Types of decision support arrangements

You may now, or in the future, have challenges making decisions or lack capacity to make certain decisions and need support with them. A decision support arrangement is a type of legal arrangement that can help you.

You must be aged 18 or over to make a decision support arrangement.

You may need different levels of support to make a specific decision at a specific time. The arrangement depends on your level of capacity, present and future, and the type of decision.

If you are currently facing difficulties making decisions, or may in the near future, 3 decision support arrangements are available. These are tiered from needing some support with decisions to having decisions made on your behalf.

Decision-making assistance agreement

If you need support when making some of your own decisions, you can make a decision-making assistance agreement. In this agreement, you choose somebody you know and trust to be your decision-making assistant. They will help you get information and to understand it, so you can make specified decisions for yourself.

Co-decision-making agreement

If you find it difficult to make certain decisions on your own, or may be shortly unable to do so, you can make a co-decision-making agreement. In this agreement, you choose somebody you know and trust to be your co-decision maker to make specific decisions jointly with you. You will need a doctor and another healthcare professional to check your capacity and confirm that you are able to enter into this agreement.

Decision-making representation order

If you can’t make certain decisions on your own or with somebody else’s support, the Circuit Court may appoint a decision-making representative to make certain decisions for you. The court does this in a decision-making representation order. The court will notify the Decision Support Service and send them a copy of your decision-making representation order.

If you are planning ahead for a time when you may not be able to make certain decisions yourself, you have 2 types of future planning arrangements available.

Advance healthcare directive

You can make a written statement about the type of medical or surgical treatment you want or do not want, if in the future you are unable to make these decisions. This is called an advance healthcare directive (AHD). You must have capacity to make an AHD. As part of an AHD, you can choose someone you know and trust as your designated healthcare representative to act on your behalf, advising healthcare workers of the decisions you made in the directive. You are not obliged to nominate a designated healthcare representative if you make a AHD.

Enduring power of attorney

You can make an enduring power of attorney if you do not currently have capacity issues, but would like to plan ahead for a time when you may no longer have capacity. This is an arrangement where you appoint someone you trust as your attorney. Their job is to act on your behalf to make certain decisions if you are unable to in the future. An enduring power of attorney cannot cover healthcare matters, as these must be dealt with in an advance healthcare directive. You or your attorney, on your behalf, must register the agreement with the Decision Support Service. They keep a register of enduring power of attorneys.

The decisions you include in an enduring power of attorney, a decision-making assistance agreement or co-decision-making agreement can be about 2 different aspects of your life:

• Your personal welfare
• Your property and money matters

Your personal welfare could include decisions on your accommodation, employment, education or training, social activities, healthcare (but not decisions about treatment) and well-being. You can make an advance healthcare directive to outline the medical treatment you would prefer in the event that you can no longer communicate your wishes.

Your property and affairs could include the control, management, buying, selling, mortgaging, of some or all of your property or possessions or your property rights.

Your money matters could include your business, taxes, trade, contracts, social welfare.

A decision supporter is somebody who can help you to make certain, specific decisions. The level of decision-making support is defined by the type of decision-support agreement you have and what is written in it.

Talk to those you trust about who could act as a suitable decision supporter for your arrangement.

The Decision Support Service have 13 codes of practice for decision supporters, interveners and relevant professionals, These documents will give guidance on their role and responsibilities under the Assisted Decision-Making (Capacity) Act 2015.

The Decision Support Service will keep a register of decision support arrangements.

Not everyone will be able to search the register. Access will be limited to certain organisations, people in certain professional bodies that have been approved by the Decision Support Service and some members of the public who can show they have a legitimate interest.

The Decision Support Service will keep a searchable register of:

• Co-decision-making agreements
• Decision-making representation orders
• Enduring powers of attorney

They will also keep a record of everybody who asks to search a register.

Read more about searching the register on the Decision Support Service website.

The register will only become active on the Decision Support Service website once searchable arrangements are registered, check this update for more information.

The Decision Support Service (DSS) has information and videos for people making decision support arrangements.

The DSS have also provided a list of important terms used in assisted decision- making.

You can read A Guide to the Legal Aspects of Caring and the Practical Guide for Family Carers on the Assisted Decision-Making (Capacity) Act 2015 from Community Law and Mediation and Family Carers Ireland.

If you or your family would like more information, you can contact the Decision Support Service information team using the contact details below.