Residential Services & Roles of a Direct Support Professional
Residential services is where home meets care! DSPs are the superheroes who provide personal care, empower skills, and sprinkle emotional support, creating a safe haven for independence and a life well-lived.
Quality of Life
Quality of life refers to an individual's overall well-being and satisfaction with various aspects of their life. It is a subjective and multidimensional concept that takes into account various physical, psychological, social, and environmental factors that influence a person's sense of happiness and fulfillment. Quality of life can vary greatly from one person to another and is influenced by a wide range of factors.
Below you will find a form, and in the form, you will be asked to write down five (5) things that are important to you and your quality of life.
Some of the most common answers that employees respond with are;
Are able to make choices in their lives, and their choices are encouraged, supported, and respected.
Have close, supportive relationships with friends and family.
Live in a home that is comfortable for them and with people who know and care about them.
Participate in activities they find enjoyable.
Have access to health care and have the best possible health.
Feel and are safe.
Are treated with dignity and respect.
Are generally satisfied with their lives.
The Direct Support Professional and Their Roles
A Direct Support Professional (DSP) works with and supports individuals in the places they live and work. DSPs perform their jobs in licensed homes, day programs, supported or independent living environments, or work sites. A DSP has many important roles to play. You are:
A PARTNER: supporting individuals in leading independent lives and participating in and contributing to the community.
A TEACHER: finding creative and fun ways to help individuals learn meaningful skills and provide them with information to make the best choices for themselves.
An AMBASSADOR: to the individual’s community, encouraging others to support individuals with developmental disabilities as neighbors, friends, and co-workers.
An ADVOCATE: supporting individuals in exercising their rights and responsibilities.
A SUPPORTER: seeking to understand the likes, dislikes, hopes, and dreams of individuals you support and cheering individuals on as they make progress toward their life goals.
All of the roles that you play have a common focus: supporting individuals to live the kind of life they hope and dream about. The DSP is a Partner, Teacher, Ambassador, Advocate, and Supporter. The DSP is not a Boss or one who orders people around and makes them do things they may or may not want to do.
Likewise, the DSP is not a Parent to the people they support. The job of the DSP carries a great deal of responsibility, and it is easy to get these roles confused. Unlike a parent, legal guardian, or conservator, the DSP does not have the responsibility to make important life decisions for individuals they work for and with. Instead, the individuals themselves, with the help of parents, legal guardians, or conservators, make decisions about their own lives.
Values to Guide Your Work
Here are some good examples:
Choice:
Services and supports should be based on the individual and his/her needs and preferences.
Individuals (with help from parents, legal guardians, or conservators when needed), should take part in decisions about their own lives, such as where and with whom they live, where they work, their relationships with others, the way in which they spend their time, and their goals for the future.
Relationships:
Individuals with disabilities have the right to develop relationships, marry, be a part of a family, and be a parent if they choose.
Support may be needed to develop intimate relationships; such as transportation, family counseling, or training in human development and sexuality.
Support may be needed to help people start and keep relationships with friends and fellow community members.
Regular Lifestyles:
Individuals should have a chance to be involved in the life of their community in the same ways as their neighbors, friends, and fellow community members.
Services should be provided whenever possible in the home and community settings where individuals live and work.
Cultural preferences should always be honored.
Individuals should have the training needed to be as independent and productive as possible.
When an individuals needs change, services should be changed as well, to assure that the individual can continue living where he or she chooses.
Individuals should be comfortable where they live, have privacy when they need it, and should have a say in the way their living spaces are decorated and arranged.
There should be services and supports that allow a minor with developmental disabilities to live with their families whenever possible.
Health and Well Being:
Individuals have a right to be free from harm and live a healthy lifestyle.
Individuals have a right to medical, mental, and dental care and treatment when they need it.
Individuals should have a chance to learn how to keep themselves healthy, or have services and supports that keep them healthy.
Rights and Responsibilities:
o Individuals with a developmental disability or mental illness have the same basic legal rights as other citizens.
o Individuals have a right to privacy and confidentiality of personal information.
o Individuals have a right to treatment and habilitation, dignity, privacy, and humane care; prompt medical care and treatment; religious freedom; social interaction; physical exercise; and to be free from harm.
o Individuals have the right to make choices in their own lives, such as, where to live, who to live with, education, employment, leisure, and planning for the future.
o Along with all of these rights are responsibilities, such as respecting the privacy of others and being an informed voter.
o Individuals should have a chance to learn about their rights and responsibilities and how to advocate for themselves.
