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Know what's important and what helps
Good decision support is all about the supporter understanding the person and what support works for them.

Thinking about the whole person
Te Whare Tapa Whā model is a Māori approach to health and wellbeing. Imagine well-being as a house with four walls. Each wall is a different part of our health and life.
- Physical
- Mental and emotional
- Family and social
- Spiritual
Each wall is important. If one wall is weak, the whole house is shaky.
Good decision-support means the supporter must
- understand the whole person
- understand what support helps them make decisions
We need to think about all four walls of Te Whare Tapa Whā .
Taha Wairua: What is important?
Taha wairua is about what gives your life meaning and helps you feel connected to something bigger than yourself.
For supported decision-making, good supporters need to understand what is important to the decision-maker (their will and preference).
- What do they want their life to look like?
- What do they truly care about?
- Who are the important people in their life?
- What makes a good day?
- What motivates them?
- How are their culture and beliefs important to them?
Taha Tinana: Physical health and body
Physical things can make choosing hard:
- Trouble talking
- Hard to move around
- Can't hear or see well
- Feeling tired
- Being in pain or injured
- Feeling sick or unwell
Examples of things that might help
- Special talking tools
- Sign language help
- Using pictures
- Comfortable spaces
- Taking breaks
- Talking when the person isn’t tired or hungry
Taha Hinengaro: Feelings and thinking
Feelings can make choosing hard
- Low confidence
- Feeling sad
- Feeling worried
- Past bad experiences
Examples of things that might help feelings
- Encouragement
- Being patient
- Creating calm spaces
- Celebrating small wins
- Talking with a counsellor
Some parts of thinking can make choosing hard
- Memory
- Understanding information
- Concentration
Examples of things that might help thinking
- Breaking information into small steps
- Using pictures
- Simple language
- Taking time
- Checking understanding
Taha Whānau: Social connections
Social things can make choosing hard
- Feeling alone
- Not having a support network
- Supporters or family members not listening or understanding
Examples of social things that might help
- Circles of support
- Community connections
- Family involvement
- Advocacy (getting help to speak up)
- Cultural support
Note it down
It can be helpful for the supporter and decision-maker to note down
- What is important to the person?
- What helps them understand and communicate?
- Who they want to help them make decisions
Make a simple guide
- Use simple words
- Use pictures if helpful
Share the guide with supporters to help them understand.
Emily's story
With her decision supporters, Emily wrote down
-
- What is important to her
- What works for supported decision-making.
They call it "Emily's Decision-making Manifesto".
This helps Emily’s supporters
-
- Know what her goals are
- Support Emily to make decisions that help her towards her goals.
You can read Emily's Decision-Making Manifesto here (PDF 42 KB) external
You can meet Emily in this video. She shares her experience of supported decision-making. This video is about 11 minutes long.
Emily’s story is shared from Belonging Matters.
Video transcript
Opening slide: How to best support me to make decisions with Emily Raymond
Logos: Belonging matters, Talks that matter
Good morning. My name is Emily Raymond, and today I'm going to talk about how people can best support me to make decisions.
It's important for people who have a disability to make decisions about their own life and to get support from the people they trust. Examples are mum, dad, siblings or support workers.
We all need to get advice from other people sometimes
Often, if you have a disability like me, the people around us in our life make decisions for us. This is not good as we don't learn to make good decisions or solve our own problems.
Before I talk about decision making I would like to tell you a bit about myself.
About Me
I work for belonging matters as an office assistant. I work once a week on a Thursday for four hours and I also have my own business which I started in the first covid lockdown. I make and sell greeting cards and other products. I'm an organizer and member of the belonging matters advisory committee where we hold meetings on Zoom three or four times a year talking about different subjects.
The things I enjoy doing are going to the gym. Spending time with my two nieces and going out with friends. I also love animals.
One day when I find a suitable housemate I am hoping to be getting a little puppy.
I also enjoy going to the movies and craft.
Decision Making
I live in my own home and am enjoying that. I'm currently looking for a housemate to live with as I have had a few bad experiences with housemates in the past where they haven't been a good support or just haven't been the right fit. Sometimes they have made decisions for me.
In the future I would like to continue to live in my own home, make some more friends, find a paid job in something I enjoy doing and become a pet owner.
It is important that I make my own decisions in my life because if someone makes a decision for me it might be the wrong decision or it might be a decision I don't like. It's my own life and making decisions helps me to learn about making better decisions and being able to solve my own problems. Just imagine if someone made decisions about your life.
The best people to help me make decisions are my family and my support workers as they are the people who know me the best.
My support workers help me to make decisions because I understand that sometimes I have trouble making decisions. They know what my goals are and help me to make decisions that help me towards my goals.
My family helps me to make decisions around going to stay at their house for the weekend or spending time looking after my two-year-old niece as my brother lives in Franklin and I don't get to see her very often. They also help me to make decisions support workers health and managing my own home.
