Supported decision-making and capacity
Learn more about supported decision-making and what it means to lack the capacity to make decisions.
What is supported decision-making
Like everyone, people with disability can benefit from support when making decisions.
Providing support or making reasonable adjustments to meet a person’s needs can help them to make their own decisions and have decision-making independence.
Supported decision-making allows you to help someone to make their own decisions and have control over the things that impact and are important to them.
Video | Supported decision-making is a human right
What is capacity?
Decision-making capacity is the ability to make your own life decisions by:
What could affect someone’s decision-making capacity?
If you are 18 years or over, you are presumed to have capacity to make your own decisions unless it can be legally shown that you:
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lack capacity due to disability, including an age-related condition,intellectual disability, brain injury or mental illness
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temporarily lack capacity, for example during a coma following an accident
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are able to make some decisions but not others.
Does having a disability affect capacity?
Having a disability does not automatically mean that a person lacks capacity.
Many people with disability can make their own decisions with some guidance to:
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clarify issues and choices to aid decision-making
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help you make a specific type of decision.
How to determine if someone lacks capacity?
A person’s lifestyle or a poor or controversial personal decision does not mean that they lack capacity.
You may not agree with their decision, but it’s important to determine if:
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the person is simply making a 'bad' decision
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they lack capacity to make decisions.
Definitions
- supported decision-making
Helping someone to understand and make their own decisions, so they remain in control of making decisions that are important to them.
Mary's story
Mary is in the early stages of dementia.
The Public Guardian is appointed as her guardian with authority to make decisions on her behalf about home services, and medical and dental consent.
Mary's doctor informs the Public Guardian that Mary understands and consents to a prescribed flu vaccination treatment.
In this instance, the Public Guardian does not need to provide consent on Mary's behalf.
Definitions
- consent
Permission for something to happen or agreement to do something.
What happens in a disagreement about capacity?
It’s important to help someone get all the support that they need to make their own decisions and to protect their rights if they are being assessed for capacity.
If there is disagreement, then an assessment can be requested from a clinical neuropsychologist, geriatrician or psychiatrist.
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DO |
DON’T |
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Start by assuming they do have capacity to make their own decisions. |
Assume that because they are unable to make a decision in one area that they can’t make decisions in all other areas of their life. |
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Focus on their ability to make a decision.
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Focus on whether the decision they make is good or bad. |
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Respect their privacy.
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Assume they lack capacity because of age, appearance, disability or behaviour. |
Alice’s story
Alice appointed her daughters Jean and Susan as her Enduring Guardians.
When she developed dementia, her daughters disagreed about Alice’s capacity to make her own decisions about home-based services.
Susan feels her mother can currently still make her own decisions, but Jean believes she and Susan should make decisions on Alice’s behalf.
Alice’s doctor assesses her capacity to make her own decisions and finds that she lacks capacity. Susan and Jean take over decisions as joint Enduring Guardians.