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Informed Choice Toolkit:


Supported decision making

Understanding supported decision making

Supported decision making emphasizes the importance of people with disabilities making and communicating their own decisions about their lives.

We all use supported decision making. For example, many people consult family and friends before making big decisions, such as where to live. Sometimes we consult experts to help us make complicated decisions, such as talking to our doctors about medical treatments. Still, the final decisions are up to us.

Supported decision making is an effective tool to help people who need help with decision making. Supported decision making can be used across many settings, including educational and medical systems as well as social services.  

All people need at least occasional help to make decisions. Even when someone can't make decisions independently, they may still be able to participate in decision making with the support of others. Supported decision making is a person-centered approach, where a person is empowered to make decisions with the support of trusted family, friends and members of their professional teams — rather than others making decisions for the person, such as through guardianship.

At the center of supported decision making is the decision maker. The decision maker chooses who helps them make decisions. These people are called supporters. Supports can be family, friends, service providers — anyone chosen for this role by the decision maker. Supporters must agree to serve in this role.

The decision maker identifies which decisions need support. Examples include decisions about money, housing, education, relationships and health care.

The decision maker also decides what kind of help would be useful in making those decisions. For example, the decision maker may want help gathering or understanding information, or perhaps communicating a decision to others. The possibilities are endless.

Supported decision making is based on the ideas of self-determination and dignity of risk.

Self-determination means that someone directs the plan for their own life. During the planning process, the person decides what's most important to them, creates meaningful outcomes and, with the help of their supporters, works toward those outcomes to live the most fulfilling life possible.

People who exercise self-determination are more likely to live independently, have financial stability, be employed at higher paying jobs and make greater advances in their employment. Self-determination has also been shown to predict post-high school success in employment and independent living.

Supported decision making preserves dignity of risk, or the idea that taking reasonable risks is a necessary part of self-determination and self-esteem. Supported decision making helps people learn to manage — and avoid — risks.

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