The DSP Problem

The DSP Problem

It has been a long while since my last post.  In fact, the last blog created a wonderful stir among the little community that reads my stuff.  I am about to make another potential stir.  I am ready. Hope you are as well…

For the past few months I have heard a few leaders of human services organizations that employ direct support professionals refer to something called, “The DSP Problem.” The theory behind the DSP Problem is that because direct support professionals are unqualified, undertrained, apathetic, unreliable and overall entry level pawns in a game that the issue of turnover, morale, abuse and neglect rests on the shoulders of the lackluster workforce.  Human service leaders are looking to correct the DSP Problem by increasing pay, improving training and finding “better” direct support professionals? The problem can be solved simply.  Right?

I believe NOTHING is further from the truth.   I do not feel that there is a “DSP Problem”. The 4 million people who currently provide direct support in the United States are very committed and professional people doing their great work, unspectacularly, everyday.  They help make the idea and notion of community living possible for many vulnerable and alienated fellow citizens.  The direct support professionals, aside from a scant few, are not the problem.

There is a “Leadership Problem”.   There are some wonderful and amazing leaders in our field.  I know many of them personally, and likely if you are reading this, you are probably a leader with whom I agree and respect.  The leaders in our field that refer to a “DSP Problem”, in my opinion, are finally beginning to see the vital role that direct support professionals have in the lives of the people they support.  States, municipalities, and organizations are now putting direct support professionals in a slightly more positive light and subsequently addressing the emerging profession of direct support by raising the expectations of the field.  Competencies for direct support professionals are being recognized and created.  Direct support professionals are beginning to be developed, educated and recognized as PROFESSIONAL.  This is a new day for DSPs but we should not view the situation as a “DSP Problem”.

I think the best solution for the “Leadership Problem” is to let the evolution of direct support take it's course!   Everyday, I have a great privilege to meet and work with direct support professionals.  I see their talent and skill.  I see the passion they have for their craft.  Most importantly, I see first hand what they do to improve the outcomes for people they support.  As managed care organizations and accreditation bodies like CQL (Council on Quality and Leadership) and NADSP (The National Alliance for Direct Support Professionals) continue to raise a bar for direct support, and as personal outcomes become the primary focus of our work, the leadership in our field will have to follow suit. On that note,  I work with closely several organizations throughout the country that are helping direct support professionals achieve a national credential.  (By the way they never referred to the "DSP Problem")!

Yes, there is a direct support workforce crisis (that was predicted 25 years ago by researchers and scholars) but the warnings were not listened to.  We will need 1 million direct support workers by 2022.  That said, with all the developing educational opportunities and career ladder options that are being established by progressive leadership in this country, we will see the “Leadership Problem” improve.  Thanks to direct support professionals and what they do each day to improve the lives of the people they support, leaders in the field (including me) will be humbled, will be inspired and most of all see there was never a “DSP Problem”.  We will learn from the DSPs who help create a world we everyone belongs. They will lead us. 

Happy Thanksgiving.  This year please make sure to thank a direct support professional.

I "love" the guys....

Been a while since a post.  I am not as prolific a blogger as others in this cyber world of opinions and insights but I usually write when I am moved, inspired, pissed or feeling like something needs to be said.   Now, is one of those times.

I have been spending lots of time with direct support professionals these last two months.  I have probably have met with over 400 direct support professionals these past weeks and there is a serious concern.

Many direct support workers use a phrase that is all too common,  "I love the guys".  Worse yet is when I hear a DSP say, "I love MY guys"!  It is truly amazing how much this is said and how offensive it is. Let me explain.

Relationships that are created between direct support professionals and people supported should be based on professional competence and ethics.  It should never be based on "love" of the people or a notion that one "loves" the persons they are paid to support.  In fact, this is a dangerous idea.

 I have heard brand new direct support professionals, within one day of working with people with developmental disabilities, say..."I just love these guys"!  "They are like my family member already"!  I have even heard things like this: "If I ever leave this job or have to move or something like that, I will always keep in touch my MY guys"!   I cannot count the number of times I have seen DSPs, and other staff as well, suddenly depart willingly or otherwise from an agency or organization....more importantly, from the relationship where they "loved" the guys.....never to be heard from or seen again. 

To me saying things like, "I love my guys" objectifies people with disabilities, diminishes the profession of direct support and ultimately is an impossibility. (It is also sexist in that the term guys implies male gender)  I know of no other profession other than perhaps religious clergy where loving the customer is accepted.  Also, saying "my guys" implies your ownership and control "over" people.  This is totally against the message of our code of ethics and is a slippery slope into servitude. 

