A workshop exploring how to design individualised and community-focused support for older people. Developed in partnership with ACH Group and delivered in Adelaide on 4th December 2014.

1. Citizenship & Creative Support
Talk by Dr Simon Duffy of The Centre for Welfare Reform
Day for ACH Home Care Team Advisors, 4 December 2014

2. • Why citizenship should be central
• How to achieve citizenship
• How to organise for citizenship
• How professionals can be citizens

3. For thousands of years people have
struggled to achieve citizenship - to be seen
as an equal and for the rights and duties
that go with citizenship. But, today we’ve
forgotten the true meaning of citizenship.
The welfare state, which should support
citizenship, instead treats us as tax payers,
service users, consumers or patients. This is
not just wrong, it is unsustainable.
It is time to see citizenship as the purpose of
the welfare state and to ensure our society
supports citizenship for all.

4. Citizenship is not the
whole of life. But it is
critical to the life we lead
together - in community.
If we ignore it we will find
ourselves in big trouble.

5. 3 negative questions
• If we are not enabling citizenship for others then
what are we trying to do instead?
• If we are not organised to promote citizenship then
what are we organised to promote?
• If we are not acting as citizens in our work then
what role are we playing?

6. Who are the citizens?

7. Citizenship seems
so distant
• Politics used to mean
‘community life’
• Citizens were just ‘people of the
city’ or community (although
admittedly not all people were
allowed to be citizens)
• Now politics happens
‘elsewhere’

8. Our current understanding of
citizenship is unsustainable
• Voting - an activity that takes a few seconds every
few years.
• Passport - the ability to leave the community (and
then come back)
• Equal rights - being able to get help and protection
from others.
Citizenship can’t just be about getting
it must be about giving if it is going work.

9. Sustainable citizenship
• The ideal of citizenship must have value within the
community.
• The work of citizenship must be to practically
welcome people into citizenship.
• The conditions for citizenship must be available
to all - we must organise for it.

10. We regard wealth as being something to be
properly used, rather than as something to boast
about… Here each individual is interested not only
in their own affairs but also the affairs of the
community… We do not say that one who takes no
interest in community life is minding their own
business; we say they have no business here at
all....
... each single one of our citizens, in all the manifold
aspects of life, is able to show themselves the
rightful lord and owner of their own person, and do
this, moreover, with exceptional grace and
exceptional versatility. [Pericles]

11. Is this dignity?

12. • Dignity and respect are linked.
• Dignity means worth. We each have equal worth,
but sometimes our situation causes others to treat
us without worth, without respect, in an undignified
way.
• Respect means seeing someone in the right way.
• Citizenship is a way of living together as equals -
with mutual respect.

13. Mark Haydon-Laurelut and Karl Nunkoosing explored
what underpins abusive or positive relationships in
‘care settings’. They argue that:
• We tend to treat the challenges of dignity and
respect as merely a matter of acceptance or
affection - being nice.
• But it is possible to be nice to someone and yet fail
to respect them.

15. • Acceptance must be combined with a positive view
of someone’s potential for contribution and the
community’s willingness to accept that gift.
• You can like them - yet protect them from life.
• You can also be positive without wanting to be with
them - controlling from a distance.

16. Alternatives to citizenship
Their analysis aligns well with philosophical thinking
about community and citizenship. Broadly the
alternatives to citizenship are:
• Individualism - protecting me or mine
• Collectivism - controlling them (workers,
consumers, service users etc.) for their own good

17. A philosopher from Mars
would hear a people
talking like rugged
individualists and
pretending they didn’t
need other people
(neoliberals).
But he would see
government taking
increasing control over
people’s lives in the
interests of their well-being
(utilitarianism).

18. The problem with
utilitarianism
• It flourishes despite deep philosophical flaws
• It dominates social science and social policy
• It seems democratic, but implies elitist control
• It’s linked to euthanasia: killing people to reduce
pain
• And eugenics: killing or breeding people to
improve happiness, race or IQ (pick your poison)

19. The citizenship alternative
• Citizen is both an independent individual and an equal
member of a community to which he or she is bound by
duties - responsibilities
• Thus citizenship opens up the door to reconciling our
fundamental need to be respected by others - as an equal
- in all our diversity.
• The dual nature of this ideal reflects the two modes of its
corruptions: liberalism (individualism) or collectivism
(statism)
• Citizenship remains a real possibility.

