The probate court may appoint legal guardians to make decisions on behalf of older adults regarding medical needs, living arrangements, or finances. This study aims to highlight the challenges of guardianship for older adults and ways to improve practice at the county level. Focus group discussions were comprised of probate court judges and other court staff, and guardians (including family members, volunteers, attorneys, and professionals) in five counties within the state of Ohio. Themes identified illuminate challenges regarding responsibility to care, elder mistreatment, and administrative bottlenecks. These counties have developed some promising practices including commitment to excellence, resource stability, and community collaboration, to address these challenges.