Checklist Use To Increase Personal Assistant Management

Background

Personal assistant care may be one of the most important independent living services for people with severe disabilities, because it allows them to get the kind of help in their community that otherwise would only be available in more restrictive environments, such as nursing homes.

Purpose and Anticipated Benefits

The checklist attempts to overcome management deficits by outlining specific job descriptions in performance checklists. Each checklist details the steps in a particular work routine (health care, housekeeping, environmental maintenance, etc.). They may also include information on how often routines are to be performed, materials needed, and set-up procedures. Checklists not only provide instructions to the caregiver, but also help the employer monitor, evaluate, and provide feedback to the caregiver on his or her performance. By using the checklists to periodically re-evaluate and provide feedback to the attendant, consistent performance can be maintained.

Who

Gary Ulicny along with Amy Adler, Sarah Kennedy, Michael Jones, and other Research and Training Center on Independent Living at the University of Kansas staff developed the personal assistant procedures.

When

This project started in 1982 and continued for several years.

Method

After a review of relevant literature to identify problems and effective procedures, a preliminary manual was made of the findings and reviewed by seven nationally known experts and users of assistant services. Their input was used to modify the manual that addressed the difficulty in interviewing applicants, lack of a specific job description, and consumer inability to provide effective performance feedback. Training procedures were developed along with structured scripts for interviewing, training, and supervision. Performance checklists also were developed by consumers with short task descriptions. Ten consumers with disabilities ranging in age from 17 to 46 were taught the procedures.

To individualize lists, a person needed to determine what areas of personal care with which he or she needed. General categories, like bathing or housekeeping, were selected from a prepared list. From these general categories, individuals chose areas in which they need attendant care. Once the checklists were finalized, they were used for a variety of administrative functions. For example, when interviewing a prospective attendant, the employer allowed applicants to review the checklists so they know exactly what will be expected of them. Upon hiring, checklists also served as a job responsibility contract. They, too, were used in training and gave the attendant a visual picture of what needed to be done, when it needed to be done, and in what order

Results

Results of training and supervision evaluations revealed that consumers using the checklist and feedback procedures substantially reduced the number of errors performed by attendants, trained attendants to perform fewer errors than attendants trained by medical personnel, and one year later, trained attendants effectively without any trainer assistance. In addition, surveys revealed that both consumers and attendants were more satisfied with each other’s performance and interactions after using the procedures. In the first couple of years after the procedures were developed, more than 20 centers for independent living adapted them for their consumers.

Conclusion

Perhaps the most important implication of this study is that consumer control of assistant services has been shown to be effective. Because national policy has moved toward consumer-directed attendant services, it’s likely that funding for attendant services will be influenced by consumers’ ability to direct these services. Procedures developed during this research provide consumers with an inexpensive method of receiving quality services without relinquishing control. The procedures also provide a method for documenting their competency.

Products

Ulicny, G. R., Adler, A. B., & Jones, M. L.  (1988). Consumer‑direct­ed attendant management. American Rehabilitation, 14(3), 22‑23, 30‑31.

Ulicny, G. R., & Jones, M. L. (1988). Consumer management of attend­ant services: Benefits and obstacles. NARIC Quarterly: A Newslet­ter of Disability and Rehabilitation Research and Resources, 1(2), 1, 6‑14.

Ulicny, G.R., & Jones, M.L. (1985). Enhancing the attendant management skills of persons with disabilities. American Rehabilitation, 11(2), 18-20.

Ulicny, G.R., Elwell, J.S., & Jones, M.L. (1984). Disabled employers can increase their attendant management skills. Independent Living Forum 2(3), 1-5.

Ulicny, G.R., & Jones, M. L. (1986). Enhancing attendant management skills of people with disabilities. American Rehabilitation, 11(2), 18‑20.

Ulicny, G.R. (1987). Invited participation in working conference on quality assurance in attendant services, Berkeley, CA.

Ulicny, G.R., Adler, A. B., & Jones, M. L. (1987). Increasing disabled consumers’ management skills. American Psychological Association, New York, NY.

Ulicny, G. R., & Bradford, B. W. (1987). Exploring consumer-attendant

relationships. National Conference on Independent Living, Washington, DC.

Ulicny, G.R., Adler, A.B., Kennedy, S. E., & Jones, M. L. (1988). A step‑by‑step guide to training and managing person­al attendants. Lawrence, KS: Research and Training Center on Independent Living, University of Kansas