Supported decision-making - Guide for families, friends, and carers
What is supported decision making?
Supported decision-making is about empowering someone to make their own decisions, with support tailored to their needs.
As a supporter, your role isn’t to make decisions for the person but to help them:
- understand their options
- consider the pros and cons
- express their choices.
It’s about supporting, not replacing, their decisions.
Examples of supported decision-making in action:
- Helping a family member understand their healthcare options so they can decide which treatment, if any, to receive.
- Assisting a friend in weighing up the pros and cons of a financial decision to help them to make an informed choice.
- Providing information in an easy-to-understand way to enable someone to confidently make their own decision.
Why supported decision making?
Supported decision-making is recognised internationally as a fundamental human right.
- Under Article 12 of the UN Convention on the Rights of Persons with Disabilities (UNCRPD), every person has the equal right to make decisions about their life. Families and carers play a crucial role in supporting this right, not replacing it.
Relevant legislation in Queensland and Australia includes:
- National Disability Insurance Scheme Act 2013 promotes ‘choice and control’ for people with disabilities.
- Aged Care Act 2024 provides for older people with the ability to make their own care decisions with appropriate support.
- Guardianship and Administration Act 2000 (Qld) provides a framework for substitute and supported decision-making.
- Powers of Attorney Act 1998 (Qld) governs enduring powers of attorney and advance health directives.
The Disability Royal Commission (2023) emphasised: "People with disability have the right to be supported — not substituted — in their decision-making. Families must honour this by enabling, not taking over, choices."
Practical benefits of supported decision-making:
- Promotes participation, self-determination, and dignity.
- Provides a less restrictive alternative to guardianship.
- Recognises that decision-making ability can vary depending on the situation.
Why does this matter for families, friends, and carers?
By supporting someone to make their own decisions, you are:
- helping them stay in control of their life
- supporting their choices rather than replacing them
- preserving their dignity and boosting their confidence in decision-making
- upholding their right to make their own decisions while respecting their views, wishes, and values.
How does supported decision-making work?
Supported decision-making is a flexible and personalised approach that empowers individuals with impaired capacity to make their own decisions with the right support. The process depends on the person, the decision, and the level of support needed.
How to provide support:
- Listen: Understand their preferences, values, and needs.
- Inform: Share clear, accessible information about their options.
- Simplify: Break down complex decisions into small steps.
- Allow time: Let them process the information to make their decision.
- Respect: Accept their decision, even if differs from your own.
Support can be from family or friends (informal) or from professionals like support coordinators or social workers (formal).
You can assist with decisions about:
- Healthcare: Understanding medical advice and choosing treatments.
- Lifestyle: Deciding on housing, relationships, or hobbies.
- Financial and legal matters: Budgeting or understanding contracts.
The goal is to provide the right level of support while respecting their autonomy and ensuring their decisions reflect their own values and preferences.
How do I put supported decision-making into practice?
Supported decision-making is a collaborative approach that respects the person’s autonomy, values, and preferences. Before starting, it’s important to allow the person to identify who they want as a supporter. They need to take the lead on choosing who they’d like helping them to make decisions. For supported decision-making to work, the person needs to feel sure their supporter will listen to them.
Core principles to follow:
1. Start with the belief that everyone can make decisions
Capacity to make decisions must be assumed and every effort should be made should be made to empower someone to make their own decisions.
2. Support don’t substitute
Help the person understand, think through, and express their choice.
3. Respect their values
Use their preferences and goals to guide the process.
4. Balance dignity and safety
Explain risks but avoid taking control. A risky choice isn’t necessarily a wrong choice.
5. Be flexible
Adapt your support to fit the person and the decision.
For practical guidance, our 8-step supported decision-making checklists provide advice for decisions about living arrangements, healthcare, aged care or NDIS matters.
Who can use supported decision-making?
Anyone who needs help making decisions can benefit, including people with:
- disabilities
- acquired brain injuries
- dementia
- complex communication needs.
Even those who can make many decisions independently may need support for more complex ones.
Does supported decision-making mean the person doesn’t need a guardian or attorney?
Not necessarily. The goal is to support the person to make their own decisions. However, if they cannot make certain decisions even with support, formal arrangements (e.g. a guardian or attorney) may be needed.
How does OPG fit into this?
At the Office of the Public Guardian (OPG), the Public Guardian is appointed by the Queensland Civil and Administrative Tribunal (QCAT) to act as a substitute decision-maker. This means OPG has been appointed to make decisions on behalf of someone who is unable to make that decision, even with support. This is an extremely restrictive option because it removes a person’s legal rights to make their own decisions.
Making a substitute decision should only be used as a last resort, and only if meaningful attempts have been made to support the person to make their own decisions. Supported decision-making is less restrictive and a more viable alternative to guardianship.
What happens if someone’s decision-making ability is impaired?
In Queensland, an adult is presumed to have decision-making ability unless proven otherwise.
If there are concerns about someone’s decision-making ability:
- An assessment can be conducted.
- If the person cannot make a decision even with support, other arrangements (e.g., attorney, guardian) may apply under the least restrictive option principle.
Resources to help you get started
Use our supported decision-making resources designed for family, friends, and carers to support someone in making decisions about their life:
- An 8-step approach to supported decision-making – factsheet and checklist
- Supported decision-making for living arrangements – checklist
- Real world scenario - supporting Evelyn to make living arrangements decisions – case study
- ADA Law - Supported decision-making: Your right to participate in decisions
- Australian Government Disability Gateway - Supported decision making
- Office of the Public Advocate, South Australia - Supported decision-making videos - videos