Call on public-facing services to apply Assisted Decision-Making law

The majority of Irish adults say that have either never heard of (44%) or don’t understand (16%) laws on Assisted Decision-Making – and just 15% say they know what is required as a result of the law.

In new RED C research launched by Safeguarding Ireland today, almost half (46%) were not aware of the greater legal responsibilities it places on health services, banks, utilities, and Government services to support the voice of all adults.

Since the Assisted Decision-Making (Capacity) Act came into effect in 2023, all people now have legal protections – particularly adults with communication or decision-making capacity challenges – to ensure that their important decisions about money, health and welfare are voiced and respected.

The RED C research was based on a national representative sample of 1,001 adults and launched to mark Adult Safeguarding Day 2025 (7/11/25) – an annual initiative coordinated by Safeguarding Ireland supported by the HSE.

The Assisted Decision-Making law is particularly relevant for adults who live with an intellectual disability, an acquired brain injury, a mental illness, dementia, or age-related frailty.

Under the law all services and professionals – in both the public and private sectors – have legal responsibility to take steps to support each person’s communication as needed, and to engage with formal support arrangements if a person needs help from an appointed decision supporter.

In the survey:

• 46% of respondents either didn’t understand (13%) or didn’t know (33%) that health services, banks, utilities and Government services have a legal responsibility to take necessary steps to support at risk adults with their communication and decision making. 
• 38% believed that, when a person has a challenge, that the responsibility lies with themselves ‘to take the initiative and find a way’ to voice their decision. 

Safeguarding Ireland Chairperson Patricia Rickard Clarke said both responses show a need for greater awareness: “The message for Adult Safeguarding Day is that respecting rights is a responsibility of all services – and that’s the law. Under Assisted Decision-Making law, everyone is presumed to have capacity and barriers must be addressed to the greatest extent possible.

For example, if a person has challenge with communication – there are many ways to facilitate their voice such as meeting in person and giving additional time, using assistive technology, or working with a language interpreter.

“If a person has reduced decision-making capacity, then we now have in law three different levels of formal support which can be put in place and applied if they are needed. These are a Decision-Making Assistant, a Co-Decision Maker, or a Decision-Making Representative.

“Information on setting up these arrangements can be sought from the Decision Support Service (DSS), a State Agency dedicated to this area. It also registers arrangements and can investigate complaints.

“Both the DSS and HSE have been proactive in promoting the law – but implementing Assisted Decision-Making properly is wider and the shared responsibility across all services and providers who engage with the public, in both the public and private sector.”

Furthermore, the survey revealed misunderstanding of who has legal authority to act on a person’s behalf – as more than a third either disagreed (9%) or did not know (26%) that only someone who has been formally registered as a person’s ‘decision supporter’ has a legal authority to speak on their behalf. A next-of-kin while often an important contact, does not have any legal authority.

HSE Chief Social Worker Amanda Casey welcomed the survey which showed that awareness of the Assisted Decision-Making (Capacity) Act continues to grow. However, she said more work is needed.

“Services and professionals have a responsibility to maximise each person’s voice and to support them to make their own decisions. The HSE National Office for Human Rights and Equality Policy has been providing training, support and advice on the new legislation and on the HSE Consent Policy.

“This training is available to health and social care sector professionals, organisations or individuals who are looking to better understand and apply assisted decision-making guiding principles and supports.

“The RED C Poll shows an increased awareness, compared to a previous similar survey, that only those with legal authority can make decisions on behalf of another person. However, more work is needed to enable services understand their legal responsibilities. See www.assisteddecisionmaking.ie.”

On Adult Safeguarding Day, Ms Casey said that applying the assisted decision-making law in practice was a key enabler to prevent abuse of at risk adults, but it was also essential to call out and report any concerns of adult abuse.

“If you have a concern about a serious and immediate danger of adult abuse, call the Gardaí at 999 or 112. If you have a safeguarding concern about an adult at risk of harm you should contact your local HSE Safeguarding Team. There are regional teams covering all areas of the country with details at www.hse.ie/safeguarding. Abuse concerns can also be reported online via the HSE’s online Adult Safeguarding Portal at https://adultsafeguardingportal.hse.ie”

In conclusion Patricia Rickard-Clarke said: “If a person – seeking to access any service – needs support to have communication barriers overcome, this should be provided. If a person has difficulty exercising decision-making capacity, then supervised support arrangements are available. And importantly for a person to have authority to speak for their loved one, they must be appointed under an arrangement covered in the law.”

Adult Safeguarding Day is an initiative of Safeguarding Ireland and supported by the HSE. More information, and the RED C survey, are at www.safeguardingday.ie

Further Information

Ronan Cavanagh, Cavanagh Communications: (086) 317 9731.

Safeguarding Ireland promotes safeguarding of adults to protect them from all forms of abuse by persons, organisations and institutions and to deliver a national plan for promoting their welfare

Safeguarding means putting measures in place to uphold our rights, to support our health and wellbeing, to reduce our risk of harm – and to empower us to protect ourselves.

Contacts on Adult Abuse and Assisted Decision-Making

Concerns of adult abuse

• If an urgent or serious issue, call the Gardaí: 999 / 112
• If an ongoing concern, contact the HSE Safeguarding and Protection Teams
  • Contact details of local teams: www.hse.ie/safeguarding
  • Report online via the HSE safeguarding portal: https://adultsafeguardingportal.hse.ie

Decision Support Service

• Understanding Assisted Decision-Making
• Putting in place a Decision Support Arrangement
• Making an Enduring Power of Attorney
• Making an Advance Healthcare Directive
• A concern relating to a decision supporter, complaints@decisionsupportservice.ie
• www.decisionsupportservice.ie or call 01 211 9750.

HSE National Office for Human Rights and Equality Policy

• Provides advice, guidance and training on Assisted Decision-Making in health and social care services
• See www.assisteddecisionmaking.ie and queries to adm@hse.ie.

Irish Hospice Foundation

• The Think Ahead resource (includes an Advance Healthcare Directive template)
• See www.thinkahead.ie, or call 01 679 3188.