Supported Decision-Making Service

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Supported Decision-Making Service for Persons with Disabilities | Service Model
The Human Rights Center for People with Disabilitis
H. Personal characteristics affecting support
Any support should accommodate the person's individual needs. However, several general
characteristics that considerably affect support may be identified:
1. Age: As noted, the participant's age and personal history may influence the support process.
Young participants between 18-21 years of age may not be able to benefit from the full potential
of the supported decision-making service, as they still attend educational institutions and have
a limited degree of decision-making control over their lives. However, their admittance into
this sort of service may reduce the chance of having a guardian appointed, which is common
in this age group. The issue of accommodating supported decision-making to senior citizens is
discussed in detail in
2. Type of living accommodations: The supporter's role is greatly affected by the nature of
the person's living accommodations – out-of-home of living arrangements, living with family
members (in most cases the parents) or independent living accommodations. The more limited
the person's support sources, such as a person living independently without supported housing
services, the broader and more vital the role of the decision supporter may be. However, when
the participant lives in a housing program, supported decision-making issues may increase and
may also include the person's difficulties vis-à-vis the service providers within the program,
thoughts about leaving the program and services that are not provided by it. Possible tensions
between the supporter's role and the role of the housing program staff should be considered.
3. Functioning and independence level: Supported decision-making services may be offered to
participants with varying levels of functioning and independence. Supporting persons who are well
aware of their wishes and experience difficulties mainly in implementing themwill be very different
from providing support to persons who experience difficulties in establishing their will (either due to
pressures exerted by the environment, absence of clear will or lack of decision-making experience).
Along with the above factors, many additional factors should be mentioned such as religion, gender,
economic situation, stage in life, family status etc. We disagree with the current trend of considering
the type of disability as a major element in designing the services provided to a person seen within
welfare services. In keeping with prevalent attitudes in the field of disabilities that put the emphasis on
needs rather than disabilities, our position is that supported decision-making services should also put
the emphasis on the person's specific needs. So, for instance, some pilot participants with psychosocial
disabilities needed assistance with understanding
information, linguistic simplification and exploring
their will, in a manner which was not materially
different from the needs of participants with
intellectual disabilities. In addition, 12 out of the
22 pilot participants had more than one disability
and therefore the division into different categories
of disability does not suit reality. However, we do
believe it is important to highlight, in supporter
training and practical coaching, certain aspects of
the different disabilities, related to typical ways of
coping, if such exist, and any relevant services and
rights that may be relevant to said disability.
Pilot participant:
Michal comes to see me once a
week. She is smart, patient and
sensitive. She really tries to help me.
I can call her if I have a problem. I
am not alone. A reaching hand
is a huge thing. I would like to be
understood rather than judged, to
be accepted despite the difference.
Without paternalism and without
condescension.