The exploratory study found that participants, including those with cognitive disability, mostly supported the broad concept of supported decision making. However supporters saw this as a complex, dynamic and frequently chaotic process. Fundamental to the process were relationships and tailoring support to the individual.
The skills and knowledge required included communication skills, self-awareness, the capacity for reflective discussion, conflict resolution skills, and knowledge of strategies for tailoring the decision making process to the individual. The study revealed multiple dilemmas and tensions associated with supporting someone with cognitive disability to make a decision but most commonly mentioned were remaining neutral, managing conflicting perspectives amongst differing supporters, balancing rights with risk and best interests, and resource constraints.
The study provides some key insights into the practice of supporting people with cognitive disability to make decisions and knowledge that can be incorporated into training programs for people in this role. The findings also highlight the need for further research in this area, particularly in relation to ‘what works’ in support for decision making for people with cognitive disability