Supported Decision-Making
Supported decision-making uses tools and supports to help persons understand, make, and communicate their choices. By using supported decision-making, persons are able to make choices and be more independent for a longer time. Supported decision-making can be used in guardianships or conservatorships to help protected parties make choices.
Iowa law doesn’t use the phrase “supported decision-making.” But the guardianship and conservatorship statute requires that “third-party assistance” be considered in deciding if a guardianship or conservatorship is needed. With enough third-party assistance, a guardianship or conservatorship may not be needed. Third-party assistance can be help provided by family, friends or service providers. This assistance can use supported decision-making.
Supported decision-making is based on the needs of the person. Some people may need help with only a few things, such as financial issues or medical problems. Others may be fine going to the grocery store alone but may need someone to assist at a doctor’s appointment. Types of support may include:
- Taking more time to make decisions
- Making a list of pros and cons
- Providing information in a different format—written or video
- Setting up a joint bank account (if your supporter misuses your funds, it may be hard to get your money back)
- Using plain language materials to describe the issue
- Bringing someone to appointments to help the person remember and discuss options
Friends, family or service providers can develop or provide these supports.
For more information: National Resource Center for Supported Decision-Making https://supporteddecisionmaking.org/
Substitute Decision-Making
Substitute decision-making is different than supported decision-making. When people cannot make decisions for themselves, guardians and conservators must make decisions for them. This is called substitute decision-making. The guardians or conservators must act in the protected person’s best interest, not their own interest.
A guardian or conservator needs to think about several factors when making decisions for someone else:
- Remember how you would like to be treated if someone was making decisions for you
- Take actions and make decisions that maximize independence
- Use the powers that the court gives you but allow the protected persons to make decisions they are able to make. Supported decision-making should be used.
In order to know what decisions to make, a guardian or conservator should:
- Get to know the protected person
- Understand any needs or problems the protected person may have
- Ask questions and seek opinions about how to meet the needs of the protected person
In making decisions for a protected person, a guardian or conservator may need to consent or agree to some treatment or plan. That consent or agreement should be “informed.” Informed consent is usually used for health care decisions but can be used in other areas. It means the person giving the okay about a decision or action understands:
- What is being agreed to
- The good and bad things about it
- Other options that are available
The person giving consent should be able to give a reason for making the choice.
Informed consent requires that the person giving the okay:
- Understands how to make a good decision
- Has the information to make a good decision
- Has the ability to make good decisions
- Is agreeing to something freely, without being forced or pressured by someone else.
Additional Resource
The National Guardianship Association listed below has developed ethics and standards of practice for guardians and conservators. This information is available on its website.
National Guardianship Association
174 Crestview Drive
Bellefonte, PA 16823
Phone: 877-326-5992
Fax: 814-355-2452
Website: www.guardianship.org
The Consumer Financial Protection Bureau has resources on managing someone else’s money. https://www.consumerfinance.gov/consumer-tools/managing-someone-elses-money/
For more information on guardianship and conservatorship, download a brochure here.