21. We make citizenship real by
1. Finding our sense of purpose
2. Having the freedom to pursue it
3. Having enough money to be free
4. Having a home where we belong
5. Getting help from other people
6. Making life in community
7. Finding love

22. This protects our dignity
1. Our life is seen to have meaning
2. We are not on someone else’s control
3. We can pay our way - we’re not unduly dependent
4. We have a stake in the community
5. We give others the chance to give
6. We contribute to the community
7. We are building the relationships that sustain community

23. What is citizenship ?

24. Citizenship is also very
practical
Everyone can be a citizen
Everyone can contribute
& the best support
strengthens
citizenship for all

25. 1. Purpose
• Citizen’s have a sense of
purpose - a meaningful life
• People’s sense of meaning
has many sources
• We must listen and look for
meaning in the right places
• We each have purpose - we
just don’t always know it

27. Nan & Direction

28. This is not
person centred planning

29. Help & Connect in Newcastle

30. 2. Freedom
• People have a right to be free
• But we need relationships with
others to be free
• We need to provide help with
information, communication
and good representation
• A man in a desert is not free -
he’s just alone

32. Michael & Freedom

35. 3. Money
• People need the resources
necessary to be citizens
• The chance to earn and save
• Money for services is really
the person’s entitlement
• People only do things for us
for love or money - why not
have both?

37. John-Paul & Money

41. 4. Home
• People need a home of their
own
• That means living with the
people we want to
• Safe, secure and private
• Going into a home - means
losing your home

43. Patrick & Home

45. Then the old Vainamoinen put this into words:
“Strange food goes down the wrong way
even in good lodging;
in his land a man's better at home loftier.
If only sweet God would grant
the kind creator allow
me to come to my own lands
the lands where I used to live!
Better in your own country
even water off your sole
than in a foreign country
honey from a golden bowl.”
From the Finnish epic poem: The Kalevala

46. 5. Help
• Citizens need help - its not
independence that build
community but dependence
• But help must be good help
• Supporters need to
understand what good help
demands
• If you need nobody you're no
use to anybody

48. Trevor & Help

52. Individualise Everything

53. 6. Life
• Life is made by living
• Work, play, volunteering and
having fun
• Life happens in community
• But it really matters that you
are in the right community for
you

55. Doreen & Life

59. The lame rides a horse
the maimed drives the herd
the deaf is brave in battle.
A man is better
blind than buried.
A dead man is deft at nothing.
A Viking Poem from the Havamal

60. People don’t shop for services they build
stronger community.

63. 7. Love
• We all need love - life without
love is hell
• Love comes in many forms
• We need to understand how to
nurture and encourage love
• Love is what creates
citizenship and new citizens

65. Margaret & Love

68. In order to create there
must be a dynamic force,
and what force is more
potent than love?
Igor Stravinsky

69. Creativity - the art of making the best
from what you have

71. fruitful questions flow from an understanding of your purpose
there is no tool for creativity other than your whole humanity

72. ?
How do we support
citizenship

74. 1. Get good at listening for direction
2. Build relationships that liberate people
3. Get clear about entitlements
4. Respect and deepen roots
5. Be flexible - in the extreme
6. Get stuck into community
7. Look out for love

76. fruitful questions flow from an understanding of your purpose
there is no tool for creativity other than your whole humanity

77. What is allowed?
Asking forgiveness
not permission.

79. • Split into pairs
• Think about your caseload
TASK ONE
• Identify the support arrangement you are most proud of
• List the different kinds of things that the person spent their
budget upon?

