Department of Health

Substitute decision-making and restrictive practices in aged care

A guide to identifying a Restrictive Practices Substitute Decision-maker in residential aged care.

All appointments for Restrictive Practices Substitute Decision-makers in Victorian residential aged care setting are made and regulated under the Aged Care Restrictive Practices Substitute Decision-maker Act 2024 (Vic)External Link .

This Act responds to the Commonwealth Government's legislation and regulations that defer to state and territory laws for identifying who can act as a Restrictive Practices Substitute Decision-maker to consent to the use of restrictive practicesExternal Link , on behalf of a person living in residential aged care who doesn't have capacity to provide informed consent themselves.

The Act only applies to aged care residents in residential aged care settings and not to other settings, such as disability services, hospitals or mental health settings. From November 1, 2025 with the commencement of the new Aged Care Act 2024 (Cth) all category 6 services, including residential aged care and bed-based Transition to Care Programs (TCP) delivered in hospital settings will be subject to the Aged Care Restrictive Practices Substitute Decision-maker Act 2024 (Vic).

Hierarchy of Restrictive Practices Substitute Decision-makers

The Act establishes a hierarchy of substitute decision-makers who can consent to the use of restrictive practices in residential aged care settings when the aged care resident does not have capacity to provide consent.

A person is not automatically appointed as a Restrictive Practices Substitute Decision-maker just because they are the aged care resident's guardian, attorney or medical treatment decision maker. This means these types of decision-makers are not automatically empowered to provide informed consent to the use of restrictive practices as a substitute decision-maker in residential aged care.

Download the printable flowchart, which outlines at a high level how the hierarchy operates at the Restrictive Practices Substitute Decision-maker in aged care webpage.

More information

For further information related to the use of restrictive practices, behavioural support plans, or the Commonwealth's aged care legislation and regulations, please contact the Aged Care Quality and Safety Commission:

If you have questions regarding the appointment of restrictive practices substitute decision-makers and Victorian legislation, please contact the Aged Care Policy team in the Victorian Department of Health:

Reviewed 20 November 2025

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