As New York's population ages, more older adults are navigating complex decisions about healthcare, housing, finances, and daily life. For some, these decisions are made in the context of cognitive change. Too often, guardianship becomes the default response when support is needed, even when less restrictive alternatives may suffice.
Project Guardianship's Supported Decision Making (SDM) initiative explores how older adults can be supported in making their own decisions through trusted relationships, values-based conversations, and person-centered planning. The initiative is grounded in the belief that decision-making support should enhance, rather than replace, an individual's ability to direct their own life.
What is Supported Decision Making?
Supported Decision Making is an approach that helps individuals make and communicate their own decisions with the support of trusted people in their lives. Rather than transferring decision-making authority to someone else, SDM focuses on providing the information, guidance, and support a person needs to understand options, express preferences, and remain at the center of decisions that affect them.
While Supported Decision-Making has been widely explored for people with intellectual and developmental disabilities, Project Guardianship examines how this approach can be meaningfully adapted to meet the unique needs of older adults.
Our Approach
The initiative combines research, collaboration, and direct engagement with older adults to better understand how decision-making support can be integrated into aging services and community-based programs.
By listening to older adults and learning from practitioners across multiple disciplines, Project Guardianship is identifying approaches that reflect how decisions are actually made throughout later life. The work recognizes that decision-making is shaped by personal values, trusted relationships, family dynamics, available resources, and changing circumstances.
The initiative acknowledges that older adults often prioritize maintaining independence, preserving control over their lives, and making decisions that reflect their own goals while balancing the needs of those around them.
What’s Next: Integrating Values-Based Support
Effective decision-making support is not a one-time intervention. It is an ongoing process that develops through trusted relationships and evolves as a person's circumstances, preferences, and needs change.
Project Guardianship is working to incorporate these principles into existing and emerging programs, helping practitioners engage older adults in meaningful, values-based conversations over time. This work promotes practical, relationship-centered approaches to Supported Decision Making that strengthen autonomy, reduce unnecessary reliance on guardianship, and help older adults make decisions that reflect their own values and goals.