Thirtieth Anniversary Issue on Progress and Priorities in Direct Support
The Power of Observation and Conversations
Essential skills for Supporting People as They Age
A lot has changed since 1996. Back then, everyone wanted “The Rachel” haircut from “Friends,” danced the Macarena, collected Beanie Babies, played video games on the Nintendo 64, and watched ironic movies like “Jerry Maguire” or “Titanic.” One thing hasn’t changed: everyone gets older.
Over the last thirty years, how direct support professionals (DSPs) support people as they age has also changed. We stopped assuming something was wrong with a person so professionals should make decisions for them. Today, we embrace person-centered support, where the person directs their own lives, makes their own decisions (sometimes with support), and shapes their own futures.
John Leo, David Liscombe and Michelle Leo
To illustrate this evolution, let’s look at two Frontline Initiative articles, written 14 years apart by the same person.
2012: On Aging: What DSPs Should Know
In 2012, David Liscomb wrote an article with his DSP Tom Harmon in the Frontline Initiative on Later Life Supports. David described a difficult time in his life when his best friend of twenty years, also his housemate, had suddenly moved out of the house because of health reasons. No one talked to David about it before or after. David didn’t know where his friend had moved and he had no way to visit his friend. It also left David without means to pay his rent. Without a DSP who was paying attention and taking the time to listen, David might have carried this sadness alone for a long time. One of David’s vocational DSP noticed he seemed down and asked him about it. The DSP helped David see his friend and find a new living arrangement. The DSP knew it was important to David to have a strong and attentive circle of support. His advice to DSPs was to talk to the people they support. He said, “Aging brings changes. It is important that people know it’s OK to talk about the feelings they are experiencing about those changes. Talking opens up the door to exploring options and possibilities.”
Fast forward to 2025. As Frontline Initiative editors and the editorial board planned the issue, Supporting People as the Age, David’s name came up again. David has been intentional about planning his retirement. He continues to do the things he likes to stay active but listens to his body and has slowed down some. About his retirement, author Michelle Leo from The Arc Jefferson and a longtime friend of David’s, wrote, “David’s commitment to advocacy and his focus on the positive are defining aspects of his life in retirement. He is taking a slower pace but remains active for the good of his community.”.
In his first article, David encouraged people to be thoughtful about who they include in their circle of support as they age. He took his own advice. Before retiring, David and John Leo created a plan that supports David to continue living how he chooses.
What has changed in DSP Support?
When we asked David what has changed in DSP support since his first article, he shared, “I have noticed that DSPs show more patience with older people than they do with middle‑aged or younger people, and I really appreciate that. I didn’t like it when I was younger, but now I don’t mind if a DSP is physically close to me while supporting me. I never feel like I am rushed. When I am rushed, I do not feel safe, so I like the extra time my caregivers allow me to take when I’m completing everyday tasks or self‑care routines.”
We also asked what DSPs do better today. David explained, “I think DSPs receive better training today on things like Alzheimer’s disease, dementia, and other age‑related conditions. That type of training was not as good twenty years ago as it is today.”
Just as DSP practice has evolved, Frontline Initiative has also evolved to include alternate ways to share content. A Closer Look at Frontline Initiative podcast was launched in 2023. A recent guest is David Liscomb, joined by Michelle and John Leo. In Episode 12, we talk about how David and John planned for David’s retirement. Just as he did in 2012, David shares what DSPs should know when supporting someone as they age, especially when planning for and living out retirement.
Thank you, David, for being part of Frontline Initiative for the past fourteen years. We can’t wait to see what we create together next.