Support the decision, and keep the person in it

Ideas for everyday support

Clear information, time and suitable communication can help a person participate in decisions that affect their everyday life.

Choosing an activity, considering a move or agreeing who may receive information can involve very different decisions. The support needed should relate to the decision in front of the person, rather than a broad assumption about what they can or cannot do.

This article considers the everyday work of supporting choice. It begins with a simple habit: keep the person involved in understanding the question and exploring the options.

Start with the relevant principles

In England and Wales, the Mental Capacity Act sets out principles that include presuming capacity, supporting people to make their own decisions and not treating an unwise decision alone as evidence of a lack of capacity. SCIE’s overview explains these principles and the wider framework.

Questions about a person’s capacity need the appropriate assessment and professional process for the particular decision and time. A diagnosis, an unusual preference or a communication difference does not answer that question on its own.

Make the question clear

Explain what is being decided and why it needs attention. Avoid combining several decisions into one broad request for agreement. A person considering a new activity may need separate information about the activity, the travel and the cost.

Ask what information would help them compare the options. Use a format they can understand and give them an opportunity to ask questions. Where time is available, a pause between explanation and decision may be useful.

Notice whose preference is being heard

Relatives and professionals may have important information, but their preference is not automatically the person’s preference. Make space for the individual to express a view using their chosen communication approach.

If accounts differ, record that difference accurately and explain the next step. Avoid changing a record of what the person said into what someone else thinks they should have said. Clarity supports a more respectful process.

Be honest about the available options

A choice is meaningful when its consequences and limits are explained. If an option is unavailable, say why and explore the alternatives. Do not offer a choice simply to make a predetermined action sound collaborative.

Where a formal process is required, explain the roles of the people involved and how the individual can participate. Support may include help to understand a meeting, identify a representative or ask for information to be presented differently.

Questions to improve an everyday conversation

Have we explained one specific decision clearly?
What support would help the person understand and communicate?
Have we recorded their own view accurately?
Does the next step need a formal assessment or further advice?

The reflection to carry forward is to make participation visible. A careful process should preserve the person’s voice even when a decision is complex or other people have different views.