1. “When Life Happens” Helping People Adapt to Change Melissa A. DiSipio, MSA, PCHC AAIDD 2011

2. Objectives Participants will be able to… Promote health and safety during transition. Identify behavioral aspects of moving and the effects of change. Learn importance of documents needed (Lifetime Medical, Family History, Insurance). Identify tactics to increase awareness of cultural sensitivity (family, environment, ethnicity)

3. HOW DO YOU COPE WITH CHANGE?

4. Some changes that occur Change in house layout (environment) Change in peers Change in community Change in staff Change in physicians Change in day programming/school/job Change in activities Change in expectations Change in day to day routines Change in health

5. Psychology of Transition Enduring a life transition can be stressful enough to cause depression, various anxiety disorders, physical illness, the disruption of social relationships, etc. Change can also represent new beginnings, friends and improved experiences. Our job is to highlight and support the latter.

6. General Signs of Adjustment Issues Perseveration/questions about the move Fixation on things associated with the move Increase talk of past events Increase in adverse behaviors – Fight or Flight is the natural response to change Increase in aggressive behaviors Increase in avoidance behaviors

7. Psychological Indicators of Adjustment Issues Depressed mood most of day, almost daily. Loss of interest or pleasure in almost all activities Weight and/or sleep problems Restlessness* or slowed down Concentration problems Being easily fatigued* Muscle tension** Irritability* Possible target symptoms of depression if 5 or more symptoms * possible signs of depression or anxiety target symptoms ** usually associated with anxiety only Adjustment Disorder or trauma related diagnoses are also possible

9. Suggestions - Involve the person as much as possible or as much as they would like throughout change. Try to maintain daily routines. Be patient. Empathize with the individuals feelings. Observe for adjustment issues. Don’t rush the person into new programs, etc. Slow down –We All Need Time!

11. Know the Individuals you Support! Personality and Culture Likes and Dislikes Identify health care needs Create an environment that welcomes C.H.O.I.C.E. Communication is KEY!! Acknowledge thoughts and feelings about the anticipated change Support discussion about prior experiences

12. Wellness Triangle Create a triangle representing the three sides of wellness. Physical Wellness My favorite physical activity is... My favorite healthy food is... A physical health goal I have is... Mental Wellness My favorite movie/TV show/music is... A favorite hobby is… A mental health goal I have is... Social Wellness The most important people in my life are... My favorite thing to do with friends is... A social health goal I have is... Houck Middle School www.houck.salkeiz.k12.or.us Physical Mental Social

13. Coping with Transition Involve the individual completely in the process. Create a new sense of normalcy - Resilience Planning + Preparation = Productivity Be patient and empathize Create link to the past – Photos, furniture, decorations, contacts/visitation Assist the individual in getting involved in the new community Create smooth transitions

14. Coping with Change In with the new and the old!!

15. What do you need to know about the person?

16. What is important? The person Team meetings Staff education Observant Process – slow introduction Involvement

17. What will help? Individual Support Plan Lifetime Medical History /Physician support Behavioral Health History – behavior support plan Health Insurance information Therapy option when appropriate A good history and involvement from family and previous staff

18. “My Life is My Own” Everyday Lives Incorporate cultural traditions in a time of transition. Examples: – Italian Tradition (wine, bread and salt) – Native American Tradition (smudging) – African American Tradition (house blessing) Give responsibility – aids the individual in feeling in control of their transition.

19. Social Capital Matters Decreases rate of suicide, colds, heart attacks, strokes and cancer Reduces crime, teenage pregnancy, child abuse, welfare and dependency People cheer us up, bring us chicken soup when we’re sick, offer job leads when we’re unemployed, loan us money when we’re broke, watch our kids…

20. Resources www.pbrookes.com/store/books/bradley- 6261/excerpt.htm www.pbrookes.com/store/books/bradley- 6261/excerpt.htm www.health.state.pa.us/transitionchecklist http://www.joarduo.com/2008/11/what-are- traditions-surrounding-moving.html http://www.joarduo.com/2008/11/what-are- traditions-surrounding-moving.html http://www.strengthforcaring.com/manual/ab out-you-celebrating-cultures/cultural- traditions-and-respect-for-elders/ http://www.strengthforcaring.com/manual/ab out-you-celebrating-cultures/cultural- traditions-and-respect-for-elders/

21. THANK YOU !!! Melissa A. DiSipio, MSA, Assistant Director, Philadelphia Coordinated Health Care (PCHC), SE PA Health Care Quality Unit (HCQU) mdisipio@pmhcc.org (215) 546-0300 (ext. 3636)