{"id":2792,"date":"2022-04-05T15:24:24","date_gmt":"2022-04-05T14:24:24","guid":{"rendered":"https:\/\/www.sense.org.uk\/?page_id=2792"},"modified":"2026-02-25T15:22:02","modified_gmt":"2026-02-25T15:22:02","slug":"making-decisions-about-your-life","status":"publish","type":"page","link":"https:\/\/www.sense.org.uk\/information-and-advice\/life-stages\/adult-life\/making-decisions-about-your-life\/","title":{"rendered":"Making decisions about your life"},"content":{"rendered":"\n<p class=\"is-style-intro\">This page is about your rights as a disabled person with complex needs to make decisions for yourself about how you want to live your life.<\/p>\n\n\n\n<p>It also covers what happens if you find it difficult to make decisions and your family, or other people, need to make decisions for you.<\/p>\n\n\n\n<p>You\u2019ll also find information about advocacy \u2013 what it is and how it works.<\/p>\n\n\n\n<p class=\"is-style-default\">On this page:<\/p>\n\n\n\n<ul class=\"wp-block-list is-style-primary-bullets\">\n<li><a href=\"#your\">Your right to make decisions<\/a><\/li>\n\n\n\n<li><a href=\"#parents\">For parents and carers<\/a>\n<ul class=\"wp-block-list\">\n<li><a href=\"#mentalcapacity\">The Mental Capacity Act 2005<\/a><\/li>\n\n\n\n<li><a href=\"#how-can-i-support\">How can I support my family member to make a decision?<\/a><\/li>\n\n\n\n<li><a href=\"#how-do-i-know\">How do I know if my family member cannot make their own decision?<\/a><\/li>\n\n\n\n<li><a href=\"#how-are-decisions-made\">How are decisions made in my family member\u2019s best interests?<\/a><\/li>\n\n\n\n<li><a href=\"#deputy\">Appointing a deputy through the Court of Protection<\/a><\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><a href=\"#advocate\">What is an advocate and what do they do?<\/a>\n<ul class=\"wp-block-list\">\n<li><a href=\"#when\">When is an advocate used?<\/a><\/li>\n\n\n\n<li><a href=\"#longer\">Longer-term advocacy support<\/a><\/li>\n\n\n\n<li><a href=\"#power\">Power of Attorney<\/a><\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><a href=\"#adrt\">Advance decisions to refuse treatment (ADRT)<\/a><\/li>\n<\/ul>\n\n\n\n<p class=\"is-style-default\">Remember, the laws are there to help you. They make sure that, together with your family and the professionals who support you, you can make the right decisions.<\/p>\n\n\n\n  <div class=\"wp-block  box    is-style-textured-grey-tint-10  align-right  size-medium\">    <div class=\"acf-innerblocks-container\">\n\n<h2 class=\"wp-block-heading\"><strong>Sense is here for you at every stage of life<\/strong><\/h2>\n\n\n\n<p class=\"is-style-default\">We support disabled people with complex needs of all ages.<\/p>\n\n\n\n<p class=\"is-style-default\">From our free play sessions for children under eight, to our <a href=\"https:\/\/www.sense.org.uk\/our-services\/support-for-adults\/residential-care\/\">adult residential care services<\/a>, we\u2019re with disabled people and their families every step of the way.<\/p>\n\n\n\n<p class=\"is-style-default\">Get in touch with our team to find out more about Sense services.<\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-primary\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/www.sense.org.uk\/information-and-advice\/information-and-advice-service\/\">Contact us<\/a><\/div>\n<\/div>\n\n<\/div>\n  <\/div>\n\n\n\n\n<h2 class=\"wp-block-heading\" id=\"your\">Your right to make decisions<\/h2>\n\n\n\n<p>In England, the Care Act 2014 is the law that covers all adult social care provision.<\/p>\n\n\n\n<p>It says that if you are an adult with care and support needs, you have a right to have these needs met and to have control over your day-to-day life.<\/p>\n\n\n\n<p>Local authorities must be guided by this principle.