Introduction: The Problem with One-Size-Fits-All Care Approaches
When Emma first entered the disability support system after her accident, she quickly discovered a frustrating reality: despite the best intentions of many support workers, she often felt like a collection of needs rather than a whole person. Her schedule was dictated by staff availability rather than her preferences. Activities were chosen based on what was available for “people like her” rather than her individual interests. And worst of all, many decisions about her life were made without her input at all.
Emma’s experience isn’t unique. For decades, disability support has been dominated by standardised approaches that prioritise operational efficiency over individual experience. While this system may be easier to manage and scale, it fundamentally fails to recognise the diverse needs, preferences, and aspirations of the people it serves.
This is the problem with one-size-fits-all care: it rarely fits anyone well.
The consequences extend far beyond mere inconvenience. When support is generalised rather than personalised, it can undermine dignity, restrict choice, limit potential, and ultimately diminish quality of life. People with disabilities become passive recipients of services rather than active participants in their own lives.
But there is a better way.
Person-centered disability support represents a fundamental shift in how we think about and deliver care. Rather than fitting people into existing service models, it creates support systems around the unique needs and goals of each individual. It recognises that while two people might share the same diagnosis or disability, their lives, preferences, capabilities, and aspirations remain distinctly their own.
As a family-run NDIS provider, we’ve seen firsthand how transformative truly individualised support can be. When care is built around the person rather than the system, remarkable things happen. Independence flourishes. Confidence grows. And lives change—not despite disability, but alongside it.
In this article, we’ll explore the evolution, principles, and profound benefits of person-centered care, sharing insights from our experience as a small, family-oriented provider committed to treating every participant like a member of our own family.
The Evolution of Disability Support: From Institutional to Person-Centered
The history of disability support in Australia reflects a global journey from institutionalisation to individualisation—a journey that continues to evolve today.
The Institutional Era
For much of the 20th century, disability support was dominated by an institutional model. People with disabilities were frequently separated from their communities and placed in large residential facilities where:
- Standardised care was provided with little regard for individual preferences
- Residents had minimal control over daily decisions or life choices
- Support focused on basic needs rather than personal growth or fulfilment
- Medical perspectives dominated, with disability viewed primarily as a condition to be managed
This approach, while sometimes well-intentioned, resulted in isolation, dependency, and lost potential for countless individuals.
The Group Home Transition
From the 1970s onwards, Australia began moving away from large institutions toward community-based models, particularly group homes. While this represented progress, many problematic aspects remained:
- Services were still designed around operational convenience
- Individual choice remained limited by group living arrangements
- Support continued to be scheduled around staff rosters rather than resident preferences
- Meaningful community integration was often minimal
The Rights-Based Revolution
The 1980s and 1990s saw the emergence of disability rights movements and the beginning of a fundamental shift in thinking. People with disabilities and their advocates began demanding recognition not just as service recipients but as citizens with equal rights to self-determination.
Key developments included:
- The Disability Discrimination Act 1992, which prohibited discrimination based on disability
- Growing recognition of the social model of disability, which identified societal barriers rather than individual impairments as the primary problem
- International frameworks like the UN Convention on the Rights of Persons with Disabilities, which Australia ratified in 2008
The NDIS and Person-Centered Transformation
The introduction of the National Disability Insurance Scheme (NDIS) in 2013 represented a watershed moment in Australian disability support. For the first time, funding was attached to individuals rather than services, enabling unprecedented choice and control.
The NDIS was explicitly designed around person-centered principles:
- Participants determine their own goals and aspirations
- Funding can be used flexibly to purchase supports that best meet individual needs
- Emphasis on capacity building alongside direct support
- Recognition of the importance of informal supports and community participation
This shift from service-centered to person-centered approaches continues to transform the landscape of disability support in Australia, though the journey is far from complete.
