Key principles
- Recognise and respect the difficulties faced by the person who is losing capacity.
- Understand the medical and other factors that may be affecting the person’s behaviour and capacity, such as memory loss and difficulty communicating.
- Foster the person’s dignity and self-esteem by encouraging them to continue making or contributing to decisions as much as possible.
Approaches to decision-making
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Allow your role to change as the person’s capacity decreases.
- Assisted decision-making may involve simple things such as taking the person to meetings and making sure they understand documents.
- Supported decision-making may involve exploring and explaining issues but allowing the person to make the final decision.
- Substitute decision-making involves making decisions on behalf of the other person.
- If you have to make a decision for another person, check if they have given verbal or written directives about how they would want the decision to be made.
- If they have not given directives, use substituted judgement – what you believe the person would have chosen themselves.
- If you are not clear what they would have chosen, decide on the basis of their best interest – after weighing up all the information about the situation, including what might be known of their wishes.
- If you are having difficulties in this role, ask for help and support from family or friends, your GP, or support groups such as those run by Alzheimer’s Australia.