Supported Decision Making

A process to empower and assist vulnerable people to make more good decisions. A webinar presented by Citizen Advocate decision Coach Jenny Smith @https://www.facebook.com/CommResourceUnit/

Here are some take aways from her presentation:

Who Can Be Decision Supporters?

Decision supporters are individuals chosen by the person needing support or based on who they would choose. Supported Decision Making (SDM) must be consented to by the individual. Supporters can include:

• Family members

• Friends and neighbors

• Service providers (past or present)

• Experience specialists who help build decision-making capacity

• Anyone who knows the individual well or is willing to get to know them

Circumstances often determine who will take on this role. It's essential that the individual understands that the decision is ultimately theirs, even if they receive help in evaluating options.

What Decision Supporters Should Do

• Be well-trained in SDM and understand the specific SDM process being used.

• Keep accurate records of all SDM efforts.

• Be prepared to account for actions and outcomes.

• Manage associated risks, such as conflicts of interest or overriding the individual's preferences.

• Consider their duty of care to protect the person’s social or personal well-being.

• Work collaboratively with informal or Substitute Decision Makers.

Benefits of Supported Decision Making

• The process is highly individualized.

• The individual remains in control.

• It strengthens the person’s capacity to self-advocate.

• Reduces reliance on formal (paid) and informal supports.

• Improves self-confidence and awareness of decisions they can make.

Limitations of Supported Decision Making

• Timing can be critical, especially in emergencies or during significant life changes.

• Some individuals may not make the progress others desire due to the nature of their decision-making impairment.

• SDM is not a solution for all decision-making challenges, but it can be helpful when used with other supports.

• Risks include possible coercion, undue influence, or abuse by untrained supporters.

• Despite its imperfections, SDM is often better than having someone else make decisions for the individual.

The Supported Decision-Making Process

1. Identify Decisions: Clarify what decisions need to be made with the individual.

2. Ascertain Preferences: Explore the individual’s will, values, and preferences.

3. Gather Information: Collect views from the individual’s support circle and others impacted by the decision.

4. Assess Risks and Benefits: Weigh the potential outcomes, risks, and the individual’s dignity of risk.

5. Support Decision-Making: Encourage self-determination, even if there is some risk involved.

6. Reach a Decision: Help the individual weigh all known information to reach a decision.

7. Reflect and Implement: Review the decision with the individual, document it, and implement any necessary actions.

Final Reflections

• Take SDM seriously and use a structured process.

• Recognize the importance of this role and aim to remain neutral.

• Ensure that the individual’s decision aligns with their values and beliefs.

• Provide the right supports to help the individual build decision-making capacity.

• Challenge low expectations and be a catalyst for the individual’s growth and confidence.