Developing assistants management skills - Tools for Power

Developing assistants management skills
by HCIL (Hampshire Center for Independent Living)

In Swedish / på svenska

With little or no previous experience the disabled person seeking to live independently suddenly finds her/himself thrust into the role of employer. Not surprisingly the effective management skills essential to coping with the day-to-day matter of relating to her/his personal assistant are sometimes absent or under-developed.

The relationship between a disabled person and her/his personal assistants has a lot to do with simple human chemistry - but it isn't enough to leave it at that. Disabled people must adopt a responsible approach to the working relationship. It is not good enough to leave things to chance, or 'flying by the seat of one's pants'. The need for care and the control of care lie at the very heart of a disabled person's existence and we must do what we can to ensure success in our chosen lifestyle. This means that we need to be sensitive to the needs of personal assistants, both 'new' and long-standing personal assistants, and be constructive in the way we enable them to function.
Some common complaints among personal assistants are:

The lack of a specific job description - leading to unequal expectations. Personal assistant understanding that you need one thing and you believing that you are to receive something else. (Adjectives such as 'less' and 'more' are often appropriate here.)

The disabled person's inability to provide effective objective feed-back on performance. Personal assistants want and need something more than general 'complaints', 'bad temper', 'euphoric gratitude', or an (apparently) 'indifferent silence'. Caring is a job and all humans require ongoing job satisfaction, which only the employer (the disabled person) can provide.

Of course many disabled people have developed their own ways of dealing with these issues and it is not the purpose of this chapter to imply that the following is the only acceptable procedure. Rather it is to draw attention to a most important subject and to provide some ideas when considering it. Independent living advocates need to propose procedures that enable a disabled person to train and manage attendants more effectively. For this purpose we suggest the use of performance check lists.

Performance check lists

These are compiled by the disabled person and outline specific job descriptions. Each check list details the steps in a given work routine and can include information how often routines are performed, the materials needed and set-up procedures.

Drawing up check lists:

  • List the areas where care is essential, such as: bathing, dressing, bowel and bladder care, meal preparation, housekeeping, passive- movements, transfers, wheelchair maintenance etc.
  • For each area develop a check list by listing exactly what duties the personal assistant has to perform. This can be compiled from memory or have notes taken during the chore, or make a tape recording while the routine is being performed. It is important that the check list contains each duty to be performed.
  • It is very important that each check list reflects YOUR own requirements! You can have check lists for bathing routines, house cleaning tasks, etc.

The check lists provide:

Instructions to personal assistant, useful in interviewing and training.

Help the disabled person to monitor, evaluate and provide feedback to personal assistant on her/his performance. A prompt for occasions when the disabled person is not present.After training, the check lists can be used for continued supervision by providing a means of periodically re-evaluating performance and so stimulate feedback, thereby encouraging consistent performance by the personal assistant.

Using a check list to train a 'new' personal assistant:

Remember, each list gives a 'new' personal assistant a clear idea of what is to be done, when it is done, and in what order. This is an invaluable training aid.

Make sure the 'new' personal assistant understands each item on the check list. One way of doing this is for the 'new' personal assistant following through the list while an 'old' personal assistant does the job described. Or, the disabled person can explain each item as she/he and the 'new' personal assistant go through the list together.

Don't start on-the-job training until 'new' personal assistant understands the routine on the list.
During training the check list could be clearly displayed enabling a ready prompt for 'new' personal assistant.

Remember: the check list only outlines WHAT is to be done, the disabled person still needs to supply detailed instructions during training to ensure that the 'new' personal assistant knows HOW things are to be done.

Using a check list to provide feedback opportunities:

Immediately after a care routine is finished the disabled person and the 'new' personal assistant review the check list together, the disabled person commenting on each item as to the performance of the personal assistant. Feedback sessions ensure that the 'new' personal assistant receives positive feedback for correct performances and specific instructions to correct areas that need improvement.

Positive feedback: If an item is satisfactorily accomplished then say so and describe why, thus providing positive feedback. E.g. hair brushing "Correct - you really got to all parts, just as I like it."

Negative feedback: If an item is unsatisfactorily accomplished and needs improvement, then say so and explain why, giving specific details on how to correct the problem. E.g. hair brushing "Not correct - you missed my hair in front and behind my ears."

Ongoing feedback: For reasons of job satisfaction it is very important that the personal assistant receives regular, constructive feedback, both positive and corrective, even after the initial training period. Check lists should be used on a continuing basis, even if only intermittently, by way of ensuring ongoing positive feedback and also providing a forum for ironing out small difficulties before they become big problems.

To conclude

You may find all these suggestions frighteningly formal and perhaps contrary to your understanding of a disabled person/personal assistant relationship. You may even think that these suggestions are positively threatening, or damaging to a disabled person/personal assistant relationship. This is not the intention. The purpose is to provide a structure that can enhance communications between the disabled person and her/his personal assistant, encourage the very best from each other, and so promote job satisfaction on the part of the personal assistant. It is up to you whether you use this check list system or not, or maybe even devise your own.

The essential human chemistry: your tone, your attitude, respect, the way you interact, how you 'gel', etc., remain ingredients that only the two of you, as people, can deal with. If you don't 'get on' with each other, then a structure may enable you to survive, but it won't resolve the basic 'chemistry'.



  • Remember you are in an employer/employee situation - a business world. Don't ignore the value of developing management skills that can lead to positive benefits in the quality of your life.
  • The traditional medical model of nursing care assumes the training of the personal assistant. However, in the course of a lifetime a disabled person might employ well over 50 personal assistants. Common sense indicates that it is cheaper to systematically train one person, the disabled person, in her/his specific routine rather than 50 personal assistants.
  • Not all people will want or have the necessary skills to train personal assistants without any structured input. This is where more focus needs to be put into training and enabling the development of such skills, preferably through people who have direct experience in Independent Living, or through CILs who sometimes can offer advice and training.

Source Book Towards Independent Living,
Care Support Ideas, HCIL (Hampshire Center for Independent Living)

Address: Philip Mason
Hampshire Centre for Independent Living
4 Plantation Way, Whitehill, Bordon, Hants GU 359 HD, United Kingdom

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