One may grow to love and respect a person supported but direct support professionals need to understand that their role is not one of family or friend.  The primary role is that of  assistant, stage-hand and ally.  Most certainly we can develop affection and indeed, love, over time as we grow in our professional relationships. However, to say that the reason we work as direct support professionals is our "love" of the guys is disrespectful and ultimately not true. 

Direct support professionals are often referred to as, "angels", "God's hands on Earth", "where the rubber meets the road",  and so forth.....Most people see the work of a direct support professional as something valiant or noble. Something that not just anyone can do or wants to do.  True, the work is rewarding and many great things occur in the the relationships that grow between DSPs and the people they support, but DSPs are not angelic or noble or otherwise (at least as a blanket idea for the profession).  

Direct support is a profession.  It is still being identified and developed but stands as a wonderful and meaningful career choice.  In this profession one may develop close and meaningful relationships with people.  However, never be mistaken that the work executed on a daily basis is rooted in knowledge, skills and values....it is never rooted on the love of the people supported.  

So, if you say, "I love the guys" or "I love my guys" in your usual conversations,  I ask you to stop, reflect on this blog, and reconsider your role in the lives of the people you support.  People supported belong to themselves.  We do not own anyone.  We don't love everyone. 

As an alternative say, " I love my profession!"

Jan 23 International Day of Mourning and Memory for people w disabilities

Jan 23 International Day of Mourning and Memory for people w disabilities

Today is Wednesday January 23rd, 2014.  Please reflect, remember and celebrate the lives of people you may or may not have known who are gone..... people who had disabilities and perhaps left the world without much fanfare, love or even consideration.  Thanks to Dave Hingsburger this day is dedicated to mourn people with disabilities that have since left the earth.  Please read this segment from Dave's blog of a few years ago and learn all about this important and reverent day.  

There is a Facebook page also devoted to the cause. Please visit here.

Last year I posted this on my blog.  I am re-posting...it is such a great story and I want to retell it each year.

For many years I worked in an agency where we supported people who once lived in institutions.  They would come live with us, have a better and more meaningful life and often come to die of old age or associated stuff.... I have attended countless funerals for people who died living their lives in a modern group home versus dying inside a cold institution.  It was always an honor, a privilege and huge responsibility to ensure that the people had a send off and funerals that were just like those of people who did not experience institutional life.  As we know, many people died alone in institutions, with no name and more tragically no memorial other than a stone with a number if they were "lucky".

Anyway, at this agency where I worked, funerals, as sad as they were, represented a significant level of dignity and celebration.

Enter, 3 twenty year old Direct Support Professionals who made sure that Margaret had a really good and dignified send off. More about them in a moment.

Margaret was 95.  She lived 55 years in an institution. She lived 40 years in a group home. At the end of her life she was supported and loved by at least 30 DSPs, each a fraction of her age.  She died of natural causes and had a really good run!

Margaret had no family other than the one that was developed at the agency in which she lived the final 40 years of her life. The DSPs were her family.

When Margaret died there was a minimal amount of fanfare. She had a very typical and standard funeral except for one significant thing.  The priest who was "assigned" to her service (she was Catholic) was an itinerant priest and was mandated to preside/officiate her Mass. Well, he botched her name, did not talk at ALL about her and essentially he was an embarrassment.  After 95 years, I hope that the person responsible for introducing a soul to the next world will have a slight clue about that individual.  He did not.  THe DSPs who loved Margaret were really pissed off.
We had the Mass and were all left with a bad taste in our mouths.  The priest was clueless.  We all departed for the burial.

At the burial there is more stuff that takes place in Catholic rites. The priest did what he had to do. Frankly, it was pitiful.  Immediately prior to the burial and lowering of the casket into the ground, 3 Direct Support Professionals came to the graveside!!!! 

They demanded a eulogy.  They created one.....

Each one accounted in incredible and loving sharp detail the life of Margaret. For close to 30 minutes each of the DSPs with great emotion and love eulogized Margaret. They did this in such wonderful reverence and respect there was not a dry eye in the county. They knew everything about her.....her favorite foods, her dreams, her secrets, her passions.....These DSPs knew this woman as though they were her family.  Well, in fact....they were her family.  I was humbled, inspired and knew at that moment I was in the presence of holiness and love.  They knew her much more than an assigned itinerant priest.  Thank goodness.  Margaret was buried with love and respect thanks to these young DSPs.

As we think of people with disabilities this day let's also consider the tens of thousands of DSPs who ensure that the people they support die in a person-centered way.  Death is part of life. DSPs are a huge part of the dignified death of many people who would otherwise be given to eternity without a fair and loving send off.

Thank you DSPs for what you all do at the end of life as much as during it!