What Working Closely With Support Workers Taught Me About Complex Care

When people hear “support work”, they often picture one thing: a care home, elderly residents, and tasks like washing, dressing and cleaning. That image could not be further from the reality of support work in complex care.

Support work is one of the most misunderstood roles I have come across, and that misunderstanding does a disservice not only to the people receiving care, but to the skilled, compassionate support workers who provide tailored disability support across hospitals, private homes, children’s residential settings and specialist placements.

Here is what people often get wrong.

Support work in complex care goes far beyond care homes and the elderly

One of the biggest misconceptions is that support work only exists in care homes and only involves older people.

In reality, support work is an incredibly broad and diverse sector. Support workers care for people of all ages, from children to adults, and across a wide range of disability support settings. This includes long term hospital care, children’s residential services, private homes and specialist placements, including paediatric care.

The individuals being supported may have physical disabilities, learning disabilities, mental health needs, brain injuries or complex medical conditions. Many require highly tailored, long-term complex care support that adapts as their needs change over time.

Support work is not a single environment or a single type of person. It is as varied as the people receiving care.

Brain injuries and complex conditions require individualised care

Another common misunderstanding is the idea that brain injuries or conditions like cerebral palsy can be approached with a standard care plan.

In practice, no two individuals present in the same way.

Brain injuries can affect people physically, cognitively, emotionally and socially, often in very different combinations. One person may struggle with mobility, another with communication, memory or emotional regulation. Some individuals are highly independent in certain areas and need intensive support in others.

The same is true for conditions like cerebral palsy. The impact can range from mild physical challenges to complex physical and cognitive needs. Brain injury support requires support workers to constantly adapt their approach based on the individual, not the diagnosis.

This work requires patience, observation, flexibility and a deep understanding of how different needs show up day to day. There is no template when it comes to individualised care in complex care.

Support work involves far more than personal care

Personal care is part of the role, but reducing support work to washing, dressing and cleaning completely misses the point.

Support workers play a key role in rehabilitation, emotional support and quality of life. They are often the people encouraging service users to build independence, rather than doing everything for them. This might look like prompting, guiding and motivating rather than taking over.

Companionship is just as important as practical support. So is social inclusion. Support workers help individuals access their communities, take part in activities, build confidence and maintain relationships.

They also work closely with multidisciplinary teams, including therapists, nurses and other professionals, to deliver therapeutic approaches that support long term progress.

The emotional side of the role is huge. Being present, patient and consistent can be just as important as any physical task.

Neurodivergence as a disability is often misunderstood

There is a growing misconception that neurodivergence, particularly ADHD and autism, is overused, trendy or “not that impactful”.

The reality seen through neurodivergent support tells a very different story.

For many individuals, neurodivergence can be deeply debilitating. Some require residential care, intensive support and long-term rehabilitation. Many are non-verbal. Others experience extreme sensory sensitivities, communication challenges or difficulties regulating emotions and behaviour.

Support workers play a critical role in autism and ADHD support, helping individuals navigate daily life in a way that feels safe and supportive for them. This work requires specialist understanding, consistency and empathy.

Seeing this first hand makes it very clear that neurodivergence is not something everyone “has a bit of”. For many people, it shapes every part of their daily experience.

Support work in complex care is skilled, complex and deeply human

At its core, support work is about enabling people to live fuller, more independent lives in a way that respects who they are.

It requires emotional intelligence, adaptability, resilience and genuine care. It involves building trust, understanding individual needs and showing up consistently, even on difficult days.

The work is not easy. It can be emotionally demanding and often goes unseen. But it is also meaningful, impactful and essential.

Support workers are not “just carers”. They are advocates, companions, motivators and a vital part of complex care teams.

And they deserve to be understood as such.