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Choice and control: what it means day to day

· 2 min read

"Choice and control" is one of the most used phrases in disability and aged care. It sits at the heart of the National Disability Insurance Scheme, and Australia's new aged care law puts the rights of older people first in the same way. But a principle only matters if it shows up in ordinary life. So what does it look like on a Tuesday afternoon?

Where the idea comes from

Among the objects of the National Disability Insurance Scheme Act 2013 is enabling people with disability to exercise choice and control in pursuing their goals, and in the planning and delivery of their supports.

In aged care, the Department of Health, Disability and Ageing's policy on choice and control describes supported decision-making: people are supported, only as far as they need, to make their own decisions. The policy is clear that supporting someone to decide does not mean making the decision for them. It also recognises a person's right to take personal risks in pursuit of their quality of life.

What it looks like day to day

Choice and control is not only about plans and funding. It lives in small moments:

  • What to do today. A walk, a cooking session, a game or a quiet afternoon. Offering a few real options, and then accepting the answer, is choice and control in action.
  • How to do it. Seated or standing, alone or together, now or later.
  • Who is involved. Who comes along, who helps, and who hears about it afterwards.
  • What is shared. A person's photos, achievements and everyday moments are theirs to share, or not. Sharing should be a choice, and one that can change.
  • Saying no. A choice is only real if "not today" is respected too.

Support that steps back

Good support makes choices possible without taking them over. A few habits that help:

  • Offer, don't assume. Ask what the person would like, even when you think you know.
  • Make options visible. Pictures, videos and plain words make it easier to choose between things.
  • Give time. A pause before stepping in leaves room for a person to decide and do things themselves.
  • Ask how they would like to be helped. Some people want a hand with one step and to do the rest themselves.
  • Respect the dignity of risk. Trying something new, and sometimes finding it does not work out, is part of everyone's life.

Why it matters for an active life

People are far more likely to keep doing an activity they chose for themselves. Choice and control is a right, and it is also how healthy habits last.

At Able Wellness we built the app around that idea. A person chooses what to do from five doors (Move, Cook, Play, Go and Calm), and decides who is in their family circle and what is shared with them. Workers can sit alongside, and the decision stays with the person.

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