The Value of Personal Choice and Decision-Making

Personal choice means making decisions about all the details of our lives. Each day, as soon as we wake up we are engaged in making choices. We ask ourselves: “Should I hit the snooze button or get up?” “Should I call in or go to work?” and “What should I wear?” We also make major decisions about who to live with and what sort of work we want to do. We are in control and it feels good to be empowered and able to make our own decisions. Everyone is entitled to make decisions about their lives.

An important goal of all DSPs should be to provide people with opportunities to make both small, everyday choices in the here-and-now, as well as bigger, more important decisions for the future. This goal must drive the Individual Support Plans that are developed, the way provider agencies operate, the staffing patterns (what staff do and when they do it), and especially the daily actions of the DSPs. Choice should occur naturally and should be expected without unnecessary restrictions. Many people entered supportive services with little to no choice. It is the DSP’s responsibility to promote personal choice by noticing likes, dislikes, and opinions as forms of choice.

Informed Consent refers to one’s ability to make a decision based on a clear understanding of the facts, results of the choice, and possible future consequences. Some people do not show the capacity for informed consent and need supports from family members, an authorized representative, or a legal guardian. This is typically reserved for decisions or choices that might have an effect on a person’s health and safety. This does not mean that the day-to-day choices or expression of hopes and dreams should be restricted. DSPs are responsible for encouraging choice and consulting with alternate decision-makers when unsure.  

Methods of Helping People Learn to Make Choices

  • When teaching someone with no prior experience with making choices, you need to start small, but teach the small steps throughout the person’s day. There are many chances to make choices during the day.
  • Start with offering choices when the person gets up. First offer a drink or washing up. Then offer coffee or another favorite drink. Further offer the choice to take a bath or shower.
  • Ask what he/she would like to wear and give two or three options. If the person doesn’t speak with words, you can ask him/her to look at or touch the preferred clothing.
  • Once picking from two or three options is mastered, you can use color coded clothes hangers to foster choice without your support. You can teach him/her that all shirts and pants that match are on the same colored hangers. This also leads to teaching matching clothes when doing laundry and it helps to support a person in hanging clothes on the proper colored hanger.
  • This color coding can also be used to separate food into food groups, by using yellow containers for breads, blue for proteins, red for vegetables, and green for fruits. Teach about healthy eating by talking about how many foods need to come from each container for the day. A person can plan meals daily. This can also be done with pictures of foods. Pictures may also be used in grocery shopping.
  • When planning trips to restaurants, go by the restaurant in advance to get a copy of the menu. Teach how to make choices before going into a social situation.
  • A person who does not use words to communicate can still make choices. Have him/her look at what he/she wants to wear or wants to eat, and confirm that choice by saying something like, “Oh, okay, you would like some eggs now?” This reinforces communication while encouraging decision making.