Decision Making Agreement

What is the Decision Making Agreement tool?

The 'decision making agreement' is a way to reflect how decisions are made, in the light of this legislation.

When supporting someone in their decision-making, here are some important questions to ask:

• Do I fully understand what is important to the person and their communication?
• Am I the best person to support this decision-making?
• Is the information that I have and am giving the person relevant to the decision?
• Am I presenting it in a way that the person can understand?
• I am giving the information in the right place and time?
• Have I given the person the best chance to make the decision themselves?

This tool helps:

• To think about how much power and control people have in their lives.
• To clarify how decisions are made.
• To increase choice and control people have in their lives.

It works by helping us to think about decision making and increasing the number and significance of the decisions people make.

 

Videos

Michael Smull introduces Person-centred thinking tools to enhance voice, choice and control. He talks about using communication charts and decision making profiles.

 

 

How can the Decision making agreement tool be used?

Joan's story

Joan, 73, lives in a nursing home because of her dementia. When Joan was young, she couldn't afford chocolate, but says that now she can, staff at the residential care home won't let her. Joan has unstable diabetes and staff felt that they had a duty of care to prevent her eating something that may make her ill. However, Joan was frustrated at the lack of choice she had over her life. Chocolate means a lot to her because while she was growing up with 13 siblings in a two-up two-down with weekly visits to the pawnbrokers, it was a considered an unaffordable luxury at the time.The problem was that staff lacked an understanding of mental capacity and didn't recognise that Joan was perfectly capable of making some decisions for herself. By developing a decision making agreement, staff were clear that this was a choice Joan could make herself.

 

Joan's decision making agreement

Decision to be made	How I must be involved and who else can help	Who makes the final decision
When I eat chocolate	I can decide if I want some chocolate every now and again. It's my life. I know the consequences and the district nurse checks my blood sugar every day so she can advise me if it's a safer time to eat it.	Joan
Whether I can check my own blood sugar	My diabetes consultant at Manchester Royal Infirmary	My consultant and I together

 

James's story

James is 26 years old, and has a spinal injury. He says:

In the past I was really into sports. With my twin brother Tom, I was a County Tennis Champion. I also played rugby for my school team. I have a degree in computing and worked for a large organisation as a software developer. I am proud of my family, particularly my twin brother who qualified as a management accountant.

In June 2007 I had a C5/6 break of my spine as a result of a fall. Initially I couldn't move anything below the break. I have worked really hard and as a result of the physiotherapy I have undertaken, I have regained a lot of movement in my arms. I try to do a lot of exercise to maintain this. I am now able to push a manual wheelchair. I was in hospital for 16 months until I moved to Wheatridge Court in Nov 2008.

Within the next month, I will be moving to the bungalow attached to Wheatridge Court before finding my own place to live. I have medication for pain management, and spasm management. I have support from district nurses with skin management/pressure sores and bowel and bladder routines. I have a specialist physiotherapy session with Dave from Physibility once a week. This is how I would like people to assist me when I am making decisions about my life and health.

 

James's decision making chart

How I like information presented to me	How to present choices to me	How to help me understand information	Best time for me to makes decisions	Worst time for me to make decisions
Written information preferably e-mailed to me electronically	Comparison information or contrast scenarios	Talking through information and getting advice. I would speak to my dad or my brothers. I would also speak to Gary and Katie as they have had similar experiences	Morning time	7pm onwards as I will be tired and possibly in pain

 

Ben's decision making agreement

Ben talks about his decision making agreement.

More Examples and Stories

Evie's Decision Making Agreement.
Evie's agreement shows how a teenager has used this tool to make decisions about things she wants to do.

Ben's Decision Making Agreement.
In Ben's agreement he used this tool to make decisions about things that are important to him.

Anna's Decision Making Agreement.
Anna and the people who support her each day, used this tool to help her make the daily decisions in her life.

 

 

Related materials

A practical Guide to Delivering Personalisation, Person-Centred Practice in Health and Social Care.

This book will show how to deliver personalisation through simple, effective and evidence-based person-centred practice that changes people's lives and helps them achieve the outcomes they want. It covers why person-centred practice is relevant to the personalisation agenda and what person-centred thinking and person-centred reviews are, introducing the tools that can help you carry them out. It also explores the relationship between person-centred plans and support plans, and how person-centred practice can be used in the journey of support through adulthood - from prevention or the management of long-term health conditions to reablement, recovery, support in old age and at the end of life. There is also a chapter on taking a person-centred approach to risk.

 

Person-Centred Thinking Minibook

A pocket sized, quick reference minibook of person-centred thinking tools. This includes: sorting what's important to/for us; the doughnut sort; sorting what's working/not working; communication chart; like and admire; relationship circles; learning log. Produced in partnership with The Learning Community for Person Centred Practice.

 

Person-Centred Cards

 

These handy cards provide information on a range of person-centred thinking tools. Each card suggests the benefits of using the tools with individuals and organisations, and has step by step instructions.

 

All materials are available from the HSA Press website or by calling 0161 442 8271.

 

Related Courses

Person-Centred Thinking Skills, click here to find out more.

 

Blogs

The Decision Making Agreement tool is regularly discussed in our blog section.