Satisfaction:
o Individuals should have a chance to plan goals for the future and to work toward them.
o Individuals should be satisfied with the services and supports they receive and should have a chance to change them when they are not satisfied.
o Individuals should have a chance to have a good quality life.
o Supporting individuals in having “quality of life” means supporting them in ways that are consistent with these values: making sure that individuals have choices, spend time with family and friends, have the best possible health, are safe, and are treated with dignity and respect...all the things that are necessary for “quality of life.”
DSP Skills
Whether you are working independently or with a team, you will need to develop basic skills and knowledge to help you successfully meet the daily challenges of your job. Some of the skills required to provide the best possible support to individuals are:
Ethics: Enable the DSP to make ethical decisions.
Observation: Enables the DSP to observe people and places for things that could affect an individual’s health and well-being.
Communication: Enables the DSP to communicate in a variety of ways.
Decision Making: Enables the DSP to choose the best course of action with the information at hand.
Documentation: Enables the DSP to document important information about individuals and events.
Many situations in your work call for using several skills at the same time. For example, if an individual is sick, you might use the following skills to assist the individual.
"Ethics" to guide you in promoting the individual’s physical well-being by identifying the illness and ensuring timely medical treatment with dignity and respect.
"Observation" by using your senses to identify changes that may be signs and symptoms of illness. You might see the individual rubbing her stomach, feel her skin is cold and clammy, or hear her moaning and saying, “my stomach hurts.”
"Communication" to ask questions about someone’s pain such as, “How long has it hurt you?” Communication also means listening and understanding an individual’s response.
"Decision Making" to decide how to respond to the individual’s illness based on what you have observed and what has been communicated. For example, “Do I need to call the doctor or take her directly to the emergency room?
"Documentation" to record information about the illness in the individual’s daily log and on an information sheet to bring to the doctor’s appointment.
Navigating your Role: Exploring the Roads You Need to Know
A Direct Support Professional's skills are the well-paved roads that guide care and compassion, ensuring every individual's journey toward independence is smooth and supported.
Ethics
Ethics are rules about how people think they and others should behave. People’s ethics are influenced by a variety of factors including culture, education, and the law. Advocacy: As a DSP, I will work with the individuals I support to fight for fairness and full participation in their communities.
Person Centered Supports: As a DSP, my first loyalty is to the individual I support. Everything I do in my job will reflect this loyalty.
Promoting Physical and Emotional Well-Being: As a DSP, I am responsible for supporting the emotional, physical, and personal well-being of the individuals receiving support while being attentive and energetic in reducing their risk of harm.
Integrity and Responsibility: As a DSP, I will support the mission of my profession to assist individuals to live the kind of life they choose. I will be a partner to the individuals I support.
Confidentiality: As a DSP, I will protect and respect the confidentiality and privacy of the individuals I support.
Fairness: As a DSP, I will promote and practice fairness for the individuals I support. I will promote the rights and responsibilities of the individuals I support.
Respect: As a DSP, I will respect the individuals I support and help others recognize their value.
Relationships: As a DSP, I will assist the individuals I support to develop and maintain relationships.
Self-Determination: As a DSP, I will assist the individuals I support to direct the course of their own lives.
Observation
Observation is noticing a change in an individual’s health, attitude, appearance, or behavior.
Get to know the individual so you can tell when something changes.
Use your senses: sight, hearing, touch, and smell to observe signs or changes.
Get to know the individual’s environment and look for things that affect safety and well being.
Communication
Communication is understanding and being understood.
Listen carefully to what is being communicated through words and behavior.
Repeat back what was communicated to confirm understanding.
Ask questions to gain a more complete understanding.
Be respectful.
Decision Making
Decision-making is choosing the best response to a situation with the information that is available to you. Decision-making is an ongoing process.
Recognize/define the situation.
Identify possible responses and consider the consequences.
Choose a response and take action.
Evaluate how your response worked. Were the consequences positive? If not what could have made it work better?
Use what you learned to make decisions in the future.
Documentation
Documentation is a written record. It is a good communication tool and valuable resource.
