Synergistical assistance - combining artefactual and human assistive resources to reach desired outcomes.

Purpose: Assistance from artefacts and humans are traditionally viewed as separate, and it is often up to the individual to try to combine the different kinds of assistance to suit their needs and preferences. The purpose of this study was to gain new insights into the co-existence of and synergies between artefactual and human assistance in the everyday lives of persons with physical and cognitive impairments, through exploring and analysing narratives of individuals who have first-hand knowledge and experience.

Methods: Seven individuals took part in semi-structured interviews, which were then analysed with qualitative content analysis, grounded in cultural-historical activity theory.

Result: The participants were active agents with agendas, dreams, and needs, who shaped and made use of many different combinations of human and artefactual assistance, both formal and informal. They did this in ways that suited each person's preferences and circumstances and were often seen as complementary and synergistical. Flexible assistance could make limited energy resources last throughout the day, while less flexible or not individually tailored assistance was found to be less useful or appreciated. Assistance that was well integrated into a person's routines could become invisible and make the person feel independent despite severe impairments.

Conclusions: This study contributes new knowledge regarding how persons with disabilities utilize and mould artefactual and human assistance according to the activities they engage in as part of everyday life. When synergistical assistance works, different kinds of assistance flow seamlessly into one another and adjustment of plans and improvisations happen in the moment.