Supporting people to make their own decisions

Before concluding someone lacks capacity, staff must take all practicable steps to help them make the specific decision. In care homes, small changes in approach can affect whether the person can understand information, weigh options, and communicate their preference.

Practical support steps

• Choose a better time: some people decide more clearly after pain relief, food, rest or personal care.
• Reduce unnecessary pressure: move away from noise, crowds or rushed routines where possible.
• Check basic needs first: hunger, thirst, constipation, distress, poor sleep or needing the toilet can interfere with decision-making.
• Use communication support: hearing aids, glasses, dentures, interpreters, picture prompts, gesture, writing or one-step explanations may help.
• Offer real choices: ask about one decision at a time and avoid long, confusing explanations.
• Give enough time: some people need pauses, repetition or another attempt later in the shift.

Support should be proportionate to the decision. Routine care choices often need simple adjustments; more serious decisions may require a full communication assessment, speech and language therapy input, or clinical involvement.

For team leaders and supervisors

The question is not only "Can this person decide?" It is also "What have we done to help them decide for themselves?"