The DSP is required to document in each person’s individual record.
Do not document personal opinions, just the facts.
Be specific when describing behaviors.
Record what the person actually said or describe non-verbal communication
Describe the event from beginning to end.
Use the person’s legal name.
Do not use White Out® to correct mistakes. Cross out the error and put your initials next to it.
Don’t use one person’s full name in another person’s record.
Sign your name or initials and date all documentation.
Individuals with Disabilities
Who are the people you support? First, they are individuals. The people you support are primarily adults, male and female, and come from a variety of backgrounds. They have many unique preferences and qualities that you will get to know as you get to know them. What the individuals you support have is some type of developmental disability and/or mental illness.
Here is some basic information about the causes and kinds of developmental disabilities and mental illnesses. You are not expected to know everything about every type of disability. However, it is important that you know and understand the types of disabilities that the individuals you work with have. This knowledge will help you to provide the best possible service and supports.
What Is a Developmental Disability?
A developmental disability:
Begins before someone reaches 22 years of age.
Is something that goes on throughout an individual’s life.
Is a substantial disability for the individual.
Often means there is a need for some kind of assistance in the individual’s daily life.
Developmental disabilities include intellectual disability/cognitive impairment, cerebral palsy, epilepsy, and autism. Also included in the legal definition are people who need the same kinds of support as those who have intellectual disabilities. It does not include people who have only physical, learning, or mental health challenges.
Causes of Developmental Disability
Many things can cause a developmental disability, such as:
The mother having a serious illness, poor eating habits, poor health care, or the fact that she smokes, drinks alcohol, or uses drugs.
Chemical or chromosomal differences (like Downs Syndrome) or an inherited condition.
A lack of oxygen to the brain, low weight, or a difficult birth.
A serious accident, abuse, lead poisoning, or poor nutrition.
While keeping the above causes in mind, remember that often, the cause is not known. A developmental disability can happen in any family.
Characteristics of Developmental Disabilities
Major Kinds of Developmental Disabilities
Below you will find the major kinds of developmental disabilities: mental retardation, cerebral palsy, autism and epilepsy. You will also learn what those disabilities might look like and how that might impact how you support individuals.
Intellectual Disability/Cognitive Impairment
Onset in early development.
Lifelong impact.
Impairment in multiple areas of functioning.
Variability in severity and presentation.
Delayed developmental milestones.
Cognitive impairments (ranging from mild to profound).
Communication difficulties.
Social and behavioral challenges.
Motor skill deficits.
Dependence on ongoing support and services.
Potential co-occurring conditions.
These characteristics collectively define developmental disabilities, but it's important to remember that each disability within this category may manifest differently in individuals.
Cerebral Palsy
Impaired muscle coordination
Involuntary movements
Abnormal or exaggerated reflexes
Slow and writhing movements
Reduced movements at joints
Spastic paralysis
Floppiness or rigidity in the trunk and limbs
Unsteady walking
Abnormal posture
Problems with swallowing
Excessive drooling
Difficulty in speaking
Eye muscle imbalance
These characteristics collectively describe the range of symptoms and challenges that individuals with cerebral palsy may experience. It is important to remember that the specific characteristics can vary widely among individuals with CP.
Autisms
Social Challenges
Communication Differences
Repetitive Behaviors
Sensory Sensitivities
Narrow Interests
Difficulty with Change
Unusual Play
Empathy and Theory of Mind
Difficulty with Figurative Language
Repetitive Speech
Intelligence Varies
Motor Coordination
Savant Abilities (in some cases)
Anxiety and Emotional Regulation
Strong Attention to Detail
Difficulty in Social Situations
Need for Routine
Difficulty with Transitions
These characteristics collectively describe the range of features associated with Autism Spectrum Disorder (ASD). It's important to note that the specific characteristics and their severity can vary from one individual with autism to another.
Epilepsy
Seizures
Unpredictable Episodes
Different Types of Seizures
Auras (warning signs for some)
Loss of Consciousness (in many cases)
Convulsions (in tonic-clonic seizures)
Postictal State (after a seizure)
Triggers
These characteristics collectively describe the features and impact of epilepsy. Keep in mind that the experience of epilepsy can vary greatly among individuals, and management approaches are personalized to their unique needs.
