Supported Decision-Making in Massachusetts

In Supported Decision-Making, the adult makes decisions. The adult can choose one or more trusted supportive person(s) to help with making decisions and offering assistance where needed.

A supportive person(s) can be a family member, a friend, a care provider, a co-worker- or anyone the adult chooses.

The adult tells the supportive person where they need help which can include-

•  making decisions about health care, personal needs and relationships, finding a job, living arrangements, daily living needs and safety issues, managing money, legal matters and more
• giving the adult important information in a manner the adult can understand in order to make informed choices
• making a written care plan to communicate choices and preferences using words or pictures
• talking with doctors and other professionals to get needed care, services, supports and accommodations
• completing a Supported Decision-Making Agreement form

Making a Personal Care Plan

The adult and supportive person can make a personal health care plan to protect the adult's decision-making abilities and skills, understand health care and personal needs, and build in help and supports to get needed care and services at every phase of health.

Making a Supported Decision-Making Agreement

The agreement is a simple form which details where adults need support, how they want to be supported, and the role of each supportive person. While not required for a person to use Supported Decision-Making, the agreement can be helpful in documenting the arrangement and ensuring others – like doctor’s offices, hospitals, banks, and schools – respect it.

Supported Decision-Making is An Alternative to Guardianship and Conservatorship

Supported Decision-Making helps support and retain the individual's right to make their own choices and can be considered as an option. If the adult's essential health, personal and safety needs can be met using the option of Supported Decision-Making, then Guardianship and Conservatorship may not be necessary. However, if the adult's essential health, personal and safety needs can not be met using Supported Decision-Making and other supports, accommodations and options, a Guardianship and Conservatorship can be pursued under Massachusetts law to safeguard an adult's decision-making rights and ensure the adult receives necessary care and supports to meet their essential needs.

If a Guardianship and Conservatorship is in place, the guardian or conservator is required, to the extent possible, to encourage the person to participate in decisions, to act on the person’s own behalf, and to develop or regain the ability to manage their life. This analysis includes periodically reassessing the adult's decision-making ability and skills to see if the person’s needs can be met through less-restrictive options, including Supported Decision-Making. If so, the Guardian or Conservator should ask the court to consider restoring the decision-making rights of the adult and modifying or terminating the Guardianship and Conservatorship.

Read more about-

• Guardianship and Conservatorship
• Legal requirements for guardians, see G.L. 190B, Art V, § 5-309(a))
• Legal requirements for conservators, see G.L. 190B, Art V, §5-415)b.