Explainer - what is ‘assisted decision making’?

DECISION making is an integral part of our lives. At different times we make important decisions about our finances, property, employment, accommodation, healthcare and social support.

Overall, there are five different decision support arrangements for people who have challenges with their capacity and who may need support to make certain decisions. These arrangements are based on the different levels of support that a person requires to make a specific decision at a specific time.

The three types of support arrangements for people who currently, or may shortly, face challenges when making certain decisions are outlines as follows:

1. Decision-making assistance agreements allow you to choose which decisions you need help with. It also gives your chosen person the legal recognition to help you to make those decisions for yourself.

Your decision-making assistant does not make decisions for you. Instead, they help you to make your own decisions.

The decision-making assistant can only help with decisions that are included in your decision-making assistance agreement. This means they will be able to access relevant information and records for you if you have included this task in your agreement.

Your decision-making assistant does not make a decision with or for you. They support you to make your own decisions.

2. Co-decision-making agreements allows you to choose someone you know and trust as a co-decision-maker to make certain decisions jointly with you. These decisions could be about your personal care, property, or money matters.

After you register your co-decision-making agreement, your co-decision-maker can:

Support you in coming to a decision together. For example, the co-decision-maker will try to explain complex information to you in clear and simple terms

Help you to access relevant information and records, for example, contacting your bank or doctor

Make certain decisions together with you, for example, decisions on your finances

Make reasonable efforts to ensure a decision is implemented

Your co-decision-maker can only support you with decisions listed in your agreement. They cannot make a decision on your behalf without you - you must always be involved.

3. Decision-making representation orders are made by the Circuit Court in situations where you are not able to make a decision for yourself, even with support from another person.

An application by you or someone who has a genuine interest in your welfare for an order must be made to the Court. If the court agrees you are not able to make certain decisions for yourself, it can appoint one or more decision-making representatives to make those decisions for you.

A decision-making representation order can be time-limited. It will also limit the powers of the decision-making representative as is appropriate.

The court will list all of the decisions that the decision-making representative can make. This may include decisions about property and money matters, as well as decisions about personal welfare.

When making a decision for you, your decision-making representative must:

Make every effort to find out your past and present wishes about this specific decision, for example, getting the views of your friends, family and trusted advisors

Help you to be involved in the decision-making as much as possible

There are two types of arrangements for people who wish to plan ahead for a time in the future when they might lose capacity:

1. An Enduring Power of Attorney (EPA) is a legal device that can be set up by a person (the donor) to allow another person (an attorney) to look after their financial or personal affairs, in the event that they no longer have the capacity to do so themselves.

An enduring power of attorney is just one of the legal arrangements you can make in the event you become incapacitated or unable to deal with your affairs. The attorney’s role is to act on your behalf to make certain decisions if you are unable to in the future. An attorney does not need to be a lawyer.

EPAs do not cover decisions about medical treatment. You can make an Advance Healthcare Directive if you want to make decisions about the medical treatment you get in the event that you lose your capacity.

2. An Advance Healthcare Directive (AHD) is a written statement about the type of medical or surgical treatment you want or do not want, if in the future, you are unable to make these decisions. An AHD is only used if you lose capacity and you can no longer communicate your wishes yourself. It lets your family, carers and healthcare professionals know your wishes about your medical and surgical treatment if you are unable to make or communicate those decisions yourself.

You can appoint someone you know and trust as your designated healthcare representative to ensure your advance healthcare directive is followed.

All decision support arrangements are registered with & regulated by the Decision Support Service. This is a service that promotes the rights and interests of people who may need support with decision-making. Further information is available at www.decisionsupporservice.ie or telephone (01) 2119750

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