Supported Decision-Making (SDM)

An alternative to guardianship that enables people with disabilities and senior citizens, who are unable to fully independently care for their own needs, to nevertheless live an independent life and manage their affairs with the help of a “decision supporter.” A supporter is assigned to assist them in making and implementing their decisions.


What is SDM?

An alternative to guardianship that enables senior citizens and people with disabilities, unable to be fully independently to nevertheless live an independent life and manage their affairs with the help of a “decision supporter” – someone who assists in decision-making.

Decision supporters may assist in the following areas:

  • Receiving information, explanations, and information accessibility.
  • Help in dealing with bureaucracy in housing, medical services, national insurance, and welfare.
  • Economic management and financial planning.
  • Making decision that involve third parties, such as banks.

Who can benefit from SDM?

Any person with a health-related or cognitive impairment or disability unable to independently make all their decisions who wishes to retain control of their lives.

Among others, the service is relevant to:

  1. Senior citizens struggling to fully manage their affairs due to aging or dementia.
  2. People with cognitive, mental, communication or development impairments that require the help of a supporter to make decisions.
  3. Wards of guardianships who believe that with support, they can transition out of guardianship and become independent.

Who are “decision supporters”?

Volunteers accepted to the program after undergoing a selection process have demonstrated skills and experience in various fields. Since the relation between supporter and supported is founded on trust, the ability to establish and maintain trust is an essential prerequisite for volunteers.

Who refers and is referred to SDM?

Most referrals are made by professionals: social workers, legal aid attorneys, the court system or people associated with the court system.  Sometimes, those requesting support directly submit their request.

How does SDM work?

As of 2021, all appointments of SDMs must be made by submitting a request to courts to appoint a decision supporter. It is possible that contractual SDM will become a possibility in the future and this will enable supporters and supported to sign a contract for provision of such services.

How long does a supporter appointment last?

Generally, the courts approve a temporary order lasting several months. This may be extended if support has been provided in a satisfactory manner and both parties wish to continue collaborating.

What language is used?

In any language the supported requires

How much does it cost?

This service is provided at no cost through the Mosaica program.

Examples of SDM

A young man on the autistic spectrum whose mother recently passed away and now required assistance. His father had died years earlier. The man primarily needed help managing his finances, and therefore a businessman with a background in economics was assigned to support him in making financial decisions.

An older and disoriented woman suffering from the early stages of dementia and struggling to manage her financial affairs, including hiring a foreign caregiver to manage domestic errands at home. A volunteer who had previously managed a large office and specialized in promoting bureaucratic issues was assigned to help her.