Monday, 16 July 2012

Service Providers for People with Disabilities: What's Your Limit?

Recently I was reading through some old posts that I made on a message board. I came across one in a debate thread about whether pharmacists should be required to dispense the morning-after pill, regardless of their beliefs on abortion. This was a few years ago, not long after I'd acquired my disabilities. The topic of birth control  and the morning after pill in America had only just started the march toward the mess it's become now. But even then I seemed to know what I thought.

"It's a pharmacist's job to dispense medication," I wrote. "If that's going to interfere with their values, then perhaps they'd better find a job that's not going to interfere with their values. Or drug stores should always ensure that there's another pharmacist on hand who will dispense the pill." I remember feeling very strongly about this, as at the time there was only one pharmacy in the very small town in which I was living.

People With Disabilities - Is There a Point Where You *Couldn't* Support Someone?

I've been thinking lately about how these same sorts of issues may apply to people who support people with disabilities. What if, for example:

  • Your religious beliefs dictate that premarital sex is wrong, yet part of your job is to support two people with intellectual disabilities who want to live together as boyfriend and girlfriend and have a sexual relationship?

  • You believe that homosexuality is wrong, and part of your job is to find some community support for a person with intellectual and physical disabilities who  has just told his family and friends that he is gay?

  • A young woman with physical disabilities wants you, as her support person, to come with her to a clinic so that she can deal with an accidental pregnancy by having an abortion?  You have been pro-life for as long as you can remember.

The answer, for all of these scenarios, seems very clear-cut to me: As support people, it's our job to support people in the choices that they make. I'd want to make sure that they know all their options in their respective situations, of course, and that they're aware of all the potential consequences of their decisions. But, regardless of my beliefs (not just because I'm fine with premarital sex and the homosexual lifestyle and because I'm pro-choice), I believe that it's my job to support people with what they've requested, as they ask for it. If the same young woman decided to deal with her accidental pregnancy by keeping the baby, and I thought it was a bad decision, I'd like to think that I could, as her support worker, suck it up and give her as much assistance as possible. In fact, I'm confident that I could. I'm proud of that.

The Importance of Handling Sensitive Conversations Well

To that end, I think that support staff need to quickly learn how to present options to people with disabilities and have discussions around them in such a way that our personal feelings about the person's ultimate decision aren't obvious. The risks of the person doing to please us (or possibly spite us, depending on the circumstances - it could happen) are too high. It takes a while to learn how to conduct discussions in this manner, and sometimes it's very difficult to do. But it's vital that we do. The challenges involved with having these conversations differ according to what kind of disabilities the person with whom you're trying to communicate is living with.

In general, the prospect of having to support somebody in a decision that you wouldn't make yourself and that's highly emotional for you is daunting, but this is where professionalism comes in.  If you don't think it's something that you can handle, you need to find another staff member who can, and you need to explain to the person you're supporting that you're stepping back because you're not the best person to help right now. Handle this carefully. Be prepared to give the conversation some time. The person needs to leave the conversation knowing that it's about you, not them, and that it's just this area with which you won't offering support for the moment.

Of course, all of this is going to vary depending on what your work is with people with what disabilities, what your background and education are, and what resources you have available. But I feel pretty confident in saying that if you're not prepared to deal with something that's going to make you think, "Damn it, this person's challenge is my challenge too...can I really handle this?" then you're probably not ready for *any* helping profession, or you need to take a break. No shame in either, by the way. Far better for everyone involved to just admit it.

The thing about the helping professions is that they can be intensely humbling. Uncomfortably so, at times (at least for me). I don't think there's any shame in admitting this, either.

I know that there are people in the helping professions reading this...what say you?  Anything here strike you?


  1. I don't get paid for my helping profession, ;), but I'm a mom to an autistic child. I think your point is important for parents to hear, too. So many times, something that bothers us about our child is really our own issue. Recognizing that and resolving it is often very difficult. Just discovered your blog. Love it.

  2. I love your blog as well, and I'm so honoured to see you here. :)