Circle of Support
I also have a circle of support. These are also people I trust to help me make decisions when I moved out of
Mum and dad's place the circle helped me to think about and make decisions about where I would like to live, who with, and what I could afford. A decision that I have had to make is hiring a new support person to help with cooking. The decision I needed to make was if I liked the person or got along with them and if they had the right skills.
I needed someone to help me make the decision as sometimes, with new people, I find it hard as I get a bit nervous. The people who helped me to make the decision was my support worker and my mum.
My supporters helped me to make the decision by thinking about what I needed support with. They shared some options. One was a healthy meal delivery service and the other was employing a support person to help me learn how to cook healthy meals.
I chose to employ a support person.
They helped me to advertise and decide what to put in the ad.
My support worker helped me go through the resume. we found out the person who applied was a nutritionist and then that helped me decide that she would be as good as she would help me to make healthy choices and learn how to cook.
We developed questions and I chose which ones to ask.
They explained what would happen at the interview.
I was involved in the interview process and asked questions.
We talked about the interview when the person left. My Mum and support worker gave me time to think about the responses and share what I thought.
I thought they were all good responses and I thought she had good cooking skills and was really nice.
To help me to get to know the new person, one of my support workers came over when she started when the new person started. we also talked to her about how to best help me make decisions, the supports that I have and works best for me are one-on-one support.
Give me one decision at a time.
Walk me through the decision.
Give me time information and support to prepare. For example when I did the interview.
Give me clear options and choices. One option is not a choice.
Explain the good things and bad things that might happen.
Check that I understand the options.
Give me time to think about the decision.
Make sure I have support to try new things to see if I like them.
Let me decide if it's a bad decision or a good decision.
Give me some time to process the information I'm given.
Don't railroad me with decisions.
I need people to be quiet and listen to what I have to say and my preferences without jumping in
Support me if I make a mistake so I can make better decisions for the future. Don't deny me the opportunity to make decisions just because I make a bad one.
I need help to respect my decision even if they don't agree with me.
The support that is not helpful for me is when people rush me to make a decision, as sometimes, if I am rushed to make a decision, I can tend to make a wrong decision.
When I decide what I want without asking me first because sometimes I have trouble speaking up and telling someone hang on I don't like this decision.
Getting cross at me if I make a mistake as well. We all make mistakes from time to time. We are not all perfect.
When they give me one thing to do and then while I am doing that they give me something else to do. Because of my disabilities I find it hard to focus on trying to do two things at once.
Telling me too many things at once because I'm likely to forget what was said.
I'm now going to share an example of bad decision-making support.
I once had a housemate who didn't listen to me. She would cook for me and decide what I would eat every night. She didn't trust that I could do things. For example, she would go over my head if I told her that I had emailed the real estate agent to fix things.
She would not let me go to her and let me say how I was feeling as I if I did she would storm out of the house instead of discussing the problems she had with me. She would go over my head and complain to my mum.
This made me feel like I was a child again and I felt really uncomfortable in my own home. It had got to that the stage that two weeks before she moved that I was in tears and really couldn't cope anymore.
My support worker helped me to think about the options. I could try and solve the problem by speaking up but that didn't work. Go for a walk to calm down. Stay at Mom and Dad's for a night or two or spend time out with friends to have a break. Or discuss things in a housemate meeting.
These things didn't really work. Even if we had a housemate meeting and suggested things she would not take it on board and then that got me even more frustrated.
I spoke to Mum and Dad and said this is not working. They asked me what I wanted to do. I said I would like her to leave and find a new housemate.
My Mum and support worker explained to the housemate that it wasn't working and asked her to move out.
My wish for other people with a disability is that I hope that they can live their best lives and that the people who support them help them to make a supportive decision and not make the decision for them.
People who don't have a disability need to understand that we are not different. We are just like them and want to make decisions about our own lives. Yes, we may have ADHD, autism, and intellectual disability or a physical disability, but we are all the same no matter what. It doesn't matter what ethnicity, sexual preference, pronoun, or skin color you are, we are all the same. So I just wish that people with a disability are treated the same.
Thanks for listening
Thanks to Emily Raymond, Jane and Jeff Raymond, Jeremy and Kelly Raymond, and Kirsty Shaw, Emily's circle of support.
This presentation was made possible with the financial support of an information linkages and capacity building grant through the Department of Social Services
Produced by belonging matters. Belonging matters makes every effort to provide accurate and up-to-date material; however, information is subject to change in our materials. For reference only.
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Find out more
Here are some examples of templates. You can use these to write down what is important and what helps in making decisions.
- “How I make my decisions form” externalby People First
- “Decision-making profile and agreement” external by Helen Sanderson Associates
- "My decision support plan external": part of a booklet for supporters of people living with dementia (on page 43)
- "How to support everyday decision-making external" by Michelle Browning and Deb Rouget from Belonging Matters. This is where Emily's Manifesto comes from.