Core Principles of Person-Centered Care
Person-centered care isn’t just a service model—it’s a philosophy built on respect for human dignity and individual autonomy. While implementations vary, genuine person-centered approaches share several core principles:
1. Individual Autonomy and Self-Determination
At the heart of person-centered care is the recognition that each person has both the right and capacity to direct their own life. This means:
- Supporting informed decision-making, even when choices involve some risk
- Respecting the right to refuse particular interventions or supports
- Recognising capacity varies across different domains and can be developed over time
- Providing decision-making support when needed without unnecessarily taking over
2. Holistic Understanding
Person-centered care views each individual holistically rather than reducing them to their disability or support needs:
- Recognising the complex interplay of physical, emotional, social, and spiritual dimensions
- Understanding personal history, cultural background, and identity
- Acknowledging the importance of relationships and community connections
- Appreciating unique strengths, talents, and interests beyond support requirements
3. Focus on Capabilities and Strengths
Rather than defining people by what they cannot do, person-centered approaches emphasise:
- Identifying and building upon existing capabilities
- Creating opportunities to develop new skills and confidence
- Focusing on possibilities rather than limitations
- Recognising that capabilities evolve and can be expanded with appropriate support
4. Meaningful Participation and Inclusion
Person-centered care extends beyond basic needs to facilitate full participation in family and community life:
- Supporting engagement in personally meaningful activities
- Facilitating genuine community inclusion rather than segregated programs
- Enabling contribution through employment, volunteering, or other valued roles
- Creating pathways to develop and maintain relationships
5. Flexibility and Responsiveness
Truly person-centered support adapts to changing needs, preferences, and circumstances:
- Regular review and adjustment of support arrangements
- Willingness to try new approaches when current strategies aren’t working
- Responsive problem-solving rather than rigid adherence to predetermined plans
- Recognition that good days and bad days require different types of support
“Person-centered care isn’t about creating a perfect plan on paper—it’s about listening and adapting every day to what matters most to the person in front of you.”
Benefits of Individualised Support Plans
When support is genuinely tailored to the individual, the benefits extend far beyond mere satisfaction with services. Research and our direct experience show that person-centered approaches lead to transformative outcomes in multiple life domains:
Enhanced Independence and Autonomy
Tailored support enables people to do more for themselves and make more choices about their lives:
- Skill development targeted to personal goals increases functional independence
- Support focused on decision-making builds confidence in making life choices
- Assistive technology matched to individual needs maximises independent function
- Graded support that adjusts to changing capabilities builds progressive independence
Improved Mental Health and Wellbeing
The psychological benefits of person-centered support are profound:
- Reduced feelings of helplessness when people have genuine input into their support
- Increased self-esteem through recognition of personal strengths and preferences
- Lower rates of depression and anxiety when support is responsive to emotional needs
- Greater life satisfaction when activities align with personal values and interests
Stronger Relationships and Social Connections
Individualised approaches recognise the central importance of relationships:
- Support to maintain existing family relationships and friendships
- Opportunities to develop new connections based on genuine shared interests
- Recognition of cultural and community ties that matter to the individual
- Facilitation of reciprocal relationships rather than just care relationships
Better Physical Health Outcomes
Even physiological health improves with person-centered approaches:
- Preventative health measures integrated into daily routines in personally acceptable ways
- Higher engagement with therapy when it aligns with personal goals
- Reduced stress-related health problems
- Earlier identification of health concerns when support workers know the person well
Meaningful Community Participation
True inclusion becomes possible when support is individually tailored:
- Community engagement based on personal interests rather than available programs
- Support to participate in mainstream community activities rather than disability-specific options
- Opportunities for valued social roles and contribution
- Development of natural supports within community contexts
Cost-Effectiveness and Sustainability
Counterintuitively, person-centered approaches often prove more resource-efficient:
- Support targeted to actual needs prevents over-servicing in some areas
- Building natural supports reduces reliance on paid assistance
- Preventative approaches reduce crisis interventions
- Stability of support relationships reduces costly staff turnover
The Family-Centered Approach to Disability Support
While person-centered support focuses primarily on the individual with disability, a family-centered approach recognises that people exist within networks of relationships. This is particularly important when supporting children with disabilities or adults who maintain close family connections.
