Person Centered Thinking Day 2

Person Centered Thinking Day 2
Developed by Michael Smull with Bill Allen, Marc Archembault, Sherrie Anderson, Mary Lou Bourne, Amanda George, Cherie Goss, Julie Malette, Michael Steinbruck, and Nolda Ware

© The Learning Community for Essential Lifestyle Planning, Inc. 2006
7 questions that you should be able to answer for each person you support What is important to the person? What is important for the person? Is important for addressed in the context of what is important to? Is there a “good” balance between important to and important for? What does the person want to learn, what do we need to learn? If the person is to get the balance described and we are to learn: What needs to stay the same (be maintained or enhanced)? What needs to change? © The Learning Community for Essential Lifestyle Planning, Inc

Help people get better lives Not just better plans… © The Learning Community for Essential Lifestyle Planning, Inc

Developing and using plans in 5 stages
1. Why and how - develop the purpose and the process 2. Gather information 3. Develop a first description – how the person wants to live/needs to be supported what we are going to do to make it happen 4. Use the description and 5. Record what you learn This training focuses on how to gather information and how to use that to develop a 1st plan. Because this training skips the first step you need to help people notice what should happen. Emphasize that plans that work are always developed in partnership and that they always start with thinking about what you want to learn. The next slide has some of the questions that those who write plans should start with © The Learning Community for Essential Lifestyle Planning, Inc

Think before you plan QUESTIONS TO CONSIDER: What would you like the description to accomplish? How can the person best participate? Who is in the person’s life? What is the most effective way to learn from those closest to the person? © The Learning Community for Essential Lifestyle Planning, Inc

Gathering information
Questions to consider: Who should you talk to; who should you listen to? Who knows what? What is the best way to get their information? How can you best support the person and those closest to the person in doing this work? © The Learning Community for Essential Lifestyle Planning, Inc

Developing your own person centered description
Look for the paper that says ________ ‘s Person Centered Description and put your name and date on the face page __________’s Person Centered Description Date of the 1st plan ________________________________________________ Dates description changed __________________________________________ Purpose of the description To learn how structured conversations and looking at reputations can be used to develop a person centered description. © The Learning Community for Essential Lifestyle Planning, Inc

Find your “Relationship Map” and fill it out
Put your name in the center Fill out each section based on how close you feel to family members, friends, etc. Who is paid to support you? Your doctor, whoever cuts your hair, etc. How close do you feel to them?

Three ways to have a conversation
Linear: Branching: Meandering: © The Learning Community for Essential Lifestyle Planning, Inc

Morning Ritual

Amanda’s Morning Ritual
7:00 am Alarm goes off, clock says 7:15 a.m. Music ONLY no buzzer hit snooze once or twice (depending on how late I went to sleep) get up at 7:09 or 7:18 a.m. If up late skip breakfast Stand in closet, with door shut so light won’t wake husband and decide what I’m going to wear for the day. 7:15 am Take clothes to bathroom, turn on water in shower-must be hot, remove pj’s, get in shower, 1st wash body with MILD soap, then wash hair-mild shampoo, rinse, sometimes shave legs 7:25 am Get out of shower, use 100% cotton towel that is not ‘slick’, dry off hair 1st work down to ankles. Feet dry on their own. Spray conditioner (Paul Mitchell) leave in and comb through Wash face with Clinique-mild soap, no wash cloth, use clarifying lotion and remove eye make-up with Clinique make-up remover Put on deodorant and powder-antiperspirant (only if really hot). Put on underwear, then top. put on eye liner and mascara- No other make-up! (hurts face) Put mousse in hair. © The Learning Community for Essential Lifestyle Planning, Inc

Amanda’s Morning Ritual, con’t…
7:45 am Go into kitchen fix breakfast: Bran cereal w/skim milk, banana, OJ. Eat breakfast in living room while watching the Today Show and the Weather Channel on the 8’s sometimes 7:48 am Give cereal bowl to Oreo the cat 8:00 am Go back to bathroom, blow dry hair: Use big brush and spray gel to hold 8:17 am Brush teeth, put on slacks or skirt. Find shoes 8:23 am Quickly kiss husband good-bye and decide if coming home for lunch. Look for keys and purse, run out the door get in car, leave for work © The Learning Community for Essential Lifestyle Planning, Inc