INDIVIDUALS WITH MENTAL ILLNESS
Definition of Mental Illness
The Michigan Mental Health Code defines mental illness as “a substantial disorder of thought or mood which significantly impairs judgment, behavior, capacity to recognize reality, or the ability to cope with the ordinary demands of life.”
**For a mental or emotional problem to be a mental illness, it has to be a major problem that greatly interferes with the person’s ability to function in life.**
Definition of Serious Mental Illness
According to the Center for Mental Health Services (CMHS), adults with a serious mental illness are persons:
Age 18 and over;
Who currently, or during the past year, have been diagnosed with a mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified within the Diagnostic Statistical Manual of Mental Disorders (DSM-IV); and
That has resulted in functional impairment which substantially interferes with, or limits one or more life activities.
Mental Illness
Types of Mental Illness
Below you will see the types of mental illnesses: psychosis, schizophrenia, affective disorders, anxiety disorders, and personality disorder. You will also learn some characteristics of mental illness.
Psychosis
Sensory experiences (hearing, seeing, tasting, and less commonly, feeling or smelling things) that are not real.
Social withdrawal/withdrawing from family or friends.
Strong, inappropriate emotions, or not feeling anything at all.
Sudden decline in self-care.
Strong, persistent, unusual thoughts or beliefs that are false, and do not change regardless of evidence to the contrary.
Difficulty concentrating or thinking clearly.
Psychosis can manifest as a symptom of different underlying conditions, such as schizophrenia, bipolar disorder, or specific medical conditions. Timely intervention and treatment are vital for individuals grappling with psychosis.
Schizophrenia
Hallucinations
Delusions
Disorganized thinking
Disorganized or abnormal motor behavior
Negative symptoms
Impaired cognitive function
Impaired insight
Social withdrawal
Duration and impairment
Schizophrenia is a chronic and severe mental illness, and treatment typically involves a combination of antipsychotic medication, psychotherapy, and support services to help the individuals manage their symptopms and improve their quality of life.
Mood Disorders (Major Depressive Disorder, Dysthymic Disorder, Bipolar Disorder, Suicide)
Depressed Mood
Elevated Mood (Mania or Hypomania)
Anhedonia
Irritability
Changes in Appetite and Weight
Sleep Disturbances
Fatigue
Difficulty Concentrating
Psychomotor Changes
Feelings of Guilt or Worthlessness
Recurrent Thoughts of Death or Suicidal Ideation
It's important to note that mood disorders can take various forms, including major depressive disorder, bipolar disorder, and others, each with its own specific diagnostic criteria and nuances.
Anxiety Disorders (Panic Disorder, Obsessive-Compulsive Disorder (OCD), Post Traumatic Stress Disorder (PTSD), Generalized Anxiety Disorder (GAD), Social Phobia, Specific Phobia)
Excessive Worry
Irrational Fears (Phobias)
Physical Symptoms
Avoidance Behavior
Panic Attacks
Impairment
Somatic Symptoms
Perfectionism
It's important to note that anxiety disorders can take various forms and each specific disorder will come with its own specific diagnostic criteria and nuances.
Personality Disorders
Inflexible and Pervasive Patterns
Impairment in Functioning
Ego-Syntonic
Lack of Insight
Difficulty with Relationships
Emotional Dysregulation
Maladaptive Coping Mechanisms
Paranoid Ideation
Dependency
Narcissism
Dramatic and Erratic Behavior
Fear of Abandonment
Rigid Perfectionism
Please note that these characteristics can vary depending on the specific type of personality disorder, and not all traits may apply to every individual with a personality disorder.
General Information About Mental Illness
It used to be true that people with serious mental illness spent much of their time in psychiatric hospitals. Today, we know more about mental illness, we have better treatment programs and community supports for people who have a mental illness, and we have more effective medications for some people to control their illness. The biggest challenge faced by people with mental illness today is often the myths and misunderstandings the general public have about what it means to have a mental illness.
One of your jobs as a DSP who supports a person with mental illness is to learn about them as a person: what they like and do not like, what they have done well in their lives, what they want to do, etc. The more you can help the person feel secure, respected, listened to, and successful, the more able they will be to deal with their illness.
