Supported Decision-Making for People with Intellectual Disabilities: An Employee Perspective

This article examines the understandings and experiences of municipal frontline employees regarding supported decision-making for individuals with intellectual disabilities. It analyses experience-sharing dialogues and focus group interviews with staff members working in group homes and day-care services in Norway. The data were transcribed verbatim and analysed thematically.

The findings suggest that authentic supported decision-making may be constrained by staff members’ limited willingness to tolerate risk, as well as by their values, attitudes and interpretations of what constitutes professionally sound practice. The participants in the study agreed that time is a crucial factor, as clarifying individuals’ will and fostering decision-making skills are often time-intensive processes. Participants also emphasised the influence of relatives’ roles and attitudes in shaping opportunities and limitations for self-determination. In the absence of clear-cut solutions, staff must exercise professional judgement to balance competing values within tricky relational and structural contexts.