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Supported Decision-Making (SDM) for Independent Living

bullseyeProgram Goal

The Program for Supported Decision-Making (SDM) promotes an alternative model to guardianship that enables senior citizens and people with disabilities to live independently in their community while managing their own daily affairs.

The program aims to:

  • Develop a model of optimal support that can then be taught and disseminated nationwide.
  • Develop and promote a supported decision-making model as a recognized and accepted alternative to guardianship in the courts and among professionals and target populations.
  • Establish a national network of multi-lingual volunteer “decision supporters” who can provide high-quality professional services to senior citizens and the disabled who do not have the financial means to afford them, and without anyone in their lives to provide this supportive function.

partnersStrategic Partners

The Ministry of Justice Administrator General, “Israel Beyond Borders” JDC Israel, the Mosaica Center for Conflict Resolution, and the MARVA organization.

toolsThe Model

Supported Decision-Making (SDM) is an alternative to guardianship that enables senior citizens and people with disabilities to live independently in the community while managing their daily affairs with the help of a supporter to make and implement decisions.

The program is based on the decision-maker and supporter establishing a relationship of trust, specifically when sharing information and explanations, making information accessible, providing support when making decisions, and at times, support for following through with decisions that involve third parties—without coercion or duress.

Supporters, social workers and other professionals that work with the elderly, and family member caregivers that undergo relevant training can provide support in several areas:

  • Receiving information, explanations, and information accessibility
  • Support in dealing with bureaucracy (housing, medical services, national insurance, social services, etc.)
  • Financial and economic management
  • Help in implementing decisions that involve third parties (banks, etc.)

toolsThe Mosaica Approach

Supported Decision-Making (SDM) is an innovative pilot program conducted in Israel and abroad. In 2020, Mosaica, partnering with the MARVA organization, won the joint tender of the Administrator General in the Justice Ministry and “Israel Beyond Borders” Joint Israel to manage the pilot.

There are currently 60,000 people in Israel that have been assigned a guardian. A significant number of these can live independently with support in certain areas. However, appointing a guardian may limit their independence and violate their right to autonomy, independent management, taking responsibility of their lives and their integration in the community.

Supported decision-making is an alternative to guardianship that enables people to make their own decisions with the help of an assigned supporter.

The pilot currently includes 50 volunteers fluent in four languages that work nationwide. They work with approximately 20 decision-makers that have begun the process with program supporters. Some of them are in the process of terminating their guardianship status, a change that will completely transform their daily lives and shift them from a state of dependency to learning how to cope with reality.

The program focuses on the three primary areas of activity:

  • Events and lectures to present the SDM model to professionals in the welfare, legal, health and education systems, to professionals in NGOs that work with target populations and directly with senior citizens, people with disabilities and their respective families. This is aimed at introducing people to the alternative and offering the service.
  • Establishing a network of volunteer supporters from various cultural and religious backgrounds fluent in several languages that can work across the country. The volunteers undergo training throughout the program as well as ongoing individual and group guidance.
  • Developing training, curricula, and support for program volunteers, including online tutorials, study meetings, a database, tools, and professional forums for consultation.

To learn more about services provided by Mosaica’s SDM program, click here.

document Case Studies

A young woman with a mental disability who had a legal guardian decided she wanted to begin to live independently. She contacted the program and explained that her main problem was managing her financial affairs. A volunteer with suitable skills was assigned to help – a businessman with years of experience in various financial fields was selected as her supporter. Since then, he has been supporting her in managing her finances and several other areas. She is currently making her way in the world as a young independent woman determining her own fate.

toolsStudies on the Model

A recently published review in the context of the model

Little Dubrowitzky (2021), What Happens When a Person Can’t Cognitively Decide for Himself? Ynet.

Following the film about Britney Spears: The Ministry of Justice clarifies the Guardianship Law, Ynet.

teamProgram Staff

Alon Brachfeld

Alon Brachfeld earned a bachelor’s degree in Law and Computer Science from the Hebrew University, a Master’s degree in Philosophy from Ben Gurion University, and a Master’s law degree (LL.M with honors) from the College of Management Academic Studies, in the Human Rights Program.

He is a social activist and researcher in the field of disabilities as well as an attorney, mediator, and coordinator of Olim LeDerech (Family Group Conferences).

Susan Nirens

Susan Nirens earned a bachelor’s degree in Social Work from the Hebrew University. For the past three decades, she has been developing programs for disabled youth. She is also one of the founders and managers of the organizations, Kishorit, House of Wheels-Galilee and Kivunim. Each of these organizations has found a way to create a new reality for people with disabilities in Israel.

For more information, please contact:

Elon Brachfeld, National Coordinator and Coordinator of the Center: elon-dm@mosaica.org.il
Susan Nirens, Program Coordinator: susan-dm@mosaica.org.il