Active harm vs passive harm in disablity

Why passive support leads to harm in disability support.

So this is going to be a really hard topic to address but it needs addressing and this is because a lot of service providers don’t really understand the potential for harm in having passive support, so there are generally two forms of support one being passive support and the other being active and passive support is when a support worker does things for the client and this leads them to have fewer skills, this can be due to several things and this is quite interesting because one major one is a lack of training of the support worker and a lack of ongoing professional development training and we see that this can be a massive issue because there is no set requirement for a direct support worker to have and this, as I have stated in other formats, can be both a good and a bad thing because people need to be flexible in how they receive care.  

In some cases where a person has very complex needs the support worker would be doing what is called passive support and they would need to do passive support, and it is not inherently harmful full but it can lead to a loss of skills and independence due to the support worker directing their lives and what they can a can’t do and this is all based around your plan and this would vary from country to country but given that I am talking about the NDIS I see that this is an Australian based program and we see that it is based around a plan that is linked to your goals in that plan and it has to be linked to your disability and we see that this is a massive issue as it leads to gaps in support where support needs are given.  So we see that this is where passive support can create harm and it could be intentional harm or unintentional harm such as not knowing a person's needs, properly, giving the person a revolving door of support workers, and not actively working with the family to create a cohesive environment or even service providers not having the office staff and culture in the office to create a healthy environment for support workers and this would then rub off onto the support workers.

We also see that some support workers can coheres people into doing what the support worker wants to do and not what the client needs to do leading to further harm as the support worker if they don’t know the client they aren’t able to actively support the person in there goals, or it might be that a service provider is stuck in an out dated model of support being the medical model of care where there is rules that both the support workers and clients need to follow I am not saying that having rules is a bad thing but having them flexible depending on the clients level of function is a good idea and we see that a lot of support agencies that provide housing have to work in this model of care to provide good support however this can lead to situations that don’t seem conductive to a person living a “more ordinary life<’ and can lead to the deskilling of a person who wants to be more independent, like having to ask to have a sleep over at a family or friends house, I realise that there is paperwork involved here but I can also see where this would be planed that day and we see that some service providers it is the middle managers that have the power go to there head and they don’t realise that this is playing god with peoples lives in having this much control over there lives and can lead to the person having further mental health issues because they aren’t given options. 

As there are alternatives to passive support and they are harder to implement but in the long term have much better outcomes for both the client and the support providers, so these are things like supported decision-making, where a person is given simple options when it comes to day to day things like meals so asking if the person wants toast or cereal for breakfast, having them have a say in their day to day activities and cleaning of the house, and having days where they are simply allowed to Netflix and chill with friends over and allowing them to have reasonable freedom of movement.

I realize that this needs to be balanced with the duty of care issues but this is where alternative ways of doing things come into play such as positive behavior support plans and having an active and stable care team a team that is willing to work with a client in skills development in having the have active support.

Active support is where you involve the client in their own care and activities and give them a say in what they are doing and when such as housework in a cell house or if a person needs more help having them work one on one with a support worker to work towards goals such as activities of daily living, working or running there own business as we are seeing a lot of people with disabilities use the internet to start creating and using this to run a successful business in the long term and using it as an active platform to create change and to be an active advocate for good and to be able to help further disability rights.

As we are seeing that some service providers are hiding behind the duty of care to prevent other service providers from coming into sill homes and this doesn’t seem to make a lot of sense to me as they can come into private dwellings to provide support why couldn’t they come into a sil home to provide support. 

Active support is much more hard work from a provider's perspective and when done well can provide amazing outcomes but I am finding that because people come into the industry with very little knowledge of the impact of disability we see that people are leaving the industry just as quickly and we need to have a good stable care team to get anywhere in achieving a good level of independence that is at this person level of function and we see that this is why many people are choosing to have private support workers it cuts out the middle man and makes it so much easier to have support.

We also see that it gets unnecessary regulations that are not backed by the NDIS or NDIA out of the way and that a person is free to have the life they want to live and this is where it is good to have the options that are provided by the NDIS and I would ask service providers if their procedures are following best practices that are set down by the NDIA in person-centered care or are you still stuck in a medical model of support where there is block support or support given on your terms and a person is rewarded when they don’t need a positive behavior support plan. 

I know that this has been a difficult topic to talk about but it’s one that we need to talk about and as we have the break between Christmas and the New year I feel it’s a timely one as many people with disabilities are “farmed out to family members” and this is used as an opportunity to plan for the new year and this can often include support needs and see if the person is using the support that they need or do they need more or less or do they need a different type of support.  

This is the question I will be asking in my next post how do you know what level of care and support you does a person need?  Also,  the answer might surprise you.