Assisted Decision-Making laws bring rise in demand for independent advocacy

Demand for advocacy services grew dramatically last year – reflecting a growing public understanding of independent advocacy and the first full year of laws on Assisted Decision-Making.                                                                           

Publishing its Annual Report 2024 Sage Advocacy reported that demand for its advocacy service grew by 56% with cases increasing from 1,975 in 2023 to 3,086 in 2024. A similar pattern is evident in its Information & Support Service which grew by 53% in 12 months from 5,928 queries to 9,062 at the end of 2024.

Sage Advocacy is the national advocacy service for older people and Chairperson Mark Mellett said its 2024 report reflected a ‘coming of age’ of independent advocacy.

The service was established in 2014 and helps older people, vulnerable adults and survivors of institutional abuse to navigate State health and social supports, their finances and survivor redress services, through the direct support of a skilled independent advocate who partners with the person.

Mr Mellett said: “A landmark development, which significantly affected demand in 2024, was the commencement of the Assistant Decision-Making (ADM) laws in 2023. The ADM Act put in place legally-based decision support arrangements to maximise the voice of people with capacity challenges. 

“Sage’s network of advocates across the country were available to help people who needed support to navigate this area. Without Sage Advocacy, the ‘voice of the person’ would have been almost absent from applications for Decision-Making Representation that came before the courts.” 

The greatest number of information and support calls in 2024 related to issues people were having regarding nursing homes (17%), followed by assisted decision-making (13%) and thirdly finances (10%). 

Increased demand in 2024 put pressure on the service as its waiting list increased by 49% from 358 in Q4 of 2023 to 534 in Q3 of 2024. In response to this growth, the HSE provided significant additional funding to the service in late 2024. 

During 2024 Sage Advocacy also further expanded its remit to provide advocacy services to survivors of institutional abuse. This was requested and funded through the Department of Education.

Launching its report Sage Advocacy also officially opened a new office in Merchants Quay, Dublin 8 to facilitate staff and service growth.

Cutting the ribbon on the new office today the Minister for Public Expenditure, Infrastructure, Public Service Reform and Digitalisation, Jack Chambers said: “Sage advocacy is providing an essential service to underpin the rights and voice of older and vulnerable adults. The growth in the service reflects increasing understanding of the function, need for and value of independent advocacy. Our Government will continue to work and support Sage Advocacy on this journey.” 

CEO Bibiana Savin said that adequate funding now needs to be annualised, as independent advocacy is embedding itself as an integral aspect of strong democracy. “Acute hospitals continue to experience high levels of demand. We are playing an important role to ensure that the voice of older people, healthcare patients and survivors of institutional abuse is heard, so they can be discharged as quickly as possible to the place of their choice, with the necessary levels of support.”

Staff at Sage has grown from 40 at the start of 2024 to 50 at year end and has further increased to 64 in September 2025. Ms Savin said this growth is expected to continue in the years ahead.

“We further forecast a more than doubling of demand for services over the three years 2025-2027. Progressive social legislation which is focused on upholding people’s rights is placing increasing responsibilities and pressures on Sage Advocacy. We need to see a coherent long-term commitment at government level to resource the impact of these changes.”

In conclusion Mark Mellett added that Sage’s work has also identified a long-term need for the State to become more central in responding to the housing and care needs of older people.

“Over 80% of nursing home care is now delivered by the private sector, with the number of large commercial facilities of more than 100 beds doubling in recent years. This underlines the urgent need for government to plan and invest in a broad continuum of care within local communities. Public policy should also enable and resource community-based social enterprises that can provide housing with supports of varying levels of intensity. 

“At its heart, this is about people’s well-being, and the most important determinant of well-being is meaningful social connection with family, friends and community. Wherever possible, that connection is best supported in the home.” 

Sage Advocacy can be contacted at 01 536 7330, or email info@sageadvocacy.ie. The motto of Sage Advocacy is ‘Nothing about you / without you’.

The 2024 Annual Report can be read in full on our website.