Having a mental illness does not mean the person is violent. Actually, many people with a mental illness are very vulnerable to being hurt or taken advantage of by others. The person with a mental illness is like any other person: they have all kinds of habits, patterns, personalities, and histories that make them who they are.
Having a mental illness does not automatically mean that the person is less intelligent, or that they are ignorant, or that they are unable to have a happy, productive life. Persons with mental illness are people first! They have dreams, hopes, feelings, experiences, needs and preferences just like everyone else.
People with mental illness are often not accepted or are treated differently by others, making it hard for them to learn from their experiences, and to gain confidence about doing things that everyone does. DSP's who provide support to people with mental illness must find ways to help the person have positive experiences interacting with people who are interested in more than their illness.
As you get to know the people who you provide services to, you will learn about the specific diagnoses each of them has, what each diagnosis means in terms of the ways the person is likely to react to others and to their environment, and what the best ways are to provide service and support to the person.
RECOVERY
Recovery is a concept gaining increasing support and use as it applies to treatment for individuals with mental illness. Previous treatment models have focused on traditional medical philosophy aimed at curing the person with the illness. Recovery as a guiding vision stresses each individuals ability to achieve personal success and quality of life while managing symptoms of the illness.
A recovery plan will assist people with deciding what their personal goals are and how their recovery plan will guide them through making changes in their life. The following concepts should be included in a good recovery plan:
Personal Vision: How the person sees him or her self in the future. Future dreams will help the person create a personal vision and set goals.
Life Domain: Areas of their life to consider when creating a personal vision and dreams. When people are doing what they want to do, quality of life is improved.
Realistic Expectations: What changes in behavior are necessary and how long will it take.
Recovery Plan: A plan that is created by the person that states their agreement to work on goals that will help them achieve their personal vision of recovery. A recovery plan is a tool to make progress and change possible!
A Recovery Plan is not meant to be achieved alone. The person will need support to help achieve their recovery plan. We all need to ask for help at different times in our life. The following are examples of people that can help and support with a Recovery Plan:
Natural Supports: Friends, family and community resources available to support the person with their recovery plan.
Friends and Family: People with whom the person shares biological or personal ties. These are usually people that the person is close to and can call on for help.
Community: This is the place where the person lives, works and plays. A community can include the neighborhood and is usually the town or city the person lives in. Communities usually have several options for social supports like the United Way, Community Mental Health Centers, The Salvation Army, and food pantries.
A Recovery Plan is a personal commitment for the person to help improve their quality of life. The person agrees to the following:
Take responsibility for my actions.
Seek help from others and continue to learn.
Take the necessary actions to achieve my success.
Commit to my goals.
Celebrate my successes and those of others.
Forgive the past.
Persist even when things are difficult, and I want to quit.
Recovery is deeply personal to every individual. Recovery is a process of changing one’s attitudes, values, feelings and goals. It means taking responsibility, and working for positive change to realize a better quality of life. Recovery does not mean the person’s mental illness will be cured. It is a way of living a satisfying, hopeful, and contributing life, even with limitations caused by the mental illness.
PEOPLE FIRST LANGUAGE
Remember that...
INDIVDUALS WITH DEVELOPMENTAL DISABILITIES AND/OR MENTAL ILLNESS ARE PEOPLE!!!
While it’s important to learn about the names and causes of developmental disabilities and mental illnesses, individuals are people first. One group of self-advocates came up with the saying, “Label Jars, Not People.” For example, the subtle difference between calling Joe “a person with autism” rather than “an autistic person” is one that acknowledges Joe as a person first. This is one example of what is called People First Language. A good way to ensure that you are using People first Language is to begin describing people with the words “individual,” “person,” “man,” or “woman.”
"THE GOLDEN RULE" VS. "THE PLATINUM RULE"
It is not enough to use People First Language to show respect for individuals. It is also important to demonstrate People First Behavior. What does that mean? It means that:
You take the time to learn about an individual’s needs, strengths, and preferences.
You do not assume that you know what is best.
Your manner of supporting individuals reflects their needs, strengths, and preferences.
The old rule was the GOLDEN RULE: Treat others the way you would want to be treated.
The new rule is the PLATINUM RULE: Treat others as they want to be treated.
Now that you have completed the Residential Services & Roles of The Direct Support Professional module, please proceed to take the test. To successfully complete the course, you must achieve a passing score of 80% or higher.