Meet Carlos
Carlos is a 32-year-old male with Autism who lives in a 2-person supported living apartment with a male roommate who also has a disability. Carlos has a part-time job at a local pet store, and he has had this job for 3 years. Carlos told his mother that recently he had been running out of money before the end of the month. Carlos’ health issues include poorly controlled asthma, recent weight gain of 10 pounds, and anxiety in some social situations. Carlos’s family worries that an asthma attack could result in an ambulance trip to the Emergency Department, a very stressful environment for him. They are also concerned about his money management and the potential for exploitation.
Why Supported Decision-Making (SDM)?
Carlos stated, “I want to use SDM because it will help me make better decisions and feel good about myself and my abilities. SDM will help me keep my legal rights so I can be an independent adult.”
Developing a Supported Decision-Making Plan Using the Missouri Stoplight Tool
Carlos stated, “I want to make decisions so I can manage the important things in my life: health, money, community living. I want to have people I trust to help me make decisions. To help me with my decisions, they can:
- Help me understand my choices so can make good decisions
- Give me information in ways that I can understand.
- Use the Stoplight Tool so I can say what I can do or decide by myself, what I need help with, and what I need someone else to do or decide for me.
- Help me tell other people about my decisions.”
Steps to Creating a Supported Decision-Making Plan:
Step 1: Decide what types of activities and decisions I want help with. I will use the Missouri Stoplight Tool for this. I understand the traffic light idea of green, yellow and red.
Step 2: Choose the people I want to support me and talk to them.
Step 3: Learn about Less Restrictive Alternatives (LRAs) and resources that can help me and my supporters at the Rethinking Guardianship NC website.
Step 4: List the activities, decisions, support people and resources I will use.
Step 5: Share this information with the people who are important to me.
Step 1: Types of things I want help with are:
- Learn what sets off my asthma so I know when and how to use my inhaler.
- Know what to do when I have an asthma attack.
- Keep track of my health information because I have a lot of records.
- Set up a budget so I can pay my bills and do the things I want to. I don’t want to have a payee.
Step 2: The people I want to support me:
- I want Mom and Dad to be my main health supporters right now. But I want Maya, my favorite cousin, to know what’s going on and to help me with money management.
- I want the nurse at my doctor’s office to help me learn more about asthma.
- I will ask the leader of the adult social support group to talk with me about asthma because he has asthma.
Step 3: This is how I will learn about Supported Decision-Making and other Less Restrictive Alternatives (LRAs):
- My parents will help me use the Less Restrictive Alternatives (LRAs) Planning Hub at the Rethinking Guardianship website.
Step 4: This is my Supported Decision-Making Plan. It lists the things I will learn and use and do to make good decisions:
KEY:
HEALTH:
1. Learning About and Managing My Asthma
My Supporters and I will use these Resources:
2. Medical Emergencies and Making Important Health Decisions
My Supporters and I will use these Resources:
3. Keeping track of my Health information
My Supporters and I will use these Resources:
COMMUNITY LIVING:
1. Managing my Money
My Supporters and I will use these Resources:
Step 5: How I will share my plan
- I will keep a copy of my Asthma Action Plan, Money Plan and Supported Decision-Making Plan on my phone that is password protected, since it is my private health information and in the lock box in my bedroom.
- I will give copies of my plans to my parents and my cousin.
- I will give my doctor’s office my Asthma Action Plan.
- I will keep a copy of the Healthcare Power of Attorney on my phone, in the lock box in my bedroom and in my medical record at the doctor’s office.
Detailed Background
- Carlos lives in a supported living housing apartment with another male adult with ASD
- Carlos and his roommate sometimes have disagreements about housekeeping and money
- Several times this year Carlos has run out of money before the end of the month
- Carlos is close to his family, especially his cousin and grandmother
- Carlos’ health issues include GI discomfort, poor nutrition, asthma, anxiety
- He has difficulty managing asthma, is unsure of what triggers his asthma attacks, and what he should do in an emergency
- He sees a primary care provider at a community clinic
- He has Medicaid Insurance
- Carlos likes working at a pet store and would like to increase his hours
- He would like to volunteer at local animal shelter
- Carlos attends an adult support group for social activities
Concerns
- Carlos’ ability to manage his asthma, proper use of inhaler, what to do in an emergency
- Carlos’ ability to manage his money. His mother is concerned that Carlos may be giving money to his roommate and co-workers
- Carlos’ recent weight gain and reliance on fast food for many meals
- Carlos’ care and support as his parents age
- His grandmother is moving into a care facility
