Appointed decision-makers

You can make your own aged care decisions. However, you may want help to make your own decisions, including from people you know and trust. This is called supported decision-making.

Sometimes you may not be able to make your own decision, even with support. If this happens, you may have chosen someone you know and trust to make your decisions or someone may be chosen for you. This is called substitute decision-making.

Presumption of capacity

The Aged Care Act presumes every older person has the ability to make their own decisions. Those decisions should be respected and recognised by law. This is known as the presumption of capacity. It means people providing you with services or supporting you in the aged care system must assume that you can make your own decisions and do things yourself, including: 

• registered supporters 
• aged care providers and workers 
• health professionals 
• carers. 

They must also assume you can make your own decisions, even if someone has made a decision on your behalf before. Just because you could not make a decision in the past does not mean you cannot make them now. Each time a new decision is to be made, those around you must assume you can make the new decision.  

Finally, your decision-making ability and the decisions you make cannot be ignored just because someone else does not agree with your decisions or they involve some risk to yourself. This is called dignity of risk.  

What is supported decision-making? 

You may want or need support to make your own decisions. Supported decision-making is about having help to make and communicate your own decisions and remain in control of your life. This includes: 

• giving you information, in the way you like to receive it, so you can understand the decision to be made 
• supporting you to make a decision on a certain day, time, or location of your preference 
• using communication techniques or aids to help you communicate in the way you want to 
• having someone you choose to help support you, such as a registered supporter. 

People in the aged care system should apply supported decision-making principles and processes. You should always be included in decisions about yourself, even if you have an appointed decision-maker, registered supporter or someone else supporting you to make decisions.  

What is an appointed decision-maker? 

An appointed decision-maker is someone who can make decisions for you because they have legal authority to do so, such as: 

• guardianship 
• enduring power of attorney, or  
• similar legal authority.  

Appointed decision-makers can be appointed by yourself (such as through an enduring power of attorney) or by others (such as through state and territory guardianship arrangements). 

They can only make decisions on your behalf in line with their active, legal authority. This means that each time a person seeks to make a decision for you, they must have legal authority to make that decision. If they do not, they must not make the decision for you. 

When can an appointed decision-maker act? 

States and territories have different laws for appointed decision-makers. This means there are often different rules about when and how appointed decision-makers can make decisions for you.

For example, they may need to consider your wishes before making a decision for you. Sometimes an appointed decision-maker cannot make a decision for another person until that person has lost their decision-making ability, for some or all decisions.

Anyone providing aged care services needs to consider an appointed decision-maker’s authority before they action a request or decision made on your behalf. This includes checking the kind of authority they have and when it becomes active.

Do I need to have an appointed decision-maker? 

You do not need to have an appointed decision-maker if you can make your decisions yourself. This is even if your ability to make decisions changes from day to day, or you need support to make your own decisions.

You cannot be pressured or forced to choose an appointed decision-maker. This includes an enduring guardianship or an enduring power of attorney.

An aged care provider cannot exclude you from services just because you have not made a decision-making arrangement (like an enduring guardianship or an enduring power of attorney) or one has not been made for you (like a guardianship order made by a court or tribunal).

If your decision-making capacity is questioned, and you have an active appointed decision-maker who can make a decision for you, others such as your aged care providers may need to involve this person in decision making. However, you should still be included. 

How do I raise concerns? 

If you are worried about your decision-making rights in aged care or those of someone you support, there are ways to raise concern.

Decision-maker appointed by yourself

If you want or need decision-making help, you can choose to give someone you know and trust, or a specialist organisation, the power to make decisions for you.

This will allow them to make decisions when you do not want to or are no longer able to. For example, someone might need help making financial decisions but still feel comfortable making decisions about their daily lifestyle and preferences.

You may also want to choose alternative decision-makers. These are people who can make decisions for you if your primary decision-maker is unable or unwilling to.

Depending on your situation, an appointment may include the power to make decisions about:

• your financial or legal matters
• your lifestyle (including where you live, what you eat, and what you wear), 
• what medical or health treatment you receive, and
• the use of restrictive practice.

How you appoint a decision maker varies based on where you live, as states and territories have different rules. This includes the documents you may need and when they can be used. Documents could include:

• enduring guardianship (NSW, WA and TAS)
• Advance Personal Plan (NT)
• enduring power of attorney (all jurisdictions except NT)
• advance health directive or similar that grants substitute decision-making authority (QLD and SA)
• appointed medical treatment decision maker (VIC).

Appointments of decision makers are usually recognised Australia wide. However, some restrictions can apply. The rules are different across Australia so you should seek legal advice to understand which arrangement(s) would suit you best.

