Direct care staff have a critical role to play in helping people learn how to exercise choice, whether they are serving as a supporter or not.
For some people with disabilities, making decisions on their own will be a new experience. In some cases, particularly for people with intellectual or developmental disabilities, someone else may have been making decisions for them for them for years – their parents, their guardian, institutional staff, program staff.
The place to start is to consider the ways we make decisions in our lives and make them the same ways that people with disabilities can make decisions in theirs.
For people with I/DD, a direct care staff person may be one of the people – perhaps the only ones — who play the support role, the person to whom to turn for advice and information.
Here are some tools we think can work, based on our experience and our observations of interactions between staff and people with disabilities:
- Always include the individual in the conversation; ask for his/her opinion, even if you are talking about routine day-to-day matters, such as clothing (what shirt do you want to wear today? the green one? the striped one?); breakfast selections (oatmeal or eggs?); choice of activities (watch the news, converse with colleagues, etc.).
- Encourage and support people to make their own decisions.
- Respect those decisions.
Training in decision making should be incorporated in treatment and services plans like ISPs and IEPs. The plan could include language and provisions that all staff will, for example:
- Always interact with individuals with the belief that all people with necessary supports can make their own decisions, regardless of the extent of disability.
- Reject that only when there is conclusive proof that even with support, it is impossible.
- When there is such proof, design a plan to teach decision-making.
To design a decision-making plan, direct care staff can assist by helping to identify the person’s:
- Preferences, health status, strengths, values, developmental needs, strengths, interests, talents, service needs, including his or her
- Interests: like hobbies and activities that energize people mentally,physically, emotionally,
- Talents : like natural abilities/gifts: music, skills, writing, reading
- Values: those core beliefs that are important to people
- Environmental preferences: where person feels comfortable, motivated
- Dreams, goals: can be reflected in activities such as employment, where a person lives and with whom, relationships
The decision-making plan should advance self-advocacy and self-determination through person-centered planning:
- Encouraging self-advocacy: speaking up for oneself
- Encourage self-determination: the right to be provided opportunities, supports and authority to make choices and decisions about one’s life
- Identify and focus on preferences, interests and goals
- Identify and explore opportunities to make meaningful choices to realize goals
- Teach individuals to assume responsibility for their choices
