As of 1 July 2025, Aged Care Restrictive Practices Substitute Decision-maker Act 2024 (Victoria) (Act) has come into effect, which formally recognises who can act as a Restrictive Practices Substitute Decision-Maker (RPSDM).
An RPSDM is a person who is authorised to consent to the use of restrictive practices, where an aged care resident lacks capacity to provide informed consent themselves. If the RPSDM does not provide consent, the proposed restrictive practice cannot be applied. In such circumstances, the care provider must consider alternative approaches to ensure that appropriate care is provided to the resident, including, where necessary, applying to VCAT for consent to the use of restrictive practices.
Importantly, this appointment is separate from the appointment of any attorney or decision maker the resident may have for their financial, personal, and medical matters, and cannot be dealt with via an Appointment by Medical Treatment Decision Maker or Advance Care Directive document.
What are Restrictive Practices?
Restrictive practices are interventions that limit an individual’s freedom of movement and are used to manage or influence their behavior. They may be applied in aged care settings when a person’s behaviour poses a risk of harm to themselves and/or to others.
Examples of restrictive practices include:
| Restrictive Practice | Example |
|---|---|
| Chemical restraint | Using medication to control or manage dangerous and uncontrollable behaviour of a resident (not for a diagnosed condition) |
| Physical restraint | Using physical force to prevent a resident for the purpose of influencing their behaviour, such as physically pinning a resident down. |
| Mechanical restraint | Using a lap belt on a wheelchair to restrict a resident’s movement |
| Environmental restraint | Placing a resident in a memory support unit |
| Seclusion | Confining a resident in a room or physical space by themselves and preventing them from leaving voluntarily |
What if there is no permanent RPSDM?
If an aged care resident has not formally appointed a RPSDM, the Act sets out a default list of persons, in order of priority, to determine who can act as a ‘temporary’ RPSDM for such aged care resident.
The following persons, in the order listed, will act as a ‘temporary’ RPSDM, if they are an adult, in a close and continuing relationship with the resident and are reasonably available, willing, and able to make restrictive practices decisions on the resident’s behalf:
- Spouse or domestic partner
- Primary carer
- Oldest child, followed by other children in descending order of age
- Older parent
- Younger parent
- Oldest sibling, followed by other siblings in descending order of age.
That said, the temporary appointment ends when the restrictive practices decision is made, or if no decision is made, when the earliest of the following occurs:
- A permanent RPSDM is appointed;
- A previously appointed RPSDM becomes available, willing, and able; or
- A person with higher priority in the default hierarchy list, becomes available, willing, and able to act.
Why appoint a permanent RPSDM?
If you do not wish the default order of priority for a temporary RPSDM to apply and instead want to choose who will act as your RPSDM in relation to restrictive practices, it is strongly recommended that you formally appoint a RPSDM using the relevant form.
If no one is able to act as your RPSDM or temporary RPSDM when the use of restrictive practices is required, your care provider may need to apply to VCAT for consent, which can result in unnecessary delays and significant costs.
By appointing a permanent RPSDM, you can also record your preferences and wishes regarding restrictive practices. These will guide your RPSDM in deciding whether to consent or refuse their use on your behalf, ensuring decisions made reflect your personal values.
As such, if you are considering entry into an aged care facility in the future and have concerns about appointing the appropriate person to make restrictive practices decisions on your behalf, we strongly recommend that you complete a RPSDM form.
Other important medical appointments
In addition to appointing an RPSDM, we also recommend putting in place other legal documents that relate to your medical treatment and decision-making:
| Document | What it does for you | |
|---|---|---|
| 1 | Restrictive Practices Substitute Decision-Maker (RPSDM) Form | Allows you to appoint someone to consent to or refuse restrictive practices in aged care on your behalf |
| 2 | Appointment of Medical Treatment Decision Maker | Allows you to appoint a medical treatment decision-maker, who will have legal authority to make medical treatment decisions on your behalf, if you become unable to do so |
| 3 | Advance Care Directives | Allows you to document your values, preferences, and instructions for your future medical treatment and care. |
Having these documents in place together ensures your wishes are clearly recorded and capable of being lawfully acted upon across all aspects of your care and medical decision-making.
For tailored guidance on this process and all your estate planning needs, contact the team at iWills Legal.
