The Ugly Direct Support Professional

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When have you unintentionally reinforced stereotypes about people with disabilities?

Name: Jeff Welch
Email: jeffw@wadsp.org
Date: 30 Jan 2000
Time: 04:04:45
Remote Name: cust110.max5.seattle-k56.aa.net
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Story

Being a successful and competent Direct Support Professional means many things. It means not only fulfilling basic expectations with regard to good work habits, but also having the qualities of trustworthiness, empathy, dedication, flexibility, knowledgeability and creativity, good humor, good judgement and moral character.

Among common themes heard from Direct Support Professionals about their frustrations with their profession, are their experiences working alongside people who do not demonstrate a commitment to quality in the support that they provide. As John and Connie Lyle O'brien said, "Unfortunately, paid work with people with developmental disabilities has an enduring attraction to abusive, neglectful, exploitative, power hungry, and slothful people. While these people represent a minority of those working at any time, their influence can be devastating if it is not checked." (1) My own experience and similar experiences related by many I've encountered in the course my career bears sad reality out.

It is a disturbing feature of the support service system that DSP's whose dedication and everyday efforts go largely unrecognized, often work alongside co-workers who demonstrate negative behavior that equally often goes uncorrected. Sometimes these latter individuals demonstrate an uncanny ability to remain employed in service to people with disabilities--- either because their behaviors don't "cross the line" into overt abuse, because of their relationships with management, or due to union protections. "Warm body syndrome"---the lack of available quality applicants to work as Direct Support Professionals, and the ensuing difficulty in replacing even substandard workers is also a major contributor.

As Direct Support Professionals across the nation begin to work together to take an active role in improving quality in our own profession, we need to carefully examine our professional responsibilities close to home---in our agencies, in our support relationships, and in our communities. We certainly need to raise awareness about wages, benefits, the complex skills it takes to provide quality supports to people with disabilities in the community. We need to raise awareness about the continuing challenges faced by people with disabilities and their families when quality supports are not available as well. Equally important in these efforts is the need to raise awareness among ourselves about the importance of commitment to quality, and the need to assume responsibility for our own behavior as professionals.

Whether talking with people with disabilities, family members, managers, or Direct Support Professionals, it doesn't take long to draw out a "horror story" about a bad experience someone has had with a DSP who lacks commitment to quality. These stories take many forms, from those about DSP's that engage in behavior of questionable ethics, to those who blatantly lie, steal and abuse those they are entrusted to support. Regardless of where the event is along that continuum, the common theme of commitment to quality involves first and foremost RESPECT for those receiving supports. This appears to be the weak link and the downfall of workers who lack commitment to quality.

Today I met with one of the men that I support professionally. "Ethan" (a pseudonym to protect his privacy) is a man who met with an accident a couple of months ago. As a result, he is staying in a nursing home until he can either recuperate to the point where he is strong enough to go home, or alternative living arrangements can be made. While waiting for the nurse to sign him out for the afternoon, I heard a man calling for help from one of the rooms. A number of workers strolled by, oblivious, even though this man was shouting quite loudly, and lucidly. "Could somebody just help me put my shoe on please so that I can go to lunch?" Each time someone would appear outside his door walking by, he would repeat his plea. None of the staff save one even acknowledged him. The one who did seem to notice after he said "Could somebody help me, please?" muttered as she continued on by "I wish I could." On that, I went into the gentleman's room myself. "Hi, several people just walked by. Nobody will stop and help. Could you help me put my shoe on?" he said. I told him I was just visiting, but would be happy to help, and placed his slipper on his foot. He thanked me profusely for taking 10 seconds out of my day, just to acknowledge his simple need. Shortly after I left, he began shouting for help again, with no better results than before. As I walked by on the way out, I gave him the thumbs up, "Keep at 'em, they've got to hear you eventually." He nodded and smiled.

Ethan and I took a walk into town, only a few short blocks away. He was greeted at the barbershop where he gets his hair cut warmly by the women working there, and by customers, some of whom recognized him. While he got his hair cut, his stylist chatted with him, asking how he'd been, when he'd be returning home, etc. After he got his hair cut, Ethan looked at me hopefully, unsure of how much time I had to spend with him today. He did not want to go back to the nursing home right away. "Want to go to Beth's?" I said. Ethan is a "regular" at Beth's, and he nodded enthusiastically and said "Goodie!" an expression I'd never heard him use before. Good call, I thought.

Again Ethan was enthusiastically greeted by the folks at Beth, customers and servers remembering him and talking with him about how he'd been. Ethan loved it, this simple opportunity to get out and be a real person instead of a "patient" for just a little while.

At the other end of the room in the restaurant was a group of what were obviously people with developmental disabilities and three of their staff. A large residential provider operates in the area of Beth's, and I suspect that this group was from that company.

