Quality of Life and Quality of Service Relationships: Experiences of people with disabilities

Abstract

Quality of life’ experiences for people with disabilities who are highly dependent on services that are delivered in home-based environments are strongly influenced by the nature of their interactions with service workers. Service workers may not be aware of the felt attachments of people living in services because their own lives are relationally enriched. Role descriptions of service workers, which focus on task-orientated service, rather than relational serving, distances them from the people they serve. It is more difficult for people living in services to expand their social world and relationships with service workers may be the only validating relationships in their lives. Human service delivery involves relationships between people, which necessarily address ethical questions. This paper discusses findings of a study involving 14 agencies in Western Australia, which provide living environment services for young people with disabilities and older adults, to gain insight into service users' daily experiences and their perceptions of quality in receiving services. Immersion in different models of services over a 2-year period, and inductive analysis of interview data, has found that relationships between service users and workers lie on a continuum, with mutually supportive relationships between service users and workers at one end, and physical and psychological abuse at the other. Experiences were variable in single service contexts, highlighting the problems of using currently employed extant measures to evaluate quality in living services.