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Supported Decision Making

Supporting the person: it is their decision and their right to make the decision...it is your role to help and support them in whatever way they need to facilitate them to make their decision

Sage Advocacy - Supported Decision Making

Supporting decision-making capacity

In circumstances where a person may be finding it difficult to exercise their decision-making capacity they are entitled to support to help them make their own decisions. The type of support should be tailored to the person's own circumstances, communication means and to the specific decision. There is a responsibility to ensure the person is provided with all reasonable supports to help make choices and decisions about matters that affect them.

Supporting decision making includes providing relevant information and available options explained in a way the person can understand, working to the person's pace and giving the person enough time to understand and consider their options. It may include the use of communication aids, getting support from other people, using other professions and expertise, and engaging an advocate. 

The Guiding Principles of the ADM (Capacity) Act 2015 creates the right for a person whose capacity may be in question to be supported to make their own decisions, and there is a obligation to fulfill this right. A person 'shall not be considered as unable to make a decision in respect of the matter concerned unless all practicable steps have been taken, without success, to help him or her to do so.'

Sage Advocacy has developed the ALERT System and a guide to Supporting Decision Making. The guides can be used in practice when supporting autonomy and decision-making capacity. 

ALERT - Supporting Decision Making

A = ASK

“What is your understanding of […..the decision…..]”

L = LISTEN

Pay attention to words, feelings, body language

E = EXPLAIN

Explain everything, including all the choices, in a way that the person can understand. Consider asking someone else to help, such as a key worker or an advocate.

R = REALITY

Go through all of the possible choices and consequences, paraphrase, reflect back, summarise, and check understanding and retention.

T = TELL

“Tell me about your decision; Why is the choice important for you; How did you make this decision?”

Download our guide to Supporting Decision Making

Tips to help communication & build capacity

  • Find out all you can about the person’s communication style.
  • Make adjustments to your communication style to accommodate the person
  • Identify a suitable location that the person is comfortable in
  • Ensure you have information in an accessible format for the person
  • Use communication aids, get support from other people, use expertise
  • Remove any potential distractions
  • Be aware of your own mood and body language
  • Be neutral and impartial in how you communicate with the person
  • Support the person to make their decision without influencing their decision
  • Support the person without having an attachment to the outcome of the decision
  • Ensure it is the best time and place to speak with the person
  • Ensure the person is ready to talk, if not arrange another time
  • Let the person know what you are doing and why
  • Let the person know
    • it is their decision, and their right to make the decision
    • it is your responsibility to help them
    • you understand they may be finding it difficult to make the decision
    • it is your role to help and support them in whatever way they need to facilitate them to make their decision

Watch: Capacity is like a tunnel - maximising capacity

 

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