Morning Ritual – Part 1 Write down your morning ritual – Include as much detail as you are comfortable with Start with how you wake up and end with leaving or when you feel the morning is over Tell us how long it takes – indicate what time it starts and what time it ends This training focuses on how to gather information and how to use that to develop a 1st plan. Because this training skips the first step you need to help people notice what should happen. Emphasize that plans that work are always developed in partnership and that they always start with thinking about what you want to learn. The next slide has some of the questions that those who write plans should start with © The Learning Community for Essential Lifestyle Planning, Inc

Morning Ritual – Part 2 Work in pairs, look at each others morning ritual and learn what is important to your partner Take the sheet of paper that has “what is important to (name)” at the top Read your partner’s routine and then – This training focuses on how to gather information and how to use that to develop a 1st plan. Because this training skips the first step you need to help people notice what should happen. Emphasize that plans that work are always developed in partnership and that they always start with thinking about what you want to learn. The next slide has some of the questions that those who write plans should start with © The Learning Community for Essential Lifestyle Planning, Inc

Our Mantra for the Exercises
Guess: look at what your partner wrote and guess in your head Ask: ask your partner if your guess is correct, have a conversation Write: write down what you learn © The Learning Community for Essential Lifestyle Planning, Inc

Other Rituals Going to bed Transition Birthday Cultural/Holiday Spiritual Vacation Comfort Celebration © The Learning Community for Essential Lifestyle Planning, Inc

Good Day Bad Day

Good Day/Bad Day – Part 1 Take a new sheet of paper, divide it in half so it looks like this: Good day Bad day It is a work day, start with getting up, end with going to bed. Write down a composite of all the good moments you have had on a work day and all of the bad moments. © The Learning Community for Essential Lifestyle Planning, Inc

Good Day/Bad Day – Part 2 Work with your partner. Read their good day/bad day list. Arrange your papers to look like this: What other people need to know or do Good Day/Bad Day Important to Then using the “guess, ask, write” process, add to the what is important list. As you add each item, ask “Is there something that other people need to know or do to support you with that?” © The Learning Community for Essential Lifestyle Planning, Inc

Reputation Exercise

Reputation Exercise – Part 1
Divide a sheet of paper in half and write ‘Positive Reputation’ on the top-left side and ‘Negative Reputation’ on the top-right. POSITIVE REPUTATION Do not write on this – you can write on another person’s positive reputation, but not your own. NEGATIVE REPUTATION Write down 3 mild negatives, for example: Stubborn Directionally impaired Workaholic © The Learning Community for Essential Lifestyle Planning, Inc

For each negative, ask 3 questions: Are their circumstances in which the negative is a positive? If yes, add the positive to the list. Does the negative reflect something that is important to the person? If yes, add it to the important list. Is the negative sometimes really a negative? If yes, what do other people need to know or do to support the person when it is a negative? Add it to the “what others need to know or do to support list”. © The Learning Community for Essential Lifestyle Planning, Inc

An example using ‘stubborn’
Restated as a positive Determined What is Important to To work where my values are supported Support strategy when it is negative Get in my face, tell me, then back off © The Learning Community for Essential Lifestyle Planning, Inc

Look at what others wrote on your positive list What would you like to see listed on your description as your introduction? Move those items that make sense to you to your plan Add or change things as it makes sense to you How did that process feel? © The Learning Community for Essential Lifestyle Planning, Inc

Characteristics of people I like to work with I like to hang out with
I don’t like to work with I don’t like to hang out with © The Learning Community for Essential Lifestyle Planning, Inc

MOSQUITO Imagine you have contracted a new disease from a mosquito bite The bite causes a rash and then 2 weeks of paralysis During the paralysis you will need personal care for everything Now you are looking for the person to provide your care, so you send me a list of characteristics to look for and to avoid Look at your list of characteristics Circle those that must be present and those that must be absent Add any that are missing Clarify any that are too general to allow me to match you with the person providing the care © The Learning Community for Essential Lifestyle Planning, Inc

MOSQUITO Because there are a lot of people who have been bitten, the demand for personal care services is high. I tell you that you will just have to accept whoever I send. The person that comes will keep you healthy and safe but has the characteristics that you said needed to be absent. Remember, except for being able to talk, you are paralyzed. What would you do? © The Learning Community for Essential Lifestyle Planning, Inc

CHARACTERISTICS I WANT IN PEOPLE WHO SUPPORT ME
Look at the list that you created – What are those characteristics that need to be present? What are those characteristics that need to be absent? Write those that need to be present and those that need to be absent in your description © The Learning Community for Essential Lifestyle Planning, Inc

Looking at your description
Take a look at what you and your partner wrote, your description Put the pages in the following order – Cover page, relationship map, introduction, important to, characteristics, and know and do to support How does it look? Would someone who has never met you know – Who you are? What is important to you? How you need to be supported? Who you would want to provide that support? © The Learning Community for Essential Lifestyle Planning, Inc

Learning personality ‘characteristics’ that
need to be Present or Absent in supporters To learn the characteristics that need to be present, ask: To learn the characteristics that need to be absent, ask: Who is closest to the person? Who enjoys spending time with the person? Who helps make good days happen for the person? What characteristics do these people have in common? Who does the person avoid? Who dislikes spending time with the person? Who helps the person have bad days? What characteristics to these people have in common?

