Supported Decision-Making (SDM)
A model that empowers people with disabilities to make as many of their own decisions as possible. The intent of including 6.2 in the Quality tool is to drive providers to educate families and others about this best practice in helping people with disabilities live self-determined lives. While the goal is for supported decision-making to be used as an alternative to full conservatorship, we fully believe that supported decision-making can and should be used even within a conservatorship.
What is Supported Decision-Making?
Any set of practices or strategies that give people with disabilities the help they need to make their own decisions, rather than having others make choices for them, which, in turn, takes the person’s rights away. SDM supports people to understand and make decisions about their lives. A person using SDM selects trusted advisors such as family members, friends, or selected professionals to support them as they make decisions. SDM can look different for everyone.
Examples of some ways providers can meet Indicator 6.2:
• Hold “town hall” meetings with persons and their family members or natural supports to educate them on SDM and provide SDM resources.
• Hold and document routine discussions of SDM and providing SDM resources to persons and their family members or natural supports.
• Mailing or emailing SDM resources to persons and their family members or natural supports throughout the year, maintaining a log.
Examples of using SDM include helping a person decide by:
• Explaining information in visual or audio form instead of written.
• Giving extra time to discuss choices or try options before making a decision.
• Role-playing activities to increase understanding of choices.
• Bringing a supporter to help take notes during important appointments.
Scenario: (Supported Decision-Making)
Allie uses her communication device to inform her mom she is interested in purchasing a vehicle now that she has her license. Allie’s mom reminds her of her options for Decision-Making assistance as she tells her that this is a big decision, and she wants her to make the best choice. Allie emails her Circle of Support to notify them of her desire to purchase a vehicle and to inform them she will be meeting with her advocate as well as her father, who is her conservator. During this meeting, Allie, her advocate, her father, and her mother all take a look at Allie’s current income, including her employment and social security, as well as her monthly expenses to determine how much she can afford to spend each month. Once her budget was identified, Allie’s father took her car shopping and assisted her with purchasing the car she wanted. A week later, Allie’s father assisted her to set up autopay for her car note and insurance so they will pay timely each month for her.
Scenario: (Not Supported Decision-Making)
Olivia has been dating Ben for about two years and recently they have started talking about marriage or moving in together as potential goals for the future. As Olivia is talking with her DSP, she informs her that she wants Ben to propose soon, and she cannot wait to marry him. Olivia’s DSP quickly tells Olivia that she shouldn’t get her hopes up because she and Ben will not be able to get married since they both have disabilities. Olivia reminds her staff that she is still able to make decisions despite her disability and that she will marry Ben one day. A week later, Olivia’s DSP, home manager, and grandmother (who is her financial conservator) meet to discuss Olivia’s desire to get married to Ben in the future, however, they did not include Olivia in this discussion. Olivia’s grandmother told the DSP and home manager that as Olivia’s conservator she is making the decision that Olivia can no longer see Ben and she will never allow her to marry.
Resources to learn more and/or point providers to:
• TN Center for Decision-Making Support: https://www.tndecisionmaking.org/
• TN Council on Developmental Disabilities: TN Council on Developmental Disabilities – Supported Decision Making
• Webinars: https://www.tndecisionmaking.org/trainings-webinars/
• More Information: Supported Decision-Making SDM (for Adults) | Tennessee Center for Decision-Making Support (wpengine.com)
• SDM with someone who is non-verbal: https://www.tn.gov/cdd/engage-with-us/breaking-ground/breaking-ground-96/breaking-ground-96—my-brother-does-not-speak–but- supported-decision-making-can-still-work.html