People with SCI's who require full-time attendant care must become comfortable with having their most personal physical functions attended to by a higher worker. They must be able to direct a care attendant in all their most basic self-care needs. This arrangement requires that the individual exercise assertiveness, patience, and the practical skills required to hire qualified care attendants. Financial security influences the type of caregiving obtainable for persons with SCI's. If an individual can afford to pay well, he or she is then better able to hire more qualified care attendants.
Good pay can also guarantee more reliable service.
People with SCI's who are less financially fortunate, may have to rely on friends or family members for some or all of their care. Situations such as these can create over reliance in relationships that were not originally designed to include personal caregiving. Poor interpersonal communication, underpaid or under qualified caregivers, and the immediacies of need can unfortunately place a person with SCI's in a situation in which they are at risk for abuse or neglect. The Psychology of Disabilities by Carolyn Vash.