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

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Presentation on theme: "Person Centered Thinking Day 2 Developed by Michael Smull with Bill Allen, Marc Archembault, Sherrie Anderson, Mary Lou Bourne, Amanda George, Cherie Goss,"— Presentation transcript:

1 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

2 1.What is important to the person? 2.What is important for the person? 3.Is important for addressed in the context of what is important to? 4.Is there a good balance between important to and important for? 5.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: 6.What needs to stay the same (be maintained or enhanced)? 7.What needs to change? 7 questions that you should be able to answer for each person you support © The Learning Community for Essential Lifestyle Planning, Inc. 2006

3 Not just better plans… Help people get better lives © The Learning Community for Essential Lifestyle Planning, Inc. 2006

4 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 how the person wants to live/needs to be supported what we are going to do to make it happen what we are going to do to make it happen 4. Use the description and 5. Record what you learn Developing and using plans in 5 stages © The Learning Community for Essential Lifestyle Planning, Inc. 2006

5 QUESTIONS TO CONSIDER: What would you like the description to accomplish? What would you like the description to accomplish? How can the person best participate? How can the person best participate? Who is in the persons life? Who is in the persons life? What is the most effective way to learn from those closest to the person? What is the most effective way to learn from those closest to the person? Think before you plan © The Learning Community for Essential Lifestyle Planning, Inc. 2006

6 Gathering information Questions to consider: Who should you talk to; who should you listen to? Who should you talk to; who should you listen to? Who knows what? Who knows what? What is the best way to get their information? 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? 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. 2006

7 Look for the paper that says ________ s Person Centered Description and put your name and date on the face page © The Learning Community for Essential Lifestyle Planning, Inc Developing your own person centered description __________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.

8 1.Put your name in the center 2.Fill out each section based on how close you feel to family members, friends, etc. 3.Who is paid to support you? Your doctor, whoever cuts your hair, etc. How close do you feel to them? Find your Relationship Map and fill it out

9 Three ways to have a conversation Linear:Branching:Meandering: © The Learning Community for Essential Lifestyle Planning, Inc. 2006

10 Morning Ritual

11 Amandas Morning Ritual 7:00 amAlarm 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 wont wake husband and decide what Im going to wear for the day. 7:15 amTake clothes to bathroom, turn on water in shower-must be hot, remove pjs, 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. 2006

12 Amandas Morning Ritual, cont… 7:45 amGo 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 8s sometimes 7:48 amGive cereal bowl to Oreo the cat 8:00 amGo back to bathroom, blow dry hair: Use big brush and spray gel to hold 8:17 amBrush teeth, put on slacks or skirt. Find shoes 8:23 amQuickly 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. 2006

13 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 Morning Ritual – Part 1 © The Learning Community for Essential Lifestyle Planning, Inc. 2006

14 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 partners routine and then – Morning Ritual – Part 2 © The Learning Community for Essential Lifestyle Planning, Inc. 2006

15 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 Our Mantra for the Exercises

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

17 Bad DayGood Day

18 Good dayBad day Good Day/Bad Day – Part 1 Take a new sheet of paper, divide it in half so it looks like this: 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. 2006

19 Good Day/Bad Day – Part 2 Work with your partner. Read their good day/bad day list. Arrange your papers to look like this: 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? Good Day/Bad DayImportant to What other people need to know or do © The Learning Community for Essential Lifestyle Planning, Inc. 2006

20 Reputation Exercise

21 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 persons positive reputation, but not your own. NEGATIVE REPUTATION Write down 3 mild negatives, for example: Stubborn Stubborn Directionally impaired Directionally impaired Workaholic Workaholic © The Learning Community for Essential Lifestyle Planning, Inc Reputation Exercise – Part 1

22 © The Learning Community for Essential Lifestyle Planning, Inc For each negative, ask 3 questions: 1.Are their circumstances in which the negative is a positive? If yes, add the positive to the list. 2.Does the negative reflect something that is important to the person? If yes, add it to the important list. 3.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. Reputation Exercise – Part 2

23 An example using stubborn Restated as a positive What is Important to Support strategy when it is negative Determined To work where my values are supported Get in my face, tell me, then back off © The Learning Community for Essential Lifestyle Planning, Inc. 2006

24 Look at what others wrote on your positive list What would you like to see listed on your description as your introduction? What would you like to see listed on your description as your introduction? Move those items that make sense to you to your plan Move those items that make sense to you to your plan Add or change things as it makes sense to you Add or change things as it makes sense to you How did that process feel? How did that process feel? Reputation Exercise – Part 3 © The Learning Community for Essential Lifestyle Planning, Inc. 2006

25 Characteristics of people I like to work with Characteristics of people I like to hang out with I like to hang out with Characteristics of people I dont like to work with I dont like to work with Characteristics of people I dont like to hang out with I dont like to hang out with © The Learning Community for Essential Lifestyle Planning, Inc. 2006

26 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 MOSQUITO © The Learning Community for Essential Lifestyle Planning, Inc. 2006

