Where are the boundaries in supporting people with disabilities?

In home support is now being provided to not only people with disabilities but also to those who are ageing or have a psychological impairment. It is preferred by both government and support recipients as a viable alternative to the more costly and disruptive institutional support. This study looks at the various parties that are involved in managing the boundaries when providing support in unconventional workplaces; workplaces that are also homes; homes that are controlled and managed by the person receiving the support, not the person supervising the worker. The distance the home is from the organisation, the place from which the employee is supervised becomes a physical boundary. Boundaries are also psychological; a home is a space that forms a safe refuge from the world, a home is comforting and secure; a space that contains precious possessions. The workers are working within someone's intimate space. This creates difficulties for both the workers and their supervisors. The study takes a psychodynamic approach. What is happening at an unconscious level influences the behaviour of the various parties and can change and distort the desired outcomes for the client. The material for the study was gathered from interviews, Murray's Thematic Apperception Techniques (TAT) (Teglasi 2001) style exercises and drawings from eight clients, five coordinators and five support workers. Two workplaces were observed and seven case studies collected. A survey of 389 support workers was conducted and analysed. The results highlight the preoccupation of organisations and through them service coordinators, with controlling risk in the workplace. This puts them at odds with clients who feel they have control over their own homes. Both clients and coordinators vigorously defend what they see as their territory. The coordinators are left feeling envious of the support workers who have a close relationship with their clients, a relationship about which, they as former support workers have personal knowledge. The support worker's role is to support. They are only able to do this by defending and smothering their own emotional responses through a veil of niceness. They are unable to express many of their own feelings, which might not only be regarded as shameful but also condemned by their employer. Most staff, both support workers and coordinators lack the skills to manage and understand their own emotional responses. Although there is no easy answer to the dilemma raised within this context. I hope by identifying what is happening organisations might be able to at least understand the origins of individual carers', clients' and coordinators' behaviours and take steps to provide a safe container in which these feelings can be explored and discussed. The in-home care industry has difficulty in recruiting and retaining staff. Organisations therefore need to invest in supporting staff who work in these situations