<\/p>\n\n\n\n<p><a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/life-stages\/adult-life-and-planning-for-your-future\/assessments-for-care-and-support-if-youre-disabled\/\">Find out more about the Care Act 2014.<\/a><\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-flair-dual-primary-tint\"\/>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"parents\">For parents and carers<\/h2>\n\n\n\n  <div class=\"wp-block  box    is-style-textured-grey-tint-10\">    <div class=\"acf-innerblocks-container\">\n\n<h3 class=\"wp-block-heading\" id=\"mentalcapacity\">The Mental Capacity Act 2005<\/h3>\n\n\n\n<p>The Mental Capacity Act 2005 is about protecting any adult over the age of 16 who can\u2019t make decisions for themselves.<\/p>\n\n\n\n<p>The Act&#8217;s five principles are:<\/p>\n\n\n\n<ol id=\"block-14b1b641-0db1-4595-95b7-23cd946a16ab\" class=\"wp-block-list is-style-pink-blob-counter\">\n<li>Always assume the person can&nbsp;make the decision until you have proof they cannot.<\/li>\n\n\n\n<li>Try everything possible to support the person to make the decision themselves.<\/li>\n\n\n\n<li>Don\u2019t assume the person can\u2019t make a decision just because they make a decision you think is unwise or wrong.<\/li>\n\n\n\n<li>If you make a decision for someone who can\u2019t make it for themselves, you must always decide in their best interests.<\/li>\n\n\n\n<li>Any decisions, treatment or care for someone who can\u2019t decide for themselves should have the least impact possible on their basic rights and freedoms.<\/li>\n<\/ol>\n\n<\/div>\n  <\/div>\n\n\n\n\n<h3 class=\"wp-block-heading\" id=\"how-can-i-support\">How can I support my family member to make a decision?<\/h3>\n\n\n\n<p>There are lots of ways you can support your family member to make a decision. This includes making sure everyone involved in supporting them takes what\u2019s called a person-centred approach.<\/p>\n\n\n\n<p><a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/life-stages\/adult-life-and-planning-for-your-future\/person-centred-planning\/\">Find out more about person-centred planning and how it works.<\/a><\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"how-do-i-know\">How do I know if my family member can\u2019t make their own decision?<\/h3>\n\n\n\n<p>To make a decision, a person needs to be able to:<\/p>\n\n\n\n<ul class=\"wp-block-list is-style-secondary-bullets\">\n<li>Show some understanding of the information given to them.<\/li>\n\n\n\n<li>Remember that information long enough.<\/li>\n\n\n\n<li>Weigh up the information and use it to make the decision.<\/li>\n\n\n\n<li><a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/communication\/\">Communicate their decision<\/a> \u2013 through speech, sign language or their preferred form of communication. <\/li>\n<\/ul>\n\n\n\n<p>It\u2019s important to remember that most people, no matter how complex their needs, can make some decisions.<\/p>\n\n\n\n<p>That\u2019s why the law states that you, and everyone involved, should assume they can make the decision themselves, if they are supported to do so in the right way.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"how-are-decisions-made\">How are decisions made in my family member\u2019s best interests?<\/h3>\n\n\n\n<p>If your family member cannot make a decision about something, then the decision will need to be made in their best interests.<\/p>\n\n\n\n<p class=\"is-style-default\"><a href=\"https:\/\/www.sense.org.uk\/information-and-advice\/life-stages\/adult-life-and-planning-for-your-future\/assessments-for-care-and-support-if-youre-disabled\/\">The Mental Capacity Act \u2018Code of Practice\u2019 sets out a \u2018best interests\u2019 checklist, which must be followed<\/a>.