Restrictive Practices Substitute Decision-Maker

A Restrictive Practices Substitute Decision Maker is the person to whom you appoint to either consent or refuse for a residential aged care facility to use restrictive practices on you.  It is a new document introduced in Victoria in July 2025.

‍

What are Restrictive Practices?

Restrictive practices are actions that restrict the rights or freedom of movement of an aged care resident. There are 5 types of restrictive practices, being:-  

1. Chemical restraints;

2. Environmental restraints;

3. Mechanical restraints;

4. Physical restraints; and

5. Seclusion.
‍

More practically, this can include:-

1. Using bed rails, lap belts or low beds;

2. Physically stopping a resident from moving into an area they may wish to go but shouldn’t be going;

3. Removing or limiting access to an outside space; or

4. Forcing personal care such as showering.

‍

What does a Decision-Maker do?

Except in emergencies, your appointed decision maker will have the authority to consent to or refuse restrictive practices in residential aged care settings based on your values and wishes. They can only do this, if you cannot consent or refuse yourself.

Your decision maker cannot make decisions relating to your medical treatment, financial matters or lifestyle matters. These decisions are dealt with in your Enduring Power of Attorney and Medical Treatment Decision Maker.

‍

Who is my Decision-Maker?

You can choose who to appoint as your decision-maker(s) in a Restrictive Practices Substitute Decision Maker document. This person does not have to be the same person as who you appointed in your Enduring Power of Attorney and/or Medical Treatment Decision Maker, although commonly it is.

If you do not have a Restrictive Practices Substitute Decision Maker document, then the first available and willing person from the list below will be your decision maker:  

1. Your spouse or domestic partner;

2. Your primary carer;

3. Your adult children (in order of age, being eldest first);

4. Your parents (in order of age, being eldest first); and

5. Your adult siblings (in order of age, being eldest first).

‍

When do I need a Restrictive Practices Substitute Decision Maker document?

Anyone can obtain a Restrictive Practices Substitute Decision Maker document, although we suggest anyone over the age of 55 has one even if they are not in aged care or considering entering it.

Often people lose capacity prior to considering or entering aged care and it is therefore best to obtain the Restrictive Practices Substitute Decision Maker document in advance. If you lose capacity and do not have the document, then the hierarchy listed above will instead be used to appoint your decision maker.