27 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 MOSQUITO

28 Look at the list that you created – What are those characteristics that need to be present? What are those characteristics that need to be present? What are those characteristics that need to be absent? 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 Write those that need to be present and those that need to be absent in your description CHARACTERISTICS I WANT IN PEOPLE WHO SUPPORT ME © The Learning Community for Essential Lifestyle Planning, Inc. 2006

29 Take a look at what you and your partner wrote, your description Take a look at what you and your partner wrote, your description Put the pages in the following order – Put the pages in the following order – Cover page, relationship map, introduction, important to, characteristics, and know and do to support Cover page, relationship map, introduction, important to, characteristics, and know and do to support How does it look? How does it look? Would someone who has never met you know – Would someone who has never met you know – Who you are? Who you are? What is important to you? What is important to you? How you need to be supported? How you need to be supported? Who you would want to provide that support? Who you would want to provide that support? Looking at your description © The Learning Community for Essential Lifestyle Planning, Inc. 2006

30 Learning personality characteristics that need to be Present or Absent in supporters 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?

31 Supports wanted and needed Skills needed Personality Characteristics Needed Shared interests (nice to have) Matching Staff © The Learning Community for Essential Lifestyle Planning, Inc. 2006

32 Sad song is playing or slow melody Puckering her lips She doesnt like the song-making her sad/feel bad Change the station or song People are talking around her Screaming out loud Frustrated-people arent 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 Cramping or cannot 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 Brittanys Communication Plan What is happening______ doesWe think it meansWe should © The Learning Community for Essential Lifestyle Planning, Inc. 2006

33 What is HappeningRhonda doesWe Think It MeansAnd We Should You are pushing Rhonda Locks her chairI dont want to go there Figure out with Rhonda where she wants to go Rhonda is at the front door Kicks the doorI 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 Im done eatingTake leftovers away now You didnt remove her food Rhonda sweeps the food off her tray I told you I was finished and you didnt listen Clean up and do better next time © The Learning Community for Essential Lifestyle Planning, Inc. 2006

34 Communication Plan What is happening______ doesWe think it meansWe should © The Learning Community for Essential Lifestyle Planning, Inc. 2006

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

36 THINGS WE NEED TO COMMUNICATE WITH KYLE We want to let Kyle knowTo do this weThen support/encourage Kyle to Its time to get up (if Kyle is not already awake). Knock on Kyles bedroom door and then open it. Continue Kyles morning routine. See to be successful. Its 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. Its time to have a shave.Show Kyle his razor and shaving cream.Apply shaving cream and have a shave. Its time to have hair washed.Show Kyle shampoo.Apply shampoo and have his hair washed. Its 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. Its time to take medication.Show Kyle the syringe.Sip his medication. Its time to have teeth cleaned.Show Kyle his toothbrush.Come and sit in the kitchen and have his teeth cleaned. Its 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. Its time to go out.Show Kyle his boots.Put his boots on and walk to the door. Its time to go for a walk.Guide Kyle past the car to the gate.Walk at his own pace. Its time to go out in the car.Show Kyle the car keys or rattle the car keys. Walk to the car. Its time to go to the pub.Show Kyle his pint pot glass.Support Kyle to go to the pub. Its time to buy chocolates.Show Kyle a chocolate wrapper.Support Kyle to shop and buy chocolate. © The Learning Community for Essential Lifestyle Planning, Inc. 2006

37 What works/makes senseWhat doesnt 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 Its quiet where he lives, no sudden or loud noises that surprise him Communication People who support Eric cant quickly understand what hes saying When Eric talks people dont understand what hes 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 Being Comfortable 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 Erics Perspective

38 What works/makes senseWhat doesnt work/make sense Communication Erics 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 hes in his crawligator. Helps keep his mind on more pleasant things Most of the time Eric is comfortable Were trying to get someone to look at his wrist splints Communication Erics 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 wont use the communication system that hes supposed to use There ARE communication systems out that that Eric would love to learn to use and we dont know how to get one Being Comfortable Eric hates his wrist splints so much that he will scratch his wrists and hands so he wont have to wear them He yells and cries when hes 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 Erics Staff

39 Recording learning for Eric What we have learned about what is: IMPORTANT TOIMPORTANT 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. 2006

40 Recording learning for Eric What we have learned about what is: IMPORTANT TOIMPORTANT 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 whats 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, dont 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. 2006

41 Tools for building Person Centered Descriptions Learning Logs ?s Rituals Good Day/ Bad Day Reputation Working/ Not Working Matching Staff Communication Chart Relationship Map © The Learning Community for Essential Lifestyle Planning, Inc. 2006

42 Person Centered Description Person Centered Description Important to Important for Like and Admire Instruction s for Supporters Characteristics of Supporters Things to Figure Out © The Learning Community for Essential Lifestyle Planning, Inc. 2006

43 Learning Wheel Person Centered Description Action Planning What needs to stay the same? What needs to change? Implementation & Learning PCT Tools © The Learning Community for Essential Lifestyle Planning, Inc. 2006

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45 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. Shared Talk

46 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? 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? 4 Questions © The Learning Community for Essential Lifestyle Planning, Inc. 2006

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


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