Magazine article The Exceptional Parent

How Supported Decision-Making: Benefits People with Disabilities & Families

Magazine article The Exceptional Parent

How Supported Decision-Making: Benefits People with Disabilities & Families

Article excerpt

Self-determination was just the beginning of people with disabilities having a choice in what happens in their lives. Supported decision-making is thought of as the "next generation" of self-determination, especially for people with more significant cognitive disabilities who face the greatest threats to their self-determination. Find out what this means for individuals with disabilities and their families.

PUTTING IT IN CONTEXT

Historically, people with disabilities weren't thought of as capable of decision-making. Even when self-determination was developed, at first it was "letting" people with special needs make choices. People with disabilities shouldn't need "permission" to say where they live, with whom, where they work, go to school, etc. Even today, most parents are told to get guardianship for their family member, especially those with developmental or intellectual disabilities. In some states, limited guardianship was offered for some flexibility. However, now there are other ways to support individuals in making their own choices without taking away their rights.

ALTERNATIVES TO GUARDIANSHIP

Power of attorney (p.o.a.)/durable p.o.a.

* This gives another person the power to make legal decisions on behalf of another. A durable p.o.a. can be revoked after a person who is temporarily incapacitated (e.g., car accident) recovers.

Healthcare Proxy

* This is similar to a p.o.a. but used for health decisions.

Advanced Directives

* Sometimes called "living wills", document choices for end of life care.

Supported Decision-Making

* Making choices with support from another person (see Resources; some states have forms).

WHY SUPPORTED DECISION-MAKING?

Guardianship can have a "significant negative impact on ... physical and mental health, longevity, ability to function, and reports of subjective well-being." Conversely, self-determination leads to more independence, community integration, better health, and recognition and resistance to potential abuse.

Self-advocates want to have as much decision-making power and control over their own lives as possible. There is a new focus in systems serving people with disabilities that includes person-centered planning and supported decision making. Person-centered planning takes into account the individual's preferences and strengths in planning (see Resources). "Shared decision-making" is fairly new in healthcare but actually applies to all areas of life. Supported decision-making is known as "autonomy with support. …

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