What is Active support and how does it help prevent harm in the NDIS

 

What is Active support and how does it help people with a disability,  so active support is where the person's abilities are at the core of the support so it’s a level of support where the person with a disability and not their care team is involved in their support and make the major decisions around what they do day to day.  We see that this is the flip side to something that I talked about called Passive support that can cause harm in a person with a disability and we see that harm in support is a topic that isn’t often talked about and often people with a disability are gaslighted into believing that what the provider is giving them is what they wanted.

It might be what they need but given the nature of support work a support worker needs to know the person well to provide good support and when it’s app apart to provider active support vs passive support as both are needed but passive support carries the risk of deskilling a person leading to maladaptive coping behaviors that we see are attention seeking as if a person has no control over the direction of there life we can see that this can lead to a person not being able to reach their goals of being independent as they can be.

This is where active support comes into it and active support is based around the person-centered model of care that is in turn based on the social model of disability that says that if a person has a disability then it is the role of society to fix the barrier’s that a disabled person faces being included into society.

In fact, many things that was created for people with a disability have benefited others as well and this is positive to seeing disability through the social model of disability, so having closed captions on TV shows a mother with a young child can watch it without waking the child up.

A person who has mobility issues can order groceries through the internet and can keep in touch with people as well if they need to self-isolate due to covid or other reasons. This reduces social isolation.

Also, we see that in active support there are constantly shifting goals to allow for changing circumstances and to actively support a person with their freedom of movement in keeping this freedom of movement we see that people need to be aware that there are parents to what support worker can do for a person with a disability and if they live in the family home they have to be willing to work with the family and not actively setting the person at odds with there family. ( I have had this happen) and we see that people need to be aware of this that leads me back to active support where you involve everyone in decision making and the person who makes the decision around their support is the person with a disability if they can do so and this can be facilitated in several ways if the person has an intellectual impairment or a developmental delay. 

One option is through having plan nominees as well as supported decision making where a person is given a limited number of options that help a person decide on what they want and what is reasonable for them to achieve.   So for a person who has only a physical disability, we see that they wouldn’t need help to make decisions their support would be more practical, and in the case of a younger person, it would be decision-making around housing, work, or study.

We also see that some people might want to start a micro business so would need support to do so or to like myself start creating content and this might mean using a support worker to proofread, research content, and understand the unwritten rules of the internet and to remind the person of physical and emotional safety when creating content and deciding on what to make content about so it might mean reading about things that are challenging for a person to read about, it might mean for a support worker to facilitate the person going to networking events and to facilitate a work-life balance by having hobbies outside YouTube or other content creation platforms. 

We also see that this requires a constant and stable care team, and this can take a lot of practice and patience from everyone as the rules around active vs passive support will vary from provider to provider but active support is the best practice as it involves the person with a disability learning new skills and developing themselves with the help of a support worker and the support worker waiting until the person asks for support with tasks, in a housing situation we see that this could be prompting with activities of daily living but depending on how many clients they have in the house we see that it might be easier for the service provider to have a support worker to complete certain tasks because of the level of hygiene that is required in the house.   However again in the case of higher functioning clients, they might leave some tasks due to the clients needing to be able to develop these skills.

We also see that active support takes into account the clients family situation and if the clients family is willing to help them this is what the NDIS calls informal support and it can be a challenge for people to accept a support worker in to a persons life but I know that there has been situations in the past where having access to a support worker has been a god send to the family as it then took the pressure of the family and this is where having a support worker is a good thing and it was the very model of what good support looks like and what good communication between a support worker, their agency and the clients family looks like so this to me shows what good support is and this year for my family has been a very challenging year but in terms of me having a good and stable support team we have had to fight for it, so I will be honest and say that you often do need family support to take on the office of support organizations and if they have a revolving door of staff you often might need to ask why and this is what we did and we where not able to get access to solid answers but often this is due to privacy reasons.

 I need to respect this but when talking to friends I discovered it was due to the support workers having a lack of support from the office and we see that this is often the case as they will have procedures that are put in place but are not updated and can get very outdated very quickly and can limit a person’s freedom of moment and then it becomes an unapproved restrictive practice.

I know that there are limits to this and we need to consider if it is reasonable and necessary for the client. There are also safety issues at play hear but we need to consider the longer-term goals and if they are suitable for the client as a client with complex and challenging needs might need these practices for them to be kept physically and emotionally safe.

 However, these need to be used along with a positive behavior support plan but if a support worker isn’t trained in the plan in working with this client then the positive behavior support plan is rendered ineffective and we see that that this is where the argument for having a minimum set qualification is a good thing.

However, if we see that this restriction of the moment is applied to all clients for argument’s sake in a sill house ( supported independent living) and only one person is on a behavior management plan but it is applied across the board because it makes life easier for the support workers working in the house we see that people are at risk of resenting the support workers. After all, they have to then follow these procedures. 

I will do another post on active support and how it can be carried out in housing community situations where it is reflective of person-centred care and reflects best practices for personal development.