Supported Decision-Making Service

Supported Decision-Making Service for Persons with Disabilities | Service Model

The Human Rights Center for People with Disabilitis

Conclusion

In general, a supported decision-making service as an alternative to guardianship is a welcome,

relevant and important model for the population of senior citizens. Senior citizens – like the

population of persons with disabilities – experience disproportionate and injurious use of the

guardianship institution. Therefore, a move that would enable to provide a service that limits the

use of guardianship and provides a proper, adequate and empowering alternative – is a welcome

and proper move in terms of promoting the rights of senior citizens in Israel.

Specifically, several points for consideration or deliberation should be highlighted with respect to

the issue of implementing and adapting the proposed model to the population of senior citizens:

a. Senior citizens are not necessarily persons with disabilities. They suffer from stigma

and discrimination due to ageism. Some of them, mostly in advanced ages, develop

disability as a result of which they may be classified, in addition to being senior citizens,

as belonging to the population of persons with disabilities.

b. Senior citizens, like persons with disabilities, experience in the context of the institution

of guardianship a similar reality when guardianship over their person and property is “too

liberally” appointed.

c. Senior citizens have unique circumstances and needs as far as support in decision-making

is concerned pertaining to the types of infirmities and impairments from which they suffer

as well as the "connection" to their past preferences and values.

d. Therefore, a vision offering an alternative to the institution of guardianship as it currently

exists under Israeli law, emphasizing liberty, autonomy and respect while maintaining

full legal capacity at the highest level possible – is a vision shared by senior citizens and

persons with disabilities alike.

e. At the same time, as far as it pertains to senior citizens, the supported decision-making

model should be one of various different models from which senior citizens are able to

choose, including additional models such as advance instructions, powers of attorney,

and substitute decision-making – all according to the choices and preferences of the

senior citizens themselves. Therefore, in any support service model some of the support

services to senior citizens should also actively include support and exposure (subject to

the person's will and preference) to additional legal planning tools as future alternatives

to guardianship (such as powers of attorney and/or advance directives).

f. As far as the population of senior citizens is concerned, the social support network (mainly

family members) which was built and designed based on personal choices over the course

of many years – is of great importance in supported decision-making processes. In most

cases, family members are the ones that both in practice and often also by the choice,

will and preference of the senior citizens practically fulfil the role of the supporters in the

decision-making process. Therefore, the supported decision-making service model should

also

a-priori

give room and weight to family members of senior citizens (according to

the will and preference of the senior citizens themselves). This can be achieved by giving

the family members the opportunity to act as decision-making supporters, as well as by

making an allowance for their positions and preferences in the overall considerations and

information to be taken into account in the decision-making processes in which decision-

making supporters are involved together with senior citizens.