Standing in their shoes
If you have to make a decision for another person, the best way to approach this is to try to make the decision the person themselves would have made if they had been able to.
This means 'standing in the shoes' of the person: seeing the choices to be made from the perspective they would have had.
Work out if the person is able to make the decision
It is important to consider whether a person could make their own decision if they had additional support. Health professionals may be able to help with this. They can also assist with assessing and supporting a person to make the required decision.
Even if the person cannot make the decision themselves, you may be able to get some information from them about their preferences.
Consider any written or spoken preferences of the person
The person may have written down their preferences in relation to what they do, or do not, want in an advance care plan or advance care directive. These preferences must be respected when relevant decisions are made on their behalf.
A person's preferences may directly relate to specific medical interventions or they may be more general: documenting the person’s values and what is important to them and their goals for care. People undertake advance care planning both to assist family and people who may have to make decisions for them and also to ensure they receive care in line with their preferences.
Preferences may not have been written down but have been expressed through conversations. Speak with friends, family members or the person’s GP to see if they the person expressed anything relevant previously.
Consider what is important to the person
Consider the cultural, spiritual, religious and other preferences of the person and whether these might influence what care is wanted.
If there are no written wishes, consider how the person lived their life and how they made decisions in the past. What things are important for them to live well?
Consider the likely outcomes and whether the person would want, or tolerate, these outcomes.
You should refuse health care that is likely to result in outcomes that the person wanted to avoid. Remember that you are trying to make the decision the person would have made, not the decision you want or would make for yourself in the same situation.
Making a health decision
Ask questions and listen to the advice of health practitioners about health care options and likely outcomes. If relevant, follow the person’s written or spoken preferences or instructions. Make the decision that the person would make if they had the same information and advice that you have.
Where there are several options the person would accept, choose the one that gives them the most independence but still provides good care and maximises their health and well-being (as they would see it).
If you cannot work out what the person would have decided, make the decision that you believe is best for them.
Making decisions for someone else can be difficult and stressful. It may help to talk with a community nurse, hospital social worker, aged care staff or your GP.
Making a decision about living arrangements
Living arrangements may depend on the availability of family or a carer. The abilities and personal circumstances of those providing care and their preferences must be considered. For example, while most people would prefer to remain at home rather than entering residential care, they may also put a high value on their family and would not wish to cause ‘burn-out’ or impose an extended duty of care on those they love.
If possible, follow the person’s written or spoken preferences. Discuss with family members and others. Consider costs linked to decisions – you may need to speak to the financial decision-maker. Choose the option that gives the most independence but still provides care and maximises well-being.
For more information and assistance
- Access information and documents for your state or territory in our website's resource section
- Visit your doctor/GP for assistance
- Call the Advance Care Planning Advisory Service: phone 1300 208 582 9am to 5pm, Monday through Friday. If you need a telephone interpreter for this service, call 13 14 50, state your desired language and wait on the phone (up to 3 minutes). You can then ask the interpreter to call the Advance Care Planning Advisory Service on 1300 208 582.
This resource was produced by HammondCare in partnership with
Decision Assist. Decision Assist is funded by the Australian Government.