80. In our best packages…
personal care
transport
social assistance
cleaning
respite
cooking/preparing/eating - together
gardering
shopping
medication
information
podiatry
exercise & dancing
equipment
OT/counselling
incontinence pads
communty linking
nursing care
physio
training & education
companionship
familiy support
holiday-accom.
surgical procedure
volunteer
decluttering
fun
moving home
IT
modifications
advocacy
peer support
employment
0 10 20 30

82. What are good
questions to ask?

83. What do you
want to do
with your life?
What is really
important to
you?
What does a
good life for
you?
What do you
want to share?
What are
your
priorities?
What would you
like to be doing
in the future?
Who is really
important to
you?
What support
do you want
to build on?
What are
you part of?
Who do
you trust?
What have you
always wanted
to do?
How do you
want to
contribute?
What lights
your fire?

84. • Split into pairs
• Pick an ACAT level
TASK TWO
• Imagine that you have the level of need you associate with
that level
• But you are still the same person, same family, interests etc.
• Support each other to design the best support you can for
yourself with your year’s budget.
• Imagine the funding can be used with absolute flexibility.
• Provide a breakdown of your use of the budget.
• Challenge yourself to get best value from your money.

85. 1. Who is the main person you would
ask to represent you?
2. What will you being doing with
your life?
3. Who will you get support from?
4. Where will you live?

86. Freedom Network 52 Prof. 1
Life FT 0 PT 6 Vol. 25 Educ. 34 Love 51
Help Natural 52 PA 31 Service 54 Vol. 22
Home Family 24 Friends 1 Alone 37 Service 0
People More 30 Less 2 Unsure 6 Same 23
Happy Yes 49 No 2 Unsure 12

87. 300
225
150
75
0
Who will represent you?
Network Professional

88. 120
90
60
30
0
What will you do with your life?
FT Work PT Work Vol. Work Education Love

89. 200
150
100
50
0
Who will help you?
Natural PA Service Voluntary

90. 160
120
80
40
0
Where will you live?
Family Friends Alone Service

91. How important will the people in your be life in the future?
160
120
80
40
0
More Less Unsure Same

92. 100
75
50
25
0
Will you be happy?
Yes No Not Sure

93. Did you think of anything that -
as an ACH advisor you would
have had to think twice about
before agreeing?

94. How does reflecting on your own
life make you think about your
own role as an advisor?

95. Is there anything ACH group do
to make it easier for your to do
the right thing by people?

97. Christ does not call his benefactors loving or charitable. He calls them
just. The Gospel makes no distinction between the love of our
neighbour and justice. In the eyes of the Greeks also a respect for Zeus
the suppliant was the first duty of justice. We have invented the
distinction between justice and charity. It is easy to understand why.
Our notion of justice dispenses him who possesses from the obligation
of giving. If he gives, all the same, he thinks he has a right to be
pleased with himself. He thinks he has done good work. As for him who
receives, it depends on the way he interprets this notion whether he is
dispensed from all gratitude, or whether it obliges him to offer servile
thanks.
Only the absolute identification of justice and love makes the co-existence
possible of compassion and gratitude on the one hand, and
on the other, of respect for the dignity of affliction in the afflicted - a
respect felt by the sufferer himself and the others.
Simone Weil

98. There are eight degrees of charity, one higher
than the other. The highest degree, exceeded by
none, is that of the person who assists a poor Jew
by providing him with a gift or loan or by accepting
him into a business partnership or by helping him
find employment - in a word, by putting him where
he can dispense with other people's aid. With
reference to such aid, it is said, “You shall
strengthen him, be he a stranger or a settler, he
shall live with you” (Lev. 25:35), which means
strengthen him in such manner that his falling into
want is prevented. [Maimonides]

99. Maimonides’ 8 rules of giving
1. Don’t look down on people - respect them as your equal
2. Don’t deny people what they really need
3. Don’t wait until someone has to ask
4. Don’t force people to beg
5. Don’t act like you are doing them a favour
6. Don’t expose people to scorn or stigma
7. Don’t distinguish givers or receivers
8. Don’t let people fall into need in the first place

100. fruitful questions flow from an understanding of your purpose
there is no tool for creativity other than your whole humanity