Supports wanted and needed Personality Characteristics Needed
Matching Staff Supports wanted and needed Skills needed Personality Characteristics Needed Shared interests (nice to have) © The Learning Community for Essential Lifestyle Planning, Inc

Brittany’s Communication Plan
Sad song is playing or slow melody Puckering her lips She doesn’t like the song-making her sad/feel bad Change the station or song People are talking around her Screaming out loud Frustrated-people aren’t talking to her Go back to last sentence and tell her –direct to her Someone is doing something she wants to try Tight reflex (tight fists or head turning) She is mad or upset Involve her or lead her away Eating Pushing her spoon away and turning her head Full-wants a different food Help her try something else or give choice Cramping or cannot sleep Kicking side of bed or pulls pillow over head Need different position-need to move Move to different bed or to floor Sleep (other possibility) Grabbing at things around her- messing things up Need something better to do-she is bored Be creative-make fun activities Meal time Spitting food Talk to me as I eat Tell funny stories, or share her memories with her Someone is trying to show or tell her something Looking off –out window- no attention person Boredom-already heard this, already know this Be creative, new ideas and activities, involve a friend What is happening ______ does We think it means We should © The Learning Community for Essential Lifestyle Planning, Inc

What is Happening Rhonda does We Think It Means And We Should You are pushing Rhonda Locks her chair I don’t want to go there Figure out with Rhonda where she wants to go Rhonda is at the front door Kicks the door I want to go out Help her outside (unless there is too much pollen, about to rain, etc.) Rhonda has stopped eating Catches your eye, pulls down napkin I’m done eating Take leftovers away now You didn’t remove her food Rhonda sweeps the food off her tray I told you I was finished and you didn’t listen Clean up and do better next time © The Learning Community for Essential Lifestyle Planning, Inc

Communication Plan What is happening ______ does We think it means We should © The Learning Community for Essential Lifestyle Planning, Inc

Communication Plan When this is happens In the environment What’s just gone on The “trigger” The behavior What others notice Can be seen, heard, and felt by others Meaning of the behavior What the emotions and feelings are What’s going on inside What other people should do in response Or not do….. I do this It ususally means And I want you to #3 #1 (or 2) #2 (or 1) #4 © The Learning Community for Essential Lifestyle Planning, Inc

THINGS WE NEED TO COMMUNICATE WITH KYLE Then support/encourage Kyle to
We want to let Kyle know To do this we Then support/encourage Kyle to It’s time to get up (if Kyle is not already awake). Knock on Kyle’s bedroom door and then open it. Continue Kyle’s morning routine. See “to be successful”. It’s time to have a bath. Run bath while Kyle is in his bedroom and when bath is run open his door. Kyle will get into the bath unsupported. It’s time to have a shave. Show Kyle his razor and shaving cream. Apply shaving cream and have a shave. It’s time to have hair washed. Show Kyle shampoo. Apply shampoo and have his hair washed. It’s time to get dressed. Show Kyle his clothes. To dressed by letting him know what he needs to do. For example, pointing and tapping his leg to lift, etc. Breakfast/lunch/dinner is ready. Show Kyle his meal. Encourage Eric to go into dining room. Sit at the table and eat his meal. It’s time to take medication. Show Kyle the syringe. Sip his medication. It’s time to have teeth cleaned. Show Kyle his toothbrush. Come and sit in the kitchen and have his teeth cleaned. It’s time to go to the toilet. Show Kyle incontinence pad/leg bags/enema. Walk to the bathroom by pointing and guiding him by his elbow. It’s time to go out. Show Kyle his boots. Put his boots on and walk to the door. It’s time to go for a walk. Guide Kyle past the car to the gate. Walk at his own pace. It’s time to go out in the car. Show Kyle the car keys or rattle the car keys. Walk to the car. It’s time to go to the pub. Show Kyle his pint pot glass. Support Kyle to go to the pub. It’s time to buy chocolates. Show Kyle a chocolate wrapper. Support Kyle to shop and buy chocolate. © The Learning Community for Essential Lifestyle Planning, Inc

