On March 24, 2017, the Master Plan for Promotion of the Adult Guardianship System was formulated in a Cabinet meeting. In response, hearings were held with concerned organizations for older adults with dementia, people with disabilities, and physicians, as well as welfare-related organizations. Re-examination of the medical certificate form was also started. According to the overview of cases related to adult guardianship between January and December 2017, approximately 35,000 petitions were filed, demonstrating a slight increase compared with the previous year. This increase reflects the impact of a super-aged society and the increased number of people with dementia. A proposal for a revised form has been presented, and the use of this form is scheduled to start in 2019.
 According to the Master Plan for Promotion of the Adult Guardianship System, "investigations should be conducted to develop guidelines for supporting decision-making." The Ministry of Health, Labour and Welfare has published new revised guidelines that allow for the provision of appropriate care based on the characteristics of individuals with disabilities or dementia. The Practice Guidelines for the Process of Decision Making Regarding Treatment in the End-of-life Stage has been revised, and the revised title contains the term "care." Although these guidelines are reported to have been revised to facilitate their usage for death at home and at facilities, many problems remain. Furthermore, based on a multi-year study on support for people with dementia to make decisions, the Guidelines for Supporting Decision Making Regarding Daily and Social Lives of People with Dementia was published. This provides all individuals involved in the decision-making process of those with dementia with information on how to support them.
 This article presents an overview of the problems with the current adult guardianship system, the process to determine treatment and care in the end-of-life stage, and the support required for decision making by people with dementia.
 <Author's abstract>