&nbsp; &nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"deputy\">Appointing a deputy through the Court of Protection<\/h3>\n\n\n\n<p>If you have a family member with complex needs who cannot make decisions about their personal welfare, you can ask the Court of Protection (England and Wales) to appoint a deputy for them.<\/p>\n\n\n\n<p>Appointing a deputy is a legal arrangement. The deputy can support your family member to make a decision or, if necessary, make a decision for them.<\/p>\n\n\n\n<p>Two or more deputies can be appointed to support one person.<\/p>\n\n\n\n<p>You can also apply to appoint a separate deputy who can make decisions about your family member\u2019s property and financial affairs.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-flair-dual-primary-tint\"\/>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"advocate\">What is an advocate and what do they do?<\/h2>\n\n\n\n<p>An advocate is someone who speaks and acts on your behalf and in your best interests.<\/p>\n\n\n\n<p>They help you to express your wishes, understand information, think about the options and make decisions.<\/p>\n\n\n\n<p>An advocate can help you to:<\/p>\n\n\n\n<ul class=\"wp-block-list is-style-secondary-bullets\">\n<li>Find services.<\/li>\n\n\n\n<li>Make sure correct procedures are followed.<\/li>\n\n\n\n<li>Challenge decisions made by councils or other organisations.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"when\">When is an advocate used?<\/h3>\n\n\n\n<p>Under the Care Act 2014 (England):<\/p>\n\n\n\n<ul class=\"wp-block-list is-style-primary-bullets\">\n<li>If you\u2019re receiving care and support and have \u2018substantial difficulty\u2019 making decisions for yourself, you\u2019re entitled to have an independent advocate.<\/li>\n\n\n\n<li>If you\u2019re a carer and need support, you\u2019re also entitled to an advocate.<\/li>\n\n\n\n<li>Independent advocates do not work for your local authority.<\/li>\n\n\n\n<li><a href=\"https:\/\/www.gov.uk\/find-local-council\">Your local authority<\/a> will pay for advocacy services in your area. They can also tell you how to find and use these services. <\/li>\n<\/ul>\n\n\n\n<p>Under the Mental Capacity Act 2005 (England and Wales):<\/p>\n\n\n\n<ul class=\"wp-block-list is-style-secondary-bullets\">\n<li>If you\u2019re a person who is aged over 16 and it is agreed that you don\u2019t have the capacity to make decisions for yourself and no family or friends to support you, your local authority and the NHS have a legal duty to appoint an Independent Mental Capacity Advocate (IMCA).<\/li>\n\n\n\n<li>The IMCA will speak and act for you when it comes to making important decisions about, for example, serious medical treatment or a change of accommodation.<\/li>\n\n\n\n<li>The IMCA must also make sure that any decisions made are legal and challenge decisions if they feel they\u2019re not in your best interests.<\/li>\n\n\n\n<li>In England, local authorities appoint IMCAs. In Wales, they are appointed by a local Health Board or other NHS body.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"longer\">Longer-term advocacy support<\/h3>\n\n\n\n<p>Advocacy under the Care Act 2014 is usually arranged to help you make short-term decisions.<\/p>\n\n\n\n<p>However, there are several types of advocacy services available if you need longer-term support:<\/p>\n\n\n\n<ul class=\"wp-block-list is-style-primary-bullets\">\n<li><strong>Professional advocacy<\/strong><\/li>\n<\/ul>\n\n\n\n<p>This means appointing a professionally trained advocate to support your family member to make long-term decisions about health and care.<\/p>\n\n\n\n<ul class=\"wp-block-list is-style-primary-bullets\">\n<li><strong>Citizen advocacy<\/strong><\/li>\n<\/ul>\n\n\n\n<p>Citizen advocates are volunteers from the local community. The volunteers are supported by professional advocates.