What works/makes sense What doesn’t work/make sense
Communication People who support Eric listen and try to understand what he is saying Eric sending and receiving to family Being Comfortable People try and make Eric think of something else when he is not comfortable in his different positions It’s quiet where he lives, no sudden or loud noises that surprise him People who support Eric can’t quickly understand what he’s saying When Eric talks people don’t understand what he’s saying Having to answer “yes” and “no” when Eric has so much more to say New people take a long time to learn how Eric communicates Wearing wrist splints that he hates, are uncomfortable, may hurt Having to spend time out of his chair Having to stay on a positioning schedule when he wants to do other things Having to be in that crawligator Eric’s Perspective

What works/makes sense What doesn’t work/make sense
Communication Eric’s continued patience as we try to learn better ways to understand him Eric loves computers, maybe that will be a way he can tell us more clearly what he wants to say Helping him be in contact with his family and friends using Ruth and “other staff” fitting in and figuring out how to make the computer work for Eric “when they can”. Being Comfortable Spending time with Eric when he’s in his crawligator. Helps keep his mind on more pleasant things Most of the time Eric is comfortable We’re trying to get someone to look at his wrist splints Eric’s got a lot to say and no really clear, fast way to say it (in a way that lots of people can understand) Eric hates and won’t use the communication system that he’s “supposed” to use There ARE communication systems out that that Eric would love to learn to use and we don’t know how to get one Eric hates his wrist splints so much that he will scratch his wrists and hands so he won’t have to wear them He yells and cries when he’s in the crawligator and we have to tell him that he has to be in it Having to do things to Eric that make him uncomfortable and hurt him Perspective of Eric’s Staff

Recording learning for Eric What we have learned about what is: IMPORTANT TO IMPORTANT FOR INSTRUCTIONS FOR SUPPORTORS: If Eric is to have a good balance between important to and important for, what do other people need to know or do? What do we need to learn or figure out? © The Learning Community for Essential Lifestyle Planning, Inc

Recording learning for Eric What we have learned about what is: IMPORTANT TO IMPORTANT FOR For people to listen/understand what he says Help Eric maintain and enhance his current range of motion by wearing splints, using crawligator, spending time out of his chair, and following his positioning schedule To not wear his splints Family (staying in touch with them via ) To be part of what’s happening, not miss out Stay in his chair, not on the crawligator A quiet life (without sudden/loud noises) INSTRUCTIONS FOR SUPPORTORS: If Eric is to have a good balance between important to and important for, what do other people need to know or do? Distract/entertain him while in crawligator or doing work out of his chair. Help Eric with computer (sending/receiving from family). When you do not understand what Eric is saying, take the time to figure it out, ask others, don’t give up. What do we need to learn or figure out? How to help him have and wear splints that are comfortable or at least less uncomfortable. What works to distract/entertain him when out of his chair? Can we have a positioning schedule that works for better for Eric and is more flexible? How do we help him communicate better? Is there a communication device that will work for him? How to help new people learn how he communicates faster? Is there a way for him to use the computer more independently? © The Learning Community for Essential Lifestyle Planning, Inc

Tools for building Person Centered Descriptions
Communication Chart Matching Staff Relationship Map 4 + 1 ?s Learning Logs Reputation Working/ Not Working Good Day/ Bad Day Rituals © The Learning Community for Essential Lifestyle Planning, Inc

Person Centered Description
Like and Admire Important for Important to Person Centered Description Instructions for Supporters Things to Figure Out Characteristics of Supporters © The Learning Community for Essential Lifestyle Planning, Inc

What needs to stay the same?
Learning Wheel What needs to stay the same? What needs to change? Person Centered Description Action Planning PCT Tools Implementation & Learning © The Learning Community for Essential Lifestyle Planning, Inc

Shared Talk In pairs 4 minute turns for all 4 questions
Listener gives good attention Thinker talks 4 minutes Swap Share ‘freshest thinking’ with the group in a round Post 1-2 of the ‘best’ ideas per question Adapted from Kline, Nancy. (1998). Time to Think: Listening to Ignite the Human Mind. Cassell Illustrated.

4 Questions What did you learn? What will you try based on what you learned? (what will you start on right now?) What do you think you can accomplish? What will your challenges/obstacles be? © The Learning Community for Essential Lifestyle Planning, Inc

for more information go to:
or contact: Michael Smull 3245 Harness Creek Rd Annapolis, MD

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