What is "Supported Living"?

Supported living is a simple concept in danger of being complicated until its power to help people with developmental disabilities gets lost. Its simplicity is elegant: a person with a disability who requires long term, publicly funded, organized assistance allies with an agency whose role is to arrange or provide whatever assistance is necessary for the person to live in a decent and secure home of the person's own.

People with developmental disabilities often have ideas about what a decent and secure home of their own would be like. Each individual has different requirements for assistance and differing abilities to communicate their preferences and needs. Because their ideas, requirements, and abilities change as they grow and develop, the promise of supported living lies in its potential to deal creatively with the complexities arising from the lives of many different individuals.

The capacity to generate a variety of types of assistance is the essence of supported living. Potentially destructive complications arise from at least two sources:

• Supported living expresses a fundamentally different relationship to people with developmental disabilities than most other approaches to service do: instead of controlling people with disabilities in order to fix (train, habilitate, rehabilitate, treat) them, supported living workers seek to cooperate with people with disabilities in order to develop the assistance they need to get on with their own lives. This contrast creates dissonance for service workers and managers accustomed to services based on control; the least difficult resolution of the dissonance is to practice the habits of control and call it support.

• Supported living is developing in a time when scarcity, lack of public consensus on the management of scarcity, and rapidly escalating complexity and uncertainty haunt public managers at every level. Decades of rising expenditures on services to people with developmental disabilities (mostly present or former institution residents) have accumulated frighteningly large waiting lists (mostly of people who have been cared for by their families) for costly services. This demand has grown as hundreds of pages of statutory, regulatory, and procedural commitments have accumulated. This situation frightens many public managers into a futile search for greater and greater administrative control.

Supported living, even more than other innovations, needs slack to develop and can never be uniform and predictable in the way that services based on standardized control of clients can be. This makes supported living an attractive but threatening anomaly. Focus on the differences that supported living wants to amplify offers a base from which to negotiate the challenges of distinguishing supported living from other forms of service and evolving effective means of public accountability.

Adapted from Supported Living: What's the Difference? John O'Brien