Services for Supported Decision-Makers (SDM)

The goal of the Supported Decision-Making service is to help senior citizens and individuals with functional limitations retain control over their lives by matching them with a “decision supporter” who helps them make and implement independent decisions.

What is Supported Decision-Making (SDM)?

Supported Decision-Making (SDM) is an alternative to guardianship that enables people with disabilities and senior citizens who are unable to function entirely independently to manage their own affairs with the aid of a “decision supporter” – someone who assists in making and implementing decisions.

Decision supporters may assist in the following areas:

  • Receiving information, providing explanations, and aiding information accessibility.
  • Helping navigate 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 cognitive impairment or physical disability who is unable to independently make all of their decisions and who wishes to retain their autonomy.

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 developmental impairments that require the help of a supporter to make decisions.
  3. Wards of guardianship who believe that with support, they can transition out of guardianship and function independently.

Who are “decision supporters”?

Decision supporters are volunteers with demonstrated skills and experience in various fields who are accepted to the program after undergoing a rigorous selection process. Since the relationship between supporter and supported is founded on trust, the ability to establish and maintain trust is an essential prerequisite for volunteers.

Who refers people for SDM?

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

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 contracted SDM will become a possibility in the future, which will enable supporters and the 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?

Service is provided in any language required by the supported individual.

How much does it cost?

This service is provided through Mosaica’s Supported Decision-Making program at no cost.


A young man on the autism spectrum whose mother recently passed away 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 struggled to manage her financial affairs, including the hiring of 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.