Hovering over this group was a particularly loud and overbearing direct support staffer. The other two DSP's, appearing a bit younger, remained fairly passive. The one who caught my attention was hovering over the 10 or so "clients" at 3 different tables, distributing food and a constant stream of negativity and overcorrective chiding. As the food arrived, she passed it out, lit cigarette dangling from her mouth, the occasional ash shaking into the food as she sourly distributed giant omelets and spare plates to the people she was "supervising" on this "outing".

On of the diners borrowed a cigarette from another while this staffer left for a moment to use the restroom. When she returned, seeing him smoking (she was apparently the designated Keeper of the Smokes for this gentleman) she berated him for "going against (his) program", and told him he would be "in trouble" when he got home. This woman's continuous dialog to all of her "clients", loud enough for many nearby to hear clearly, consisted of constant corrective advice--"don't do this's" and "don't do that's". "Well you should have known betters" and "see, I told you's". I looked at Ethan across from the table, happily eating his French fries and even managing to get some ketchup on the inside of his mouth in the process, and silently promised not to turn him into a "client". Not this day, not ever.

I thought about those men across the room, who may as well have remained home with their direct support staff "running programs" instead of engaging in the cruelly misleading premise of just plain going out to eat as members of their community. While Ethan at the barbershop and at the restaurant was treated like a customer, a neighbor, a friend and member of the community by the people he encountered and served him, these poor guys with this domineering, chain-smoking, frankly poor excuse for a DSP were "clients" wherever they went. I felt ashamed on her behalf and equally ashamed for the two other women there who placidly sat and said nothing.

Over the years I have encountered many situations like I did today. As the Obriens note, there does seem to be a proliferation of "abusive, neglectful, exploitative and power hungry people" who fall into and remain in the direct support profession. Seldom are these particular people "slothful"--they actually work quite hard, and seem to at times argue that their efforts and the lack of accompanying monetary compensation justify their demeanor. In public, they sometimes broadcast their status and domination as if to announce to innocent bystanders, "See? I'm doing my job! I'm preventing these people from acting inappropriately!" Of course it is in witness to such events that I personally wish that certain DSP's could be subjected to behavior plans, which I'd cheerfully volunteer to write, complete with aversive reinforcers.

I can't do that, of course. But we who recognize our responsibilities and commit to quality have a responsibility to not tolerate this behavior in our coworkers. The O'briens note that "their influence can be devastating if it is not checked", and they are correct. Since some of these individuals are actually "senior" staffers where they work, they can give the impression to more junior DSP's that the behavior of these individuals is to be emulated. Long-term tolerance of this variety or "style" of support can give newer DSPs the idea that negative behavior is tolerated or even encouraged by the organization, even though much of it likely takes place out of sight of supervisors.

We need to insure, as Bill Gaventa says, that "(in) defining Direct Support workers as professionals we need to invite people not to emulate the worst stereotype of professionals e.g., distant, quick with advice and diagnosis, obsessed with control, fiercely protective of position, privilege, power, and having all the answers." (2) If we as Direct Support Professionals are going to insist on being treated as professionals, we need to make a commitment to quality, and quality begins with basic respect for those we serve as human beings, deserving of common courtesy.

We as Professionals in the positive sense of the term need to recognize that those we serve are first and foremost friends, family members, neighbors, and members of their community. Their status as "client", "consumer", "program participants", "residents" or "support recipients" is an artificial construct that should not overshadow their status as individuals.

As DSP's we do indeed have a responsibility to those we serve to model "appropriate behavior", and assist those we support in any number of ways. As I did my job today however, it was not the DSP's I saw at the nursing home, or hovering over people in the restaurant that were my role models. It was the barber, the customer, the waiter-- members of Ethan's community who treated "my client" just like he was anyone else. Which of course, he was and is.

Over lunch, Ethan and I discussed the news, his desire to get out of the nursing home, his new wheelchair (he loves the color) and the quality of his meal. We even talked a bit about the behavior we'd both seen and heard exhibited at the 3 tables near the window, and at the nursing home earlier that day. When he talked, I listened. When I talked, he listened. Sometimes we sat in silence and merely enjoyed one another's company.

After the large group had left, I helped him wipe the ketchup off of his fingers and comb the crumbs out of his beard and we went on our way. Two customers. Two members of the community. A person with a disability and a Direct Support Professional.

1. "Assistance With Integrity he Search For Accountability and The Lives of People With Developmental Disabilities", John O'Brien and Connie Lyle O'Brien, Responsive Systems Associates, Inc, 1994 2. Bill Gaventa, "Frontline Initiative"-Recovering the Meaning of Professional, AAMR pub.

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Name: ducbyhuui
Email: ajuqmt@kkcopw.com
Date: 13 May 2008
Time: 03:37:31
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Story

Re: Odd Behavior

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Date: 16 Feb 2008
Time: 01:45:43
Remote Name: 198.54.202.82
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