As an agency, we have diverse customers in terms of their goals and allotted hours. We have individuals who only need one or two Direct Support Professionals (DSP’s) to use the hours they want to use. We also have individuals that have enough hours to warrant multiple DSP’s to use. It’s this latter group I want to address, although some of what I say will apply to the other group.

Self-directed supports is the most important principle for us to follow in providing supports to our individuals. Here is a definition of self-directed supports:

Self-directed supports refer to services that allow individuals to have control over their own care and support options. This approach emphasizes self-determination, enabling individuals to make choices about the services they receive, including the selection of providers and the management of their care plans. The goal is to empower individuals to direct their own lives and services, fostering independence and personal agency.

With the understanding that this definition only includes services that are part of an Individual Service Plan (ISP) and our agency’s Service Agreement, we strive to make certain that our individual’s are involved in decisions that affect them. To be more direct, we must maintain the strict limitations of our service agreement as well as state rules and regulations that govern our work.

There is a potential for us to be suppressing self-directed supports unwittingly. This is true especially when an individual has a broad service agreement with us along with more hours than one DSP can manage. Such a situation requires a schedule to avoid overlapping times that we can’t bill. It also helps that different DSP’s have different assignments. This consistency is a good thing, good for us, and as a generalization, consistency is also good for our individuals.

However, a consistent schedule and delegated tasks have a dark side, one that is hard to recognize. What if our highly organized efforts to provide supports is also suppressing the growth and limiting the options of our individuals? More specifically, we may be creating an environment where an individual feels like they are obligated to roll with us organizing of their lives. In my 22 years doing this work, I’ve seen many times where and individual’s sense of adventure, hopes for the future, enjoyment of the present, and inclusion options give way to going along with a plan not entirely of their own making.

In my many years as a software, there is an axiom that makes great sense when developing software and an interface. “Always do the same thing the same way.”

I’m not so sure that translates to the work we do as Direct Support Professionals and agency leaders.

There’s also the old chestnut, “If it works, don’t fix it.”

Just because something is working, doesn’t mean it is working well enough. We should always be looking for ways to increase the independence, options, and empowerment of our individuals. Many of those ways will require us to be flexible in schedules and task assignments for our DSP’s.

As agency owner, I understand the staffing challenges that flexibility in schedules create. It isn’t my desire to cut anyone out of the hours they need to earn a living by rearranging schedules on the fly. This is one of the main reasons why we have tried to emphasize connecting individuals with more than one of our DSP’s. When hours become unavailable with one individual, it is good to have individuals who are familiar with other members of our staff to ease the inevitable transitions that happen with individuals. It eases the way for us to make necessary changes to staffing assignments.

Here are some important things that the agency and our staff can do to create more flexibility and options for our individuals.

• Hold more group activities in a 1:1 individual/DSP setting. While beneficial in itself, it also exposes our individuals to multiple members of our staff.
• Don’t assume that an individual’s unwillingness to do something different is because of their own lack of flexibility. Consider that it may be subliminal messages that we send that creates their reluctance. Find better ways to present options than just asking them if they want to do a certain activity.
• Jump out of your rut. For Lead DSP’s, foster a culture of flexibility in tasks that DSP’s are assigned to do. Let them trade times with other DSP’s that are assigned to that individual or do something different other than what was planned. For DSP’s, don’t be afraid to suggest alternatives to individuals other than what was planned. Do it with some personality, always accepting when the individual isn’t interested.
• Make more use of the Day Support Activities (DSA) services. Put more than one individual with one DSP or go to community activities. Consider that it may be that the individual isn’t bored with activities you suggest, but might be bored with you and being one on one with you in the community. Community inclusion might mean just being with an individual out in the community one on one, but if the entirety of that time isn’t spent engaging with people other than you, you are missing a big opportunity to expand an individual’s options. With DSA, you are bringing a small community with you and integrating it into the larger community.

I’m asking everyone in our agency to be aware of when you may be unknowingly limiting the options of the individuals we support by being a little too organized. Remember our second commandment of leadership, “Thou Shalt Be Flexible.”