Supported Decision-Making: What It Means in Practice

Picture a team leader making a call about where a person would live, a genuinely significant decision, in a five-minute conversation with the family, without the person themselves properly in the room for it. Everyone involved would say, if asked, that they respect the person's rights. Nobody has actually stopped to build the process that would let the person decide for themselves. That's the gap this page is about.

What is supported decision-making?

Supported decision-making is the process of helping a person make their own decisions, including big ones, by building understanding, offering accessible information, giving enough time, and involving people the person trusts. The NDIS's supported decision-making policy describes it plainly: supporters assist a person to make a decision, but they do not make the decision for them.

This applies across every kind of choice, from what to have for dinner through to where to live, who to have a relationship with, and how to spend NDIS funding. The scale of the decision doesn't change the principle. It changes how much support and time the process might need.

How is this different from substituted decision-making?

Substituted decision-making means someone else decides on the person's behalf, usually a guardian or a formally appointed nominee, when a person's will and preferences genuinely cannot be determined even with support. The two approaches sit on a spectrum, and supported decision-making is meant to be the default, with substituted decision-making used sparingly and only once real attempts at support have been made and exhausted.

The practical test worth remembering: a decision made for you is substituted decision-making. A decision made with you, using whatever support you need to get there, is supported decision-making. Most of the disagreements in this space come down to which side of that line a provider is actually operating on, regardless of what the paperwork says.

What does this look like for a support worker day to day?

• Give information in the format and pace that works for the person, not the format that's quickest for you.
• Ask open questions rather than leading ones. "What would you like to do?" rather than "You want to do this, right?"
• Allow real time for a decision rather than needing an answer immediately because the roster is tight.
• Involve the people the person actually trusts, which may or may not include family, and follow the person's lead on who that is.
• Respect the outcome, even when it's not the choice you would have made, or the choice that's most convenient for the shift.

Does this mean letting someone make unsafe choices?

Supporting a decision includes supporting decisions that carry some risk, in the same way any adult's right to make their own choices includes choices others might disagree with. This is sometimes called dignity of risk, and it sits alongside, not against, a worker's genuine duty of care. The two aren't actually in tension as often as they're made out to be. Supporting someone's choice does not mean ignoring a real and serious safety risk. It means the default is support, not override, and escalation happens when there's genuine, serious risk of harm, not simply because the person chose something you wouldn't have.

Where does a worker's role end?

Formal capacity assessments and guardianship or administration decisions are legal and clinical processes involving tribunals, clinicians and state-specific frameworks. A support worker's role is to support the person's own decision-making and to raise concerns through the right channels, not to decide, informally, that someone lacks capacity because a decision is difficult or inconvenient.

How CORA's course fits into this

CORA's course Supported Decision-Making, part of the Disability Understanding & Daily Life stream in the course library, covers how to support someone to make their own decisions using their will, preferences and rights as the anchor, and distinguishes supported decision-making clearly from substituted decision-making. It builds understanding and judgement. It does not make legal or clinical capacity determinations, those sit with the appropriate legal and clinical processes in your state or territory.

If you're mapping rights-based practice alongside the rest of the Disability Understanding stream for your team, try the Pathway Builder, free and no sign-up required, or request a demo.

Sources and further reading

• Supported decision-making policy, National Disability Insurance Agency
• NDIS Code of Conduct, NDIS Quality and Safeguards Commission
• Supporting someone with an intellectual disability, CORA Workforce

This page is general information for support workers and providers, not legal advice. Capacity, guardianship and substituted decision-making arrangements vary by state and territory. Always follow the person's individual support plan and your organisation's policies.