When someone begins looking into aged care, an important question often comes up early: “Who can help make decisions if I can’t?” 

In Australia, that role may be filled by an appointed decision-maker—a person with legal authority to act on an older person’s behalf. This guide explains what appointed decision-makers are, how they fit with the new registered supporter system, and what you need to register them with My Aged Care.


What is an appointed decision-maker?

An appointed decision-maker is someone legally authorised to make certain decisions on behalf of an older person. They may be appointed directly by the older person. At the same time, they still have decision-making capacity, or are appointed by a court or tribunal if capacity is lost and no prior arrangement is in place.

A decision-maker’s authority can cover different areas, including:

  • Financial and legal matters (for example, paying bills or managing property)
  • Lifestyle decisions (for example, where someone lives or daily care preferences)
  • Medical and health treatment decisions

The key point: decision-makers can only act within the scope of their legal appointment. Someone authorised for finances cannot automatically make lifestyle or health decisions unless their documents allow it.

Decision-makers appointed by the older person

Many Australians choose to set up decision-making arrangements in advance. The specific documents (and names) vary by state and territory, but often include:

  • Enduring power of attorney
  • Enduring guardianship (where applicable)
  • Advance health directive or similar substitute decision arrangements
  • Medical treatment decision maker appointments (for example, in Victoria)
  • Advance personal plans (Northern Territory)

These arrangements can be tailored. For instance, a person may want help with finances but feel comfortable making their own lifestyle choices for as long as possible. Many people also nominate alternative (backup) decision-makers in case the primary person can’t act.

Decision-maker appointed by a court or tribunal

If an older person has not legally appointed a decision-maker and later loses capacity, a state or territory tribunal, board, panel, or court can appoint one.

Guardian

  • Usually responsible for lifestyle decisions
  • May consent to medical and health care services

This appointment exists to protect the older person’s rights, safety, and preferences, especially when complex care decisions are required.

What changed on 1 November 2025?

From 1 November 2025, My Aged Care updated how support roles are recorded under the new Aged Care Act. The older roles known as “regular” and “authorised representative” no longer exist. Instead, people who help an older person through the system are now called registered supporters.

  • Existing regular/authorised representatives automatically transitioned to registered supporters.
  • Registered supporters can help communicate wishes, support decisions, and access information.
  • Appointment as a registered supporter does not by itself grant legal decision-making authority.

If a registered supporter also holds legal authority (like guardianship or power of attorney), that person is treated as an appointed decision-maker in My Aged Care.

Can an appointed decision-maker register without consent?

Yes. Under the new Act, an active appointed decision-maker can register as an older person’s supporter without the older person's consent, provided My Aged Care receives proof that the legal authority is current and active.

Documents needed to register an appointed decision-maker

To register an appointed decision-maker as a supporter, My Aged Care needs evidence that the arrangement is valid and active. This typically includes:

1. Legal documents

  • Enduring power of attorney
  • Enduring guardianship/guardianship order
  • Advance health directive or equivalent substitute decision document
  • Medical treatment decision maker appointment
  • Tribunal or court administration order (for financial administrators)

2. Medical evidence (sometimes required)

Some legal authorities only “activate” when a person loses capacity. If that’s the case, My Aged Care may also request medical evidence (such as a doctor’s letter) confirming the older person can no longer make decisions.

3. Proof for alternative decision-makers

If you’re an alternative (backup) decision-maker, you may need to show that the primary decision-maker is currently unable or unwilling to act before your authority is recognised as active.

What if there is no appointed decision-maker?

If no legal decision-maker is in place and an older person loses capacity, My Aged Care cannot create decision-making powers for family members. In most cases, families will need to apply through their state or territory tribunal or court to appoint a guardian or administrator. Emergency appointment pathways may exist for urgent cases.

Planning helps everyone.

Putting decision-making arrangements in place early can make aged care transitions smoother and safer. It helps ensure the older person’s will, preferences, and rights remain central—even when support is needed. Many families benefit from exploring:

  • Advance care planning (health and personal wishes)
  • Estate planning (financial and legal intentions)

How can Just Better Care support you?

Working through My Aged Care processes and decision-maker paperwork can feel overwhelming— especially if circumstances change quickly. Just Better Care can help you:

  • Understand which supporter or decision-maker role fits your situation
  • Prepare for assessments and service referrals
  • Coordinate with providers while keeping the older person involved as much as possible

If you’d like practical guidance, contact your local Just Better Care team for tailored support.