What happens if the person responsible for making decisions (Enduring Power of Attorney) disagrees with the care provider?
Confirm whether the participant can decide, check exactly what authority the attorney holds, document the provider’s safety concerns and arrange a care conference. If agreement cannot be reached, involve an independent advocate and escalate the matter through the provider, regulator or relevant state tribunal.
Key points
- Ask for details in writing and compare more than one option where possible.
- Individual eligibility, availability and outcomes can vary.
- Ask questions early and seek independent help if anything feels unclear or unsafe.
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01Guide sectionWhat happens if an Enduring Power of Attorney disagrees with the Support at Home provider?
A disagreement should first be handled through discussion, review of the person’s wishes and clarification of each party’s legal authority.
The provider should not automatically follow either the attorney or its own preferred approach without considering:
whether the participant can make the decision themselves
what the participant wants
whether the Enduring Power of Attorney is active
which decisions the attorney is legally authorised to make
whether the proposed care is safe and consistent with the support plan.
02Guide sectionThe participant’s decision comes first
Having an Enduring Power of Attorney does not mean the older person loses control of their care.
If the participant can understand, consider and communicate the particular decision, they should make it themselves. The provider must support their choices and provide information in a form they can understand.
Decision-making capacity is specific to the decision and the time. A person may need help understanding a complex contract but still be able to choose:
which worker visits
when they receive services
whether they want personal care
who receives information about them
whether they wish to change providers.
A disagreement between an attorney and the provider should not result in the participant being excluded from the discussion.
03Guide sectionWhat authority does the attorney have?
The provider should examine the actual legal document rather than relying on the title “Enduring Power of Attorney.”
The document may authorise decisions about:
finances and property
personal or lifestyle matters
contracts and service payments
healthcare, depending on the state or territory and type of appointment.
Some registered supporters also hold enduring powers of attorney, guardianship or similar legal authority. My Aged Care calls these people appointed decision-makers, but they may act only within their active legal authority.
For example, an attorney authorised only for financial matters may be able to question invoices or approve payments, but may not have authority to consent to medical treatment.
In Victoria, medical treatment decisions are generally made by an appointed or legally identified medical treatment decision-maker when the person cannot decide-not simply by anyone holding a financial power of attorney.
04Guide sectionCommon areas of disagreement
Disputes may involve:
whether a service is safe or clinically appropriate
changing or reducing services
the use of a particular worker
service prices or budget decisions
medication assistance
privacy and information sharing
hospital transfer
the use of restrictive practices
whether the person can remain safely at home
whether the participant should change providers.
The correct response depends on the type of decision.
05Guide sectionWhat should happen first?
Ask the provider to arrange a care conference involving, where appropriate:
the participant
the attorney or appointed decision-maker
the care partner
a senior provider representative
a nurse or relevant clinician
the participant’s GP or allied health professional
an independent advocate.
The meeting should clarify:
What decision needs to be made?
Can the participant make that decision with appropriate support?
What are the participant’s known wishes and preferences?
What authority does the attorney’s document provide?
What risks is the provider concerned about?
Are there less restrictive or safer alternatives?
What outcome can be agreed and documented?
Ask for the provider’s position, risk assessment and proposed options in writing.
06Guide sectionCan the attorney require the provider to deliver any requested service?
No.
Even where the attorney has authority, they cannot require the provider to:
deliver a service outside the approved Support at Home service list
use funding for something not included in the person’s approval
direct workers to act outside their qualifications
provide care the provider believes is unsafe or unlawful
ignore clinical standards
make false or improper claims against the participant’s budget.
The provider remains responsible for the safety, quality and legality of its services.
However, the provider should explain its reasons clearly and consider reasonable alternatives. It should not dismiss the attorney with a vague reference to “policy.”
07Guide sectionCan the provider ignore the attorney?
Not where the attorney has active legal authority over the decision and the participant cannot make that decision themselves.
The provider should verify the documents, record the attorney’s authority and involve them appropriately.
However, an attorney must generally act within the scope of the appointment and in accordance with the participant’s rights, will and preferences. They should not simply impose their own personal preference because they believe it is more convenient.
A registered supporter without separate legal authority can help the participant make and communicate decisions, but cannot make decisions for them.
08Guide sectionWhat if the disagreement concerns safety?
The provider should explain:
the specific risk
the evidence supporting that concern
what alternatives have been considered
what could make the proposed arrangement safer
whether clinical advice is required
whether the care plan or Support at Home support plan needs review.
For example, if an attorney insists that the participant be left alone overnight but the provider believes this presents an immediate risk, the provider may refuse to deliver an unsafe arrangement.
It should still help identify alternatives, such as:
additional support
assistive technology
overnight respite
a clinical assessment
family involvement
a Support Plan Review
another provider with different capabilities.
09Guide sectionWhat if the dispute involves restraint or medication?
Additional safeguards apply.
Chemical, physical, mechanical or environmental restraint cannot be used merely because an attorney or family member requests it. Restrictive practices must be a last resort and require the relevant assessment, legal authority, consent and monitoring.
Similarly, an attorney cannot direct a support worker to give extra medication or change a clinical treatment plan without appropriate medical authorisation.
10Guide sectionAsk for an independent advocate
An independent aged care advocate can:
explain the participant’s rights
help clarify the attorney’s role
attend meetings
help the parties focus on the participant’s wishes
assist with a formal complaint
refer the matter for legal advice where authority is disputed.
Contact OPAN’s Aged Care Advocacy Line on 1800 700 600. The service is free, independent and confidential.
11Guide sectionHow can the matter be escalated?
Where the dispute cannot be resolved:
use the provider’s formal complaints process
contact the Aged Care Quality and Safety Commission on 1800 951 822 if the concern involves provider conduct, safety, rights or service quality
contact My Aged Care on 1800 200 422 if the dispute concerns My Aged Care records, supporter registration, approved services or changing providers
obtain legal advice if the scope or conduct of the attorney is disputed
apply to the relevant state or territory tribunal if a formal decision about guardianship, attorney authority or substitute decision-making is required.
In Victoria, disputes about enduring powers of attorney or guardianship may ultimately require advice from the Office of the Public Advocate, a lawyer or an application to VCAT.
12Guide sectionWhat if the attorney may not be acting in the person’s interests?
Warning signs include an attorney who:
ignores the participant’s expressed wishes
prevents them speaking privately with workers or advocates
uses their money improperly
refuses necessary care for financial reasons
pressures them into a particular provider or arrangement
seeks access to information outside their authority
makes decisions that primarily benefit the attorney.
Raise concerns with an independent advocate and obtain legal advice. Serious financial abuse, coercion or immediate danger may also need to be reported to police or the relevant state safeguarding service.
13Guide sectionWhat should I do next?
Confirm the details with My Aged Care or the relevant provider, write down your questions and ask for important information in writing before making a decision.
14Guide sectionHelpful Local Home Help resources
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