The risk is increased if a substitute decision-maker is appointed, or the older person has been diagnosed with dementia.
‘Supported decision-making should be the preferred option at all times,’ Mr Gear told a public hearing on Guardianship, substituted and supported decision-making today (25 November).
In his evidence, Mr Gear provided practical examples of how the work of OPAN and others in supported decision-making had prevented abuse.
‘There is a common misunderstanding within the community and the aged care sector that if a substitute decision-maker has been appointed for medical decisions, the older person with disability cannot make day-to-day decisions for themselves or participate in and be part of larger decisions relating to their lifestyle, health and wellbeing,’ Mr Gear said in his witness statement.
Inclusion not substitution
‘Aged care staff often have limited understanding of supported decision-making principles and frequently take direction from Enduring Powers of Attorney or Guardians without engaging the older person in discussion about their views and preferences.
‘A common example of this is facility managers supporting substitute decision-makers to restrict residents from visiting or receiving visits from certain family members or friends, despite the resident expressing that they would like to see the visitor.’
This is a breach of the Charter of Aged Care Rights, which states an older person has the right to make choices about their care, personal and social life, including where the choices involve personal risk. The charter does not constrain these rights on the basis of disability or cognitive decline.
Understanding older people’s rights
OPAN has developed two resources to address this lack of knowledge in the community and amongst providers.
Making decisions informs service providers about how they can support consumers and assist substitute decision-makers.
Mr Gear said a growing area of concern was the practice of Enduring Guardians/Powers of Attorney restricting older people’s access to an advocate, leaving that older person vulnerable to abuse.
ACT Disability, Aged and Carer Advocacy Service (ADACAS), one of OPAN’s nine member organisations, has developed a supported decision-making toolkit that helps people with disability identify support networks, explore options and document decisions and decision-making processes.
OPAN’s Self-advocacy toolkit, which will be launched on November 29, builds people’s knowledge and capacity to advocate for themselves across a wide range of topics, including decision-making.