Supported decision-making guide

Introduction

In 2023, Brisbane community legal service ADA Law and Queensland Advocacy for Inclusion (QAI) jointly released a new guide that assists people who may need help with making decisions.

Supported decision making: helping people to make their own decisions is aimed at maximising people’s ability and confidence to make their own care and life decisions. Its purpose is to equip people with what they need to know and do to be able to make their own decisions as far as possible. As well as information for older people, the guide helps with NDIS support for younger people with disabilities.

Supported decision making guides people through the necessary steps of getting the information they need to be able to make decisions about their care needs, financial management, legal matters, health care and wellbeing. The booklet uses visual elements and easily digestible blocks of bullet point lists to support easy comprehension.

Most of the information in the guide is relevant across Australia, such as information on NDIS or My Aged Care. Other chapters, such as Healthcare, are written about Queensland legislation, so the relevant details will differ across the various states and territories.

Benefits of supported decision making

When a person makes their own decisions, with or without support, it maintains their autonomy and participation in life. Not being involved in decisions that are important to them is increasingly recognised as being harmful and in breach of the person’s human rights.

Being informed and able to make decisions may also remove the need for a guardian or other formal decision maker to be appointed through a tribunal application. While these appointments are sometimes necessary, they can also sometimes be made too hastily, and they can take many years to change if they don’t work well.

How the guide works

Supported decision making is designed in chapters that focus on one major decision, so that people don’t have to read through the whole guide to find what they need.

Each chapter starts off with a ‘Did you know?’ page of key facts. Next, questions relating to each major decision are outlined. Readers could start by thinking about what they want to find out about – for example, ‘I need …

• ‘to get help with daily living’

• ‘to keep well at home’

• ‘to start planning for moving into residential aged care’.

Chapter 2, ‘Getting help – MAC people aged 65 or older’ explains practical steps, such as contacting the My Aged Care portal and considering giving phone consent for appointment of a nominee. There are some suggestions about what sort of help should be considered and who may be available to help.

Each chapter ends with its own checklist that helps people to think more carefully about barriers to decision-making and how these barriers could be approached. The checklists include reminders that an application for guardianship is considered to be a last resort option, as it is the most restrictive option for decision making.

Nassar’s story: using the new guide

Nassar, aged 72, was recovering in hospital from a broken hip caused by a fall, and a social worker was working with him to plan his discharge. Nassar lives alone and was anxious to stay out of hospital. He had only recently stopped working and had not needed any help at home before this.

The social worker printed off the My Aged Care chapter of the Supported Decision Making Guide and left this with Nassar.

Nassar learnt from the ‘Did you know?’ page that he might be entitled to support from an advocate or care finder to get started with the My Aged Care portal. He decided to see how far he could get by starting on his own.

He moved to the ‘Accessing My Aged Care’ page and found the website for joining My Aged Care. He was able to register by using his iPad.

Together with the social worker and an occupational therapist, Nassar completed the Help at Home Checklist. This checklist allowed him to work out what help he might need and whether it would be for a short or long time.

The My Aged Care link also had a lot of information, and Nassar found out that he might be entitled to short-term care during his rehabilitation. Nassar has now registered with My Aged Care and is waiting for an assessment for short term care during his rehabilitation and then home-based care.

Once rehab is complete, Nassar can decide whether he would like to return home with extra care, or whether he’d prefer to move into a different type of accommodation with supports. He knows he doesn’t have to make that decision today.

Where to get your copy of the guide

Supported decision making: helping people to make their own decisions provides practical, accessible information to help people equip themselves for decision-making. By recognising that many people can make their own decisions either on their own or with support, the guide aligns with human rights thinking in care provision.

Download a copy from the ADA Law website