Engaging paid vs unpaid support

A young man and a support worker playing a board game together.

Finding support workers can be challenging, but with this guide, it doesn’t have to be.

Before bringing paid support into a person’s life, consider these fundamentals of recruitment:

  • Paid vs unpaid or freely given relationships
  • The nature of the support – technical or personal?
  • Getting the balance right – not over or under supporting someone.

Where to start

The first step is to answer these two questions:

  1. What is the need that the person has that can’t be met in any other way?
  2. Who is in the person’s life now and how do they support them? Is it sustainable? What’s missing?

Answering these will help you:

  • To know what your job post should look like
  • Separate support that can be provided by people already in the person’s life, like their spouse, parents, children, siblings and teachers, from additional support that really needs to be purchased, in order to sustain those informal, unpaid relationships and for the person to be able to get on with their life.

Paid vs unpaid support

Informal, unpaid or freely given relationships can be loosely defined as any relationships that have no monetary component to them i.e. the relationship between husband and wife; parent and child; brother to sister; friend to friend; colleague to colleague.

Sustaining these relationships is vital so that they can endure for a long period of time and not be damaged by the sheer magnitude of supporting someone, even someone you love, beyond what is a reasonable ask.

Bringing paid support into a person’s life, however, must not come at the expense of the typical, freely given relationships. The paid supports should supplement and complement the unpaid supports, not replace them entirely. They should enable and enhance the relationships in a person’s life.

Safeguards

You can tell a lot about a person by the company they keep, so the saying goes. You can also gauge how safeguarded an individual is, by how many people are in their life in both unpaid and paid roles.

It’s not foolproof, but the more people you have in your life, the safer you will be because hopefully, someone will notice if something is going wrong. People keep people safe and having a combination of paid and unpaid support increases the likelihood that the person is not being taken advantage of or being badly treated by anyone.

Statistics show that abuse is more likely perpetrated by someone well known to the person, so it’s important to be aware of this and never assume that someone is safe just because they live in the family home or are supported by family alone.

You can think of safeguards in two ways.

  1. Soft safeguards: family, friends, properly vetted paid supports, neighbours, neighbourhood watch, work colleagues, acquaintances, connections, relationships on many levels, etc.
  2. Hard safeguards: contingency planning; laws and legislation; Ombudsman Offices; NDIS Quality and Safeguards Commission; Police; policies and procedures.

It is important to remember that the hard safeguards only come into play once something has gone wrong, so better to really focus on the soft safeguards to hopefully prevent ever having to resort to the hard ones.

The nature of support

Another important element to consider is: what is the nature of the support I am seeking? Is it mostly to support someone in their home with housekeeping or is it predominantly personal care support?

Is it mostly to support someone to get out and about in the community – to attend classes, to learn to travel on a bus to get to work or to participate in a sport?

Can anyone provide the type of support you are looking for, or are specific skills required?

Different people are good at different things, so once you have identified the nature of the support you are seeking, it helps you to then narrow your search to the right person or people for the job. Be specific about what it is you are looking for:

  • Homemaking skills: cooking, cleaning, gardening, making beds, laundry
  • Social/community participation sport, theatre, concerts, travel
  • Personal care: showering, toileting, assisting with meals, hair and nail care
  • Medical: medications, physiotherapy, seizure support, choking and inhalation prevention

For some of these supports, training and certification may be a prerequisite. In the instance of someone needing to be given medication, only a person who has done the recognised training can administer medication.

Next, think about how many people are required to provide the level of support that is needed. Word of caution here: having only one support worker is rarely a good idea. People get sick, take holidays, aren’t right, move on. Being reliant on one person leaves you in a very vulnerable position, especially if you live alone.

It’s better to have a second person who knows the ropes, who is already part of the team and who may be able to step in and take on the additional hours to avoid gaps in support when and if needed. Plus, different strokes for different folks! The person who provides the necessary personal care support at home, may not be the right person to attend a footy game with you or the person you are supporting, on the weekend.

Additionally, and especially if the person being supported lives alone or at least doesn’t live with family or friends, more than one person providing support is an important safeguard as there are another pair of eyes seeing what is going on in the person’s life.

Getting the balance right

Sitting alongside the question of ‘how much paid support is required’ is the issue of getting the balance of support right.

Too much support can be as unhelpful as not having enough. Over supporting someone can have unintended consequences like:

  • Skill loss: If the person being supported no longer has to perform a particular task, because the person with them does everything for them, the loss of some hard won skills can be the outcome.
  • Reduced self confidence and self doubt: What is the message being given to the person if someone is with them all the time, never allowing them to have the time and space to practice skills? It could be seen as the person can’t be trusted or isn’t good enough to be left alone to get on with stuff. This could damage self confidence and esteem over time.
  • Loss of freely given relationships: This is a big one! If the person is seen to always have paid support with them, the assumption could be made that they need ‘special, trained’ people to be with them all the time, which in turn gives the subliminal message that ordinary people can’t play a part in the person’s life which more often than not, is untrue. Paid support could drive out unpaid, freely given support if it’s not thought about carefully and used wisely. A combination of both types of support is what you should be aiming for.
  • Creating dependence: There can be a very fine line between dependency and reliance. You might rely on someone to be on time, efficient, ethical, professional and competent but not necessarily be ‘dependent’ on them. Dependency is more an emotional state than a physical one, and it’s one that requires gentle and compassionate attention to what else might be missing in the person’s life, that leads them to be emotionally dependent on a worker. Do they lack friends, meaningful relationships with other people, a valued identity as an individual with gifts and talents.

Conversely, the right amount and type of support can create the opposite effect.

  • Skill development. Using every day opportunities to identify and build a skill set that the person has the capacity for and can use in meaningful ways.
  • Building confidence. Providing opportunities for the person to have some wins! To learn new skills; to have some successes even in small things and to be seen as having something to offer; to be someone!
  • Being the link to new relationships. The paid people in a person’s life should be the link to new relationships, experiences and people. They should never be a barrier or get in the way. They should be the facilitator of friendships, not be the ‘friend’. The paid support person should be friendly, thoughtful and kind and all those things, but they must focus on supporting and encouraging the freely given relationships in the person’s life, as these are the ones that will endure long after the paid relationship has ended. This might sound harsh, but it is critical to recognise that many people who require support have a never ending cycle of paid people coming into and out of their lives. This discontinuity of relationships can have a very harmful, cumulative effect on a person’s emotional wellbeing over a period of time, and sometimes a lifetime, if not recognised and minimised as much as is possible.
  • Building independence. Again, as mentioned above we want the person to know that they can rely on the paid support to provide what they need, but they themselves have capacity and skills and the confidence to get on with some things themselves and not just wait for the next ‘shift’ to take place. This may take time and great perseverance but is well worth the effort.

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