<\/p>\n\n\n\n<ul class=\"wp-block-list is-style-primary-bullets\">\n<li><strong>Peer advocacy<\/strong><\/li>\n<\/ul>\n\n\n\n<p>Trained volunteer advocates with a similar disability or experience to your family member provide support, often as part of an organised project.<\/p>\n\n\n\n<ul class=\"wp-block-list is-style-primary-bullets\">\n<li><strong>Circles of support<\/strong>\n<ul class=\"wp-block-list\">\n<li>A group of people provide support and advocacy.<\/li>\n\n\n\n<li>The person being supported is at the centre of the circle and can choose who is in the group and how they want them to support them to make decisions.<\/li>\n\n\n\n<li>Membership can change over time.<\/li>\n\n\n\n<li>A good circle will include people with different knowledge and expertise who can be called on at different times.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p>Local authorities do not generally pay for longer-term advocacy support. Most is available through local charities and services will vary depending on where you live.<\/p>\n\n\n\n<p>For more on longer-term advocacy, see <strong><a href=\"https:\/\/circlesnetwork.org.uk\/\">Circles Network<\/a><\/strong> and <strong><a href=\"https:\/\/www.voiceability.org\/\">VoiceAbility<\/a>.<\/strong><\/p>\n\n\n\n<p>You can also search online for&nbsp;\u200b\u2018advocacy + your city, county or borough\u2019 or ask <a href=\"https:\/\/www.gov.uk\/find-local-council\">your local&nbsp;authority<\/a>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"power\">Power of Attorney<\/h3>\n\n\n\n<p>If you have complex needs and the mental capacity to make decisions for yourself but would like someone you trust to do this for you, you can grant a Power of Attorney.<\/p>\n\n\n\n<p>The person with Power of Attorney can then make decisions about your health and welfare.<\/p>\n\n\n\n<p>You can also separately grant Power of Attorney for decisions related to your property and financial affairs.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-flair-dual-primary-tint\"\/>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"adrt\">Advance decisions to refuse treatment<\/h2>\n\n\n\n<p>An advance decision to refuse treatment (ADRT), living will or advance directive is a statement setting out which medical treatment(s) you do not want to receive at some point in the future.<\/p>\n\n\n\n<p>You can make an ADRT, if you have complex needs, as long as you have the mental capacity to make such a decision, possibly supported by a healthcare professional.<\/p>\n\n\n\n<p>An ADRT needs to be:<\/p>\n\n\n\n<ul class=\"wp-block-list is-style-primary-bullets\">\n<li>Written down.<\/li>\n\n\n\n<li>Signed by you.<\/li>\n\n\n\n<li>Signed by a witness.<\/li>\n<\/ul>\n\n\n\n<p>An ADRT is legally binding as long as it:<\/p>\n\n\n\n<ul class=\"wp-block-list is-style-primary-bullets\">\n<li>Complies with the&nbsp;Mental Capacity Act 2005.<\/li>\n\n\n\n<li>Applies to the situation.<\/li>\n\n\n\n<li>Is valid.<\/li>\n<\/ul>\n\n\n\n<p>An ADRT is only valid if:<\/p>\n\n\n\n<ul class=\"wp-block-list is-style-primary-bullets\">\n<li>You&#8217;re aged 18 or over and had the capacity to make, understand and communicate your decision when you made it.<\/li>\n\n\n\n<li>You specify clearly which treatments you want to refuse.<\/li>\n\n\n\n<li>You explain the circumstances in which you want to refuse them.<\/li>\n\n\n\n<li>It&#8217;s signed by you and by a witness if you want to refuse life-sustaining treatment.<\/li>\n\n\n\n<li>You have made the advance decision of your own accord, without any pressure from anyone else.<\/li>\n\n\n\n<li>You have not said or done anything to contradict the ADRT since you made it, for example, telling someone you&#8217;ve changed your mind.<\/li>\n<\/ul>\n\n\n\n<p>There is no special form or format for an ADRT but you might want to get professional help from a solicitor or healthcare professional.<\/p>\n\n\n<script 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