Guidance for shared decision making in the face of risky preferences

In day-to-day care, people may express preferences that involve risks or pose difficulties for the centre or service where they receive support. Sometimes, in order to deal with these situations, we propose general guidelines thinking that this is the fairest thing to do, when it is precisely the opposite.

Shared decision-making is an alternative way of recognising the differences that are always present in people and in everything that a given care situation involves and entails.

This brief guide proposes a sequence of action to help make prudent decisions to balance self-determination with safety and well-being of the person. All of this takes place within a framework of reflection and encounter between the main actors in caregiving: people who need support, professionals and family members.

The process detailed in this guide is recommended for those situations of particular difficulty insofar as they involve significant risks for the person him/herself, for others or entail significant difficulties in being able to support them.