As a family-run provider, we understand intimately how disability affects not just individuals but entire family systems. Our family-centered approach builds on person-centered principles while acknowledging the important role of families:
Recognising Family Expertise
Families often have unparalleled knowledge about their loved one’s needs, preferences, and communication:
- Valuing family insights alongside professional assessments
- Learning from established routines and strategies that work
- Understanding family-specific language and communication patterns
- Recognising cultural practices and values important to the family
Supporting the Whole Family
The wellbeing of a person with disability is inextricably linked to family wellbeing:
- Providing respite options that work for both the individual and their family
- Offering practical skills training for family members
- Creating opportunities for siblings and extended family to be appropriately involved
- Connecting families with relevant community resources and peer support
Balancing Needs and Boundaries
A skilled family-centered approach maintains appropriate boundaries:
- Distinguishing between the individual’s goals and family preferences
- Supporting age-appropriate autonomy and privacy
- Mediating differences of perspective respectfully
- Ensuring the person with disability remains central to decision-making
Building Family Capacity
Effective support builds family capability rather than creating dependency:
- Teaching skills that enhance the family’s ability to provide natural support
- Empowering families to navigate service systems independently
- Supporting sustainable care arrangements that prevent burnout
- Developing emergency and transition plans for critical life stages
Overcoming Challenges in Implementing Personalised Care
Despite its clear benefits, delivering truly person-centered support involves navigating several common challenges:
System Constraints
The reality of working within funded support systems can create tensions:
- Navigating NDIS categories and guidelines while maintaining flexibility
- Managing the administrative burden of individualised documentation
- Working within funding limitations to prioritise what matters most
- Balancing accountability requirements with person-centered flexibility
Solution Approaches:
- Developing deep expertise in creative NDIS plan utilisation
- Creating efficient documentation systems that capture individualised goals
- Building relationships with NDIS planners to advocate effectively
- Transparent conversation about priorities when resources are limited
Finding the Right Staff
Person-centered support requires specific mindsets and capabilities:
- Identifying staff with values alignment beyond technical qualifications
- Developing person-centered thinking skills in team members
- Retaining staff who build meaningful relationships with participants
- Matching staff characteristics with individual preferences and needs
Solution Approaches:
- Values-based recruitment that prioritises attitude and approach
- Ongoing mentoring and training in person-centered practices
- Creating stability through meaningful staff engagement and development
- Involving participants in staff selection where appropriate
Balancing Choice and Safety
Supporting choice while managing risk is an ongoing challenge:
- Distinguishing between real and perceived risks
- Supporting informed choice about reasonable risks
- Meeting duty of care obligations without unnecessary restriction
- Addressing family concerns about safety without limiting autonomy
Solution Approaches:
- Structured approaches to positive risk assessment and management
- Documented decision-making processes that demonstrate due diligence
- Incremental approaches to expanding choice and autonomy
- Education for all stakeholders about dignity of risk principles
Communication and Coordination
Effective person-centered support requires exceptional communication:
- Maintaining consistency across multiple support workers
- Ensuring effective handovers and information sharing
- Coordinating between different providers and health professionals
- Adjusting communication approaches for diverse needs
Solution Approaches:
- Centralised but accessible documentation systems
- Regular team meetings focused on person-centered outcomes
- Clear communication protocols and expectations
- Technology solutions that enhance coordination
Real-World Success Stories
While respecting privacy, these anonymised examples illustrate the transformative potential of genuinely individualised support:
James: From Program Participant to Community Contributor
Background: James, a 34-year-old man with intellectual disability, had spent years rotating through standardised day programs that left him disengaged and increasingly withdrawn.
Person-Centered Approach: Rather than placing James in another program, his support team spent time discovering his genuine interests. They discovered his passion for gardening and love of helping others.
Outcome: With tailored support, James now volunteers at a community garden two days a week and has developed a small plant propagation business he runs from home. His confidence has flourished, depression has lifted, and he’s developed natural friendships with fellow gardeners.
