To prevent the sort of abuse described in Alan’s story (below) we must presume everyone’s ability to make their own decisions – and enshrine that right in law.
OPAN acknowledges the importance of appointing a substitute decision-maker (such as a guardian or power of attorney) as part of any advanced care plan – they should be there to protect people’s rights and to make sure their directions are respected.
However, the extraordinary legal powers contained within the instruments should only be activated as last resort.
Supported decision-making, which is endorsed by the UN Convention on the Rights of Persons with Disabilities, is the first and preferred alternative.
Under this model, people are provided with the support and information they need to make their own choices.
People with cognitive conditions, such as dementia, might need more formalised assistance, but it’s rare for anyone to be incapable of making any decisions for themselves.
While someone may not have the ability to understand the extent of, and manage, their assets, for example, they can still make decisions about where they want to live and who they wish to spend time with.
OPAN is calling for supported decision-making to be embedded across aged care.
For this to be successful, we must invite people of all ages, with different disabilities, and from a range of cultural backgrounds to co-design a national policy and legislative framework.
Aged care workers and service providers will need training and support to embed supported decision-making into aged care practice.
In reforming the Aged Care Act, the government and sector stakeholders must plan how to deliver this.
Families and carers will also need information and support.
This should include a national public awareness campaign to promote understanding of supported decision-making principles and how they can maximise the rights of older people and minimise abuse.