grant it. A springing power of attorney takes effect only under specified conditions. A health care proxy or advance directive governs medical decisions. None of these documents creates a guardianship. None automatically survives a challenge to capacity. And none reliably crosses an international border.

Banks and hospitals can be cautious about accepting older documents. Foreign institutions may not recognize a U.S. power of attorney at all. In some countries, a separate local document, notarization, apostille, or court order may be required. A U.S. conservator appointed by a state court generally has authority only within that state’s jurisdiction. Selling a family home in India or accessing an account in another country may require a separate legal process there.

This is the guardianship gap: the space between what a family assumed was covered and what the law actually authorizes. It is rarely explained in advance. It often surfaces at the worst possible moment.

Two Countries, Two Legal Universes

Transnational elder care is not merely a logistical challenge. It is a collision of legal systems. A parent may hold U.S. citizenship or a green card while owning property abroad. A sibling may live in another state, another country, or on another continent. Caregivers may be undocumented relatives whose immigration status affects their ability to travel or make decisions. Assets may include bank accounts, real estate, pensions, and informal arrangements that are difficult to document.

Estate planning lawyers in the United States can draft documents that address some of these issues. They cannot rewrite foreign law. Families with cross-border assets often need counsel in both jurisdictions, a cost that many middle-income households cannot easily absorb. Courts, meanwhile, are not always equipped to evaluate foreign documents or cultural expectations about elder care.

A Patchwork of State Law

The United States has no uniform guardianship code. States vary on who may petition, what evidence of incapacity is required, whether counsel is appointed, how much notice relatives must receive, and how much weight to give a person’s stated preferences. The Uniform Guardianship, Conservatorship, and Other Protective Arrangements Act, promulgated in 2017, has influenced some state reforms, but adoption has been uneven.

For families, the variation creates uncertainty. A plan that works in California may not work in Texas. A document that is honored in one hospital may be questioned in another. Language access is another variable. Capacity hearings can be confusing even for native English speakers; for a parent whose primary language is Bengali, Gujarati, Hindi, Punjabi, Tamil, or Urdu, the proceeding may be nearly incomprehensible without an interpreter and culturally competent counsel.

The result is a system that places a heavy burden on families to anticipate problems that many would rather not discuss. The alternative—a contested guardianship—is often more costly, more divisive, and more traumatic than a planning conversation held years earlier.

What Families Can Do Before a Crisis

The most important step is early planning while the parent still has capacity. That means executing a durable power of attorney, a health care proxy, and an advance directive. It means naming backup agents. It means keeping an inventory of assets in both countries and consulting lawyers who understand both jurisdictions. It means talking openly—across siblings and generations—about who will make decisions and how disagreements will be resolved.

It also means recognizing that a power of attorney is not a substitute for a guardianship and that a guardianship in one country does not automatically travel. Families with cross-border assets should ask whether a revocable trust, joint ownership, or a foreign power of attorney is appropriate. The answer depends on the facts, the countries involved, and the state of residence.

The Diaspora Politics of Care

The guardianship gap is not only a private family problem. It is a policy question about how the United States treats aging immigrant communities. It touches Medicaid, adult protective services, court interpretation, immigration status, and the filial expectations that many families carry across borders. It also raises a question of civic imagination: whether courts and agencies can recognize that a South Asian American family may have decision-makers, assets, and obligations in more than one place.

For now, the burden falls largely on families to plan ahead and on lawyers to bridge the gap. The hearings will continue, the siblings will disagree, and the documents will sometimes fail. But the larger debate—about what care looks like when love, money, and law are stretched across two countries—is one the diaspora cannot afford to postpone.