Personal assistance is recognized as an important tool for advancing the autonomy and independence of people with disabilities. This concept is reflected in the International Convention on the Rights of Persons with Disabilities, adopted by the United Nations in 2006. The convention states that there should be “access to a range of in-home, residential and other community support services, including personal assistance necessary to support living and inclusion in the community, and to prevent isolation or segregation from the community.” The Welfare Services for Persons with Disabilities Law – 2022, affirms the commitment of the State of Israel to provide welfare services that will enable the pursuit of independent and autonomous living and integration into the community for all individuals entitled to receive services for people with disabilities, regardless of the level of support they require. The law defines personal assistance services, including support for activities of daily living, to foster independent and autonomous living in the community, as one of the areas of services to be provided.
In recent years, the Disabilities Administration in the Ministry of Welfare and Social Affairs in Israel, has been engaged in developing and improving community-based social services. In 2023, the Disabilities Administration commissioned a study from the Myers-JDC-Brookdale Institute to describe the main components and activities of existing personal assistance services and to explore effective models and best practices in use worldwide. The study findings will assist the Disabilities Administration in the further development of its services in this field.
The objective of this study was to conduct a comprehensive review of community based personal assistance services for people with disabilities in Israel and in select countries around the world. The study aimed to address the following topics: characterizing the types of personal assistants and their responsibilities in the areas of life they address; operational models, training and professional mentoring; and supervision and quality assurance mechanisms.
- A literature review of academic articles and publicly available internet-based publications from government ministries, local authorities, service-providers, and research institutions.
- In-depth consultations with experts in community based personal assistance services for people with disabilities in Israel and abroad.
- Semi-structured interviews with professionals who develop and implement services for people with disabilities in Israel.
- Personal assistance is an individualized person-centered service, in which personal assistants support people with disabilities in achieving their personal goals and objectives in any area of life, to enable their participation in the community and to enhance their overall well-being.
- Three distinct types of personal assistants were described: mentors, peer supporters and care coordinators. The role of all three types of assistants is to provide personalized guidance including: counseling, facilitating the utilization of services and formal and informal community resources, fostering the development of personal and social skills, and establishing social connections.
- At the outset, mentors and peer supporters establish common expectations, assess needs, and set personal goals. The following personal assistance process continues largely through face-to-face meetings.
- Peer supporters play a unique role as they themselves are people with disabilities, offering emotional support rooted in their own life experiences and expertise. They serve as role models for overcoming challenges and achieving goals.
- The care coordinator’s role is unique, compared to the mentor and peer supporter, since it involves writing a personal plan with the person with disabilities in addition to providing guidance for executing this plan. In many cases, the mentor and peer supporter base their work on the personal rehabilitation or treatment plan that has been developed by the person and their care coordinator.
- In all the countries surveyed, the fundamental principle underlying personal assistance is the concept of a “person-centered service.” This service is designed to enable individuals with disabilities to live their lives guided by the principles of self-determination and personal identity, personal choice, self-management, and flexible support.
- Personal assistants are typically not required to be social workers or healthcare professionals (except for care coordinators in the mental health rehabilitation services in Israel and care coordinator specialists in the UK). Instead, they are expected to possess knowledge and skills, including a basic understanding of people and ways of empowering them, interpersonal social and communication skills, coordination and organizational skills, and knowledge of disability legislation and the struggles of people with disabilities.
- Integrated Service: In most of the models surveyed, the personal assistant provides a ‘one-stop-shop’ service, identifying resources and providing information on relevant services and rights – personal, community-based, and governmental. Therefore, the care coordinator must have an in-depth and practical understanding of local and national resources and services, in addition to maintaining good professional relationships with a wide range of service providers. He/she also must be able to access and verify information and work collaboratively as part of a team to address areas of life in which he/she is less knowledgeable.
- Provide comprehensive and integrated personal assistance services in Israel, with an emphasis on coordinated care, in a ‘one-stop-shop’ coordinated and integrated model which encompasses multiple areas of life and information sources.
- Develop a personal plan together with the person with disability, emphasizing needs-based and goal-oriented approaches. This plan should be a simple, accessible, and practical tool for the person, the personal assistant and for other service providers.
- Continue to establish the concepts and practices of person-centered services for people with disabilities in Israel among professionals and service providers, using existing training materials and tools from Israel and abroad.
- Facilitate cross-ministerial knowledge-sharing to leverage best practices and facilitate service development.
- Conduct an evaluation study that will support the continued development of personal assistance services that are congruous with innovative concepts and practices.
- Examine the interface between Personal Assistance and Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) and the ways in which the personal plan can integrate these components in the most comprehensive and beneficial way.
Citing suggestion: Nagar Eidelman, R., Koren, Y., & Gorbatt, Y. (2023). Personal Assistance Services for Independent Living in the Community.RR-961-23. Myers-JDC-Brookdale Institute. (Hebrew)