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Guidance or Supervision
Guidance can be provided by:
- directing or leading someone by physical means; or
- verbal suggestion or persuasion (Scottish Adult DLA regs, reg. 7(5))
Guidance might include, but is not limited to:
- helping the individual navigate the route to a destination
- avoiding situations that the individual will experience distress
- prompting or persuading the individual to walk
- providing direction to an individual who is unable to understand any written information, signs or symbols.
Example: an individual who is entitled to the lower rate of the mobility component because he requires guidance to navigate unknown routes
Charlie is 40 years old and has Down’s syndrome. He has significant difficulty remembering visual information and following instructions. He is unable to navigate a route unless it is the one route he is familiar with. Charlie needs guidance when outdoors most of the time because he can only walk the few routes he knows.
The case manager determines that Charlie is entitled to the lower rate of the mobility component of Scottish Adult DLA.
Example: an individual is entitled to the lower rate of the mobility component because she requires guidance to move around outdoors safely
Seonaid is 34 years old and had bacterial meningitis as a teenager which has had a lasting impact on both her memory and her ability to walk unaided.
Seonaid needs someone to guide her when moving around outdoors because her memory issues make it difficult for her to remember directions. She also has difficulty concentrating. She can get distracted easily or forget where she was going because of this.
The case manager determines that Seonaid is entitled to the lower rate of the mobility component of Scottish Adult DLA. This is because Seonaid requires guidance to move around outdoors safely.
Example: an individual is not entitled to the lower rate of the mobility component because she is able to move around outdoors without guidance most of the time
Mana is 47 years old and has dyspraxia, dyslexia and attention deficit hyperactivity disorder (ADHD). Dyspraxia is a neurological condition which impacts an individual’s ability to plan or carry out motor tasks. Dyslexia is a learning difficulty that involves difficulty reading due to problems identifying speech sounds and learning how they relate to letters and words.
Mana is able to move around outdoors but is often disorganised and forgets to pack items like her phone or house keys. She also sometimes misses her bus to work because she has difficulty keeping track of time. She often needs prompting and reminding about events.
Mana meets up with friends in town but can have difficulty travelling home. She sometimes takes the wrong bus and has to return to her starting point to find the right one. Mana is able to ask for directions and read timetables when this happens. However, she says that she does find it difficult to understand them, and needs to check several times.
The case manager determines that Mana is not entitled to the lower rate of the mobility component of Scottish Adult DLA. This is because Mana can move around outdoors without guidance most of the time.
Supervision
Supervision is the precautionary or anticipatory presence of another person to monitor an individual’s physical, mental or emotional health.
This includes monitoring for obstacles or dangerous places and situations (Scottish Adult DLA regs, reg. 7(5))
Supervision might include but is not limited to:
- keeping the individual away from danger
- monitoring the individual for signs of an event such as a seizure or loss of consciousness
- speaking to the individual to keep them calm and focussed on walking
- needing to be with the individual to comfort them if they become upset or distressed
- needing to be with the individual because of the risk of them falling.
The supervision which the individual needs to be able to move around outdoors does not need to be constant supervision. The criteria is satisfied if the individual requires supervision most of the time. This means more often than not.
This section of the guidance is exclusively referring to mobility, and should therefore not be taken to support application of a “most of the time” test in relation to the care criterion.
Actual intervention may never be needed in some cases. However, what is needed is the readiness of the person accompanying the individual to intervene.
Example: an individual is entitled to the lower rate of the mobility component because she is unable to move around outdoors without supervision
Isabella is 29 years old and was diagnosed with epilepsy as a child. Despite regular treatment and medication, her condition is largely uncontrolled. This leads to frequent and unpredictable seizures. The seizures always require intervention from another person. Isabella must be accompanied by someone who knows how to assist her if she has a seizure when she is outdoors.
The case manager determines that Isabella is entitled to the lower rate of the mobility component of Scottish Adult DLA. This is because she is unable to move around outdoors without supervision.
Example: an individual is not entitled to the lower rate of the mobility component because he is able to move around outdoors most of the time
Cailean is 28 years old and has asthma. His asthma is manageable with an inhaler most of the time. Cailean can experience exacerbations which make his asthma worse both indoors and outdoors. This is more frequent in winter. He can become breathless and need his inhaler when this happens, however he is able to use his inhaler unaided. Cailean’s asthma is not a problem for him most of the time when he is outdoors, however he likes to have someone with him for reassurance in case he has an asthma attack.
The case manager determines that Cailean is not entitled to the lower rate of the mobility component of Scottish Adult DLA as he does not require supervision.
Example: an individual is entitled to the lower rate of the mobility component because he requires supervision to make sure he does not endanger himself
Zeke is 29 years old and has attention deficit hyperactive disorder and a learning disability. His behaviour is very impulsive and he has very limited awareness of danger. Zeke is likely to run towards something that interests him whether it is safe to do so or not. For example, Zeke understands that he needs to use the lights at pedestrian crossings but he often becomes impatient and does not wait until it is safe to cross.
The case manager determines that Zeke is entitled to the lower rate of the mobility component of Scottish Adult DLA. This is because Zeke needs to be supervised when moving around outdoors so he does not put himself in danger.
Example: an individual is entitled to the lower rate of the mobility component because he requires supervision to keep him calm and able to walk while outdoors
Percy is 31 years old and has autism. He can become very distressed if there is a sudden change in his environment and routine. This could involve needing to take a different route to a familiar place or a change in routine.
An example of this is roadworks requiring Percy to take a different route when walking to work. This can lead to extreme anxiety attacks which affect his ability to plan an alternative route. Percy needs another person with him to keep him calm or redirect his focus on these occasions so he can keep walking.
The case manager determines that Percy is entitled to the lower rate of the mobility component of Scottish Adult DLA as he requires supervision.