More information  

Find more information on the arrangements in your state or territory:

• Australian Capital Territory
• New South Wales
• Northern Territory
• Queensland
• South Australia
• Tasmania
• Victoria
• Western Australia

Decision-maker appointed by someone else

If you have not formally appointed someone to make decisions on your behalf and it becomes necessary, a guardian and/or administrator can be appointed for you by a Commonwealth, state or territory:

• board
• panel
• court, or
• tribunal.

They can do this by conducting a hearing and making a guardianship and/or administration order. The appointed guardian or administrator can make decisions on your behalf. The kinds of decisions they can make is up to the board, panel, court or tribunal that made the order.

A guardian and/or administrator can only be appointed to make some or all decisions for you, if you no longer have the legal capacity to make those decisions for yourself.

Guardians and administrators

A guardian is a decision-maker who may make lifestyle decisions such as where a person should live. They can also give their consent to medical and health care services generally.

An administrator acts as a financial manager and looks after a person's property and finances.

There are many factors that a court, panel, board or tribunal can consider before deciding to appoint a guardian or administrator, including:

• your ability to make your own decisions
• any relevant medical or health conditions that might affect your ability to make decisions (including dementia, intellectual disability, mental illness, or acquired brain injury)
• your own wishes
• whether appointing a guardian or administrator is in your best interests or aligns with your will and preferences.

The rules are different across Australia, so you should contact the relevant authority where you live, or seek legal advice.

More information  

Find more information on the guardianship and administration laws in your state or territory:  

• Australian Capital Territory
• New South Wales
• Northern Territory
• Queensland
• South Australia
• Tasmania
• Victoria
• Western Australia

A decision-maker appointed by yourself or by someone else can also be registered as your supporter. Appointed decision-makers recognised under the new Aged Care Act can register without the older person’s consent.

Planning for the future

While setting up your legal arrangements, you may also want to consider other arrangements for the future. Doing this can help support you, your registered supporters and loved ones through your aged care journey and after death. It can help to seek professional advice on: 

• advance care planning (including advance care plans) 
• estate planning (including your will). 

Support roles as of 1 November 2025

As of 1 November 2025, changes to support roles and relationships are in effect. The key changes are:

• From 1 November, when registering someone to support you, they will be known as your registered supporter. You can request to register someone by completing and submitting the registration form, calling My Aged Care, during your assessment process, face to face with an Aged Care Specialist Officer (ACSO), or in your My Aged Care Online Account. Some of these pathways might not be available to you, depending on your situation.
• The My Aged Care regular and authorised representative roles do not exist anymore.
• Regular and authorised representatives that were active in My Aged Care as of 31 October are now registered supporters.
• Representative relationships made under the Quality of Care Principles 2014 no longer exist and did not become registered supporter relationships. However, aged care providers can continue to engage with those former representatives if the older person requests this or the former representative has decision-making authority for the older person.
• Registered supporters help older people to make and communicate their own decisions about aged care. They have legal duties they must comply with and may receive information about an older person.
• Some registered supporters also have guardianship, enduring power of attorney or similar legal authority. They are known as appointed decision-makers for the older person and must only act in line with their active, legal authority under their Commonwealth, state or territory arrangement.

Learn more about registered supporter roles and relationships.

Documents for registering an appointed decision-maker as a supporter in My Aged Care

Appointed decision-makers recognised under the new Aged Care Act for an older person can become registered supporters without an older person’s consent. To make this application, My Aged Care must be given proof that shows the prospective supporter is an active, appointed decision-maker for the older person. This is likely to be legal documentation. Medical evidence about the older person may also be required to show that the decision-maker’s authority is active.

If you are an alternative appointed decision-maker, you can only act under certain conditions. Usually this means that you are only considered an active, appointed decision-maker if the primary decision-maker is unable or unwilling to act. You may have to provide more documentation to support this.

If the older person can make their own decisions, the registered supporter should help and support them, even if they also have active decision-making authority.

Aged care providers should ask the older people they provide care or services to if they have any registered supporters, or anyone else, they would like involved in their decision-making. Aged care providers can also check the registration of supporters on the My Aged Care Service and Support Portal. If the aged care provider is not aware of the registration or any changes to it, the registered supporter is encouraged to tell them.

Wherever possible, aged care providers must continue to ask and support the older person to make their own decisions about their aged care, even when there is a registered supporter.

What if there is no appointed decision-maker in place?

There may be times where an older person is no longer able to make decisions and has no one in place with legal authority to make decisions for them.

My Aged Care cannot give anyone decision-making powers to act on the older person's behalf, nor can it revoke or change the authority someone has to make decisions for the older person under Commonwealth, state or territory arrangements. However, if you are concerned for an older person's welfare, there are ways to support them.

For example, you can submit an application for a guardianship and/or administration order with the state or territory court, board, panel or tribunal where the older person lives. They can conduct a hearing and decide if the older person requires a legal decision-maker. They can also decide who this person will be. Some state and territory processes also include emergency options to appoint a decision-maker quickly if necessary.