Key Insight: By focusing on James’s interests and strengths rather than available programs, support enabled meaningful contribution and natural relationship building.
Sarah: Reclaiming Control Through Microboards
Background: Sarah, a woman with high physical support needs due to cerebral palsy, felt her life was controlled by a rotating cast of support workers who each did things differently, often ignoring her preferences.
Person-Centered Approach: Sarah established a microboard—a small group of committed family members and friends who help manage her support. Together, they created detailed preference documentation and took control of staff recruitment and training.
Outcome: Sarah now has a consistent team who know her well, follow her preferred routines, and support her life choices. Her health has improved, and she’s pursuing education goals previously thought unattainable.
Key Insight: Innovative governance approaches can transform support quality by ensuring the person’s voice remains central to all decisions.
The Martinez Family: Culturally Responsive Support
Background: The Martinez family, caring for their daughter with multiple disabilities, had withdrawn from formal supports after culturally insensitive experiences left them feeling judged and misunderstood.
Person-Centered Approach: A family-centered provider took time to understand their cultural practices, family dynamics, and previous negative experiences before suggesting any support arrangements.
Outcome: With culturally responsive support that respects family values while still promoting their daughter’s development, the family has re-engaged with formal services. Their daughter is making progress, and family stress has significantly reduced.
Key Insight: Cultural responsiveness is essential to effective person-centered practice, particularly for families from diverse backgrounds.
Conclusion: Guidance for Families Seeking Quality Support
Person-centered disability support represents not just a service approach but a fundamental statement about human dignity—the recognition that disability doesn’t diminish a person’s right to self-determination, respect, and individualised consideration.
As you navigate the world of disability support for yourself or a loved one, here are key insights to guide your journey:
Recognising Genuine Person-Centered Support
Look for providers who demonstrate:
- Curiosity about the whole person, not just their support needs
- Flexibility in how services are delivered, adapting to your preferences
- Willingness to problem-solve when standard approaches don’t work
- Respect for your expertise about your own life and needs
- Focus on your goals, not just what’s convenient or typical
Questions to Ask Potential Providers
When evaluating support options, consider asking:
- “How will you get to know me/my family member beyond what’s in the assessment reports?”
- “What happens if the initial support plan isn’t working well?”
- “How do you match support workers with the people you support?”
- “How do you balance safety concerns with supporting choice and independence?”
- “Can I speak with current clients about their experience with your service?”
The Importance of Relationship and Values Alignment
Technical competence matters, but equally important is finding providers whose values and approach align with your own. The quality of relationships between support workers and the person they support often determines outcomes more than any formal qualification or procedure.
For small, family-run providers like Support & Prosper Care Services, this relationship-based approach isn’t just an add-on—it’s fundamental to how we work. We believe in treating each person we support as we would want our own family members to be treated: with dignity, patience, attention to individual preferences, and genuine care.
Starting Your Person-Centered Journey
If you’re just beginning to explore support options, consider these steps:
- Reflect on what matters most to you or your family member—beyond just meeting basic needs
- Document preferences and effective approaches, creating a profile that helps new support workers understand what works best
- Start small with a specific area of support before expanding to ensure compatibility with potential providers
- Be clear about non-negotiables as well as areas where you’re open to suggestions
- Remember that good support evolves through open communication and willingness to adjust approaches
At Support & Prosper Care Services, we understand that trusting others with support for yourself or a loved one is a significant step. As a family-run provider, we bring not just professional expertise but personal understanding to the journey of creating truly individualised support.
Our commitment to person-centered care isn’t just about following best practice—it’s about honoring the uniqueness of each individual and family we work with, recognizing that behind every support plan is a person with their own story, preferences, challenges, and dreams.
When support truly centers on the person, possibilities expand, barriers diminish, and life flourishes in ways that standardized approaches simply cannot achieve.
For more information about how Support & Prosper Care Services can provide personalised support for you or your loved one, contact us at [email protected] or call +61425044406.
