Nov 10, 2022

Are you considering the resident’s choices when caring?

10_11_2022 OPAN pos
OPAN believes supported decision making is not commonly used in aged care, but that it should be to prevent abuse and protect residents' rights. [Source: Pexels]

The peak body for older Australians believes many aged care residents are not getting the chance to make everyday choices and that supported decision making needs to be introduced nationwide.

The Older Person’s Advocacy Network (OPAN) has today released a position statement on supported decision making that calls on every aged care worker and provider to rethink how they provide care.

OPAN’s position statement, ‘Supported decision making must be embedded across aged care’, is designed to be part of a broader discussion around supported decision making for older people.

This conversation has been growing in the community, Government and industry spaces following the Aged Care Royal Commission and a number of other investigations, because supported decision making and a rights-based approach can help to prevent abuse.

The timing of the position statement is important, as OPAN Chief Executive Officer (CEO) Craig Gear believes the discussion on rights is likely to ramp up with the ongoing aged care reforms and the new aged care legislation which was recently introduced.

He said even with the attention of the Government focused on human rights, introducing supported decision making will require further investment in helping every aged care worker, family member and older person to understand what it means.

“I think there is a groundswell of community consideration and organisational consideration but we need to now give people the tools, the skills, to actually deliver on supported decision making for all older people,” Mr Gear said.

Key to OPAN’s position statement is the belief that substitute decision makers – such as an appointed guardian or trustee – should only be used as a last resort, and that in many cases supported decision making can be used instead to provide the information an older person needs to make their own choices.

Even if a guardianship or trustee order is in place, OPAN believes older people should still be given the chance to make decisions where they can – for example to choose who they want to spend time with.

Yet Mr Gear said it was commonly reported that an older person receiving care is assumed to not have the capacity to make any decisions for themselves if they have a substitute decision maker.

To have supported decision making used across aged care, OPAN has called for consultation and co-design over a national policy and law framework, which would include training and support for aged care workers and providers.

Currently, OPAN believes many older Australians are not being supported to make their own decisions and are feeling like they’re not in control of their own life.

Being able to make our own decisions is in fact a human right for people of all ages, but Mr Gear said it is often not a right that is given to older people receiving aged care.

“I reflect on myself as a nurse, back when I was delivering direct care, and I would often walk in and say, ‘Come on Mrs Jones, it’s time to get up and have your shower, it’s good for you to get up and have your shower’,” said Mr Gear.

“But in doing that I’m actually not supporting her to make a decision about what she wants – just in that simple thing of does she actually want to have a shower now.” 

Mr Gear explained using supported decision making and a human rights approach would mean instead of telling Mrs Jones she should get up for a shower, a carer should ask something like, ‘what would you like to do today?’.

“She might say, ‘Actually I just watched Netflix until 1am and I want to have a sleep in, I want to have my shower in the afternoon’, so it’s building it around her rather than around my schedule,” Mr Gear said.

Mr Gear believes that we all need to learn how taking everyday choices away disempowers an older person.

“We want an aged care system that is built around empowering older people, hearing their voice, giving them respect and dignity, and this is a great way to do it – through supported decision making,” he said.

“What this does is make us pause, it makes us think; ‘Am I taking over for this person? Am I doing ‘to’ this person? Or am I working with, at their direction, and working for this person?’”

If you need support as an aged care worker, family member or older person, OPAN advocates may be able to help. You can contact an advocate on 1800 700 600.

Do you protect your residents’ rights? Tell us how in the comments below.

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  1. Well said; Supported decision should be the goal.
    It goes further in aged care, where staff try to do everything for a person who has Dementia or when new people moves into aged care.

    There is a saying in Dementia Care: “The more you do for me, the more you take away from me”

    Staff do not take time to know what the person can do or wants to do on their own.

  2. I believe the charter of OPAN should be expanded to include consumers who reside in retirement villages and receive Aged Care Packages. After all retirement villages are seen by government to be the “new aged care”.

    After all OPAN initially advocated for aged HACC clients, then HACC disabled were included and final expansion to include residential aged care. Time has passed and it is now time to convince government to expand further to include consumers with aged care packages resident in RV’s.

    I have been in a RV for 15yrs and am on a level 3 package. I have a number of chronic complaints but mobility is the major problem. In this village , and I believe many others, there is no ramp to independence in the swimming pool. An advocate could help me resolve this issue but there are many other issues that affect many residents on packages. And in all RV’s the “packaged” numbers are increasing daily, almost exponentially.


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