1 Oregon Department of Human Services Senior and People with Disabilities State Unit on Aging-ADRC In partnership with  Portland State University School of Social Work Center for Improvement of Child and Family Services

 Introductions  Check-In: How’s it going?  Your learning goals for today 2

 Review of concepts from 101,102  Practice and apply skills for Options Counseling 3

 What is Options Counseling?  Core Competencies  Skills  Assessment  Decision Making Support  Documentation 4

Options Counseling supports informed long-term care decision making through assistance provided to individuals and families to help them understand their strengths, needs, preferences and unique situations and translates this knowledge into possible support strategies, plans and tactics based on the choices available in the community. 5

Six Core Competencies  Determine the need for Options Counseling  Assess needs, values and preferences  Understand public and private sector resources  Demonstrate respect for self-determination  Encourage future orientation  Follow-up 6

 What skills and approaches are you using as an Options Counselor?  What is working well?  What are some challenges?  What skills do you want to improve? 7

Questions to ask:  What is your reason for calling today?  What would you like help with?  Can you tell me about your situation. What are you concerns and needs? What strengths and resources exist?  Do you need some assistance in considering decision about your or your loved one’s care needs? 8

The Hartman Family 9

Questions to consider:  What are the feelings of the individual and the family regarding their present circumstances?  What are the physical, mental and social needs?  What are the person’s strengths, resources, community, family and friends that can aide in planning?  What are the person’s values, goals, and cultural perspectives? 10

The Hartman Family 11

When to consider facilitating a family meeting  A facilitator is helpful when there are difficult decisions to be made and the consumer and their support people feel they need help discussing the issues and options.  Or when family members are in disagreement, or have trouble working together. 12

What issues would you want to consider? 13

Issues to consider  Who to invite  Empowering the consumer  Organizing the meeting  Facilitating the meeting  Resolving conflicts  Developing Action Plans 14

Questions to ConsiderPossible Participants  Who will be affected?  Who can help?  Who will be concerned?  Who needs to know?  Family members  Friends  Neighbors  Paid caregivers  Faith community members 15

Premise Include the consumer in all aspects of decision-making. What possible issues could arise? 16

Possible issues  When support people have concerns they are afraid to express.  When participants see Options Counselor as the decision maker  When decisions are made outside the family meeting, without the consumer 17

Organizing a meeting Agenda Preparation Location Time Follow-Up 18

Create a safe setting  Tend to feelings  Discuss “ground rules”  Remind people that they are all a part of a team, with the goal of helping their loved one. 19

Encourage Participation  Note taking or time tracker  Promote idea sharing and shared responsibility  Discuss decision making structure  Consumer's role  Participant’s role 20

Facilitate Discussion Questions to organize discussion  What are the consumer and family goals?  What needs to happen to reach these goals?  What strengths and resources exist to help reach these goals?  What additional plans and resources might be needed to reach these goals?  Brainstorm possible ideas for plans and resources.  Evaluate the pros and cons of each idea. 21

Clarify Decisions Made  Check-in with all participants  Write an Action Plan for participants 22

Options Counseling Documentation includes the continued assessment and planning that comes out of a Family Meeting Document Meeting  The issues that were discussed.  The ideas considered  Action Plan: Who is responsible for what by when. 23

Options Counseling Care Tool 24

When there is conflict  Allocate sufficient time.  Create a safe space for problem-solving to occur.  Help participants clarify what the conflict is about.  Affirm the validity of all viewpoints.  Frame the conflict in terms of a problem to be solved.  Discuss what happens if no agreement is reached  Keep in mind that the participants have the responsibility to resolve the conflict 25

Definition of conflict: A disagreement in which the parties involved perceive a threat to their needs, interests or concerns. 26

 Conflict can be good. It is an essential part of working together in a group.  Conflict is positive when: there is respectful disagreement and the willingness to consider various options.  Conflict is negative when: it is marked by anger, disrespect and a refusal to consider options 27

Three potential problems in conflict 1. Perceptions 2. Emotions 3. Communication 28

How do you get to a solution? 29

1. Identify and Focus on Interests 2. Find Common ground 3. Generate Solutions 4. Define the elements of a good solution: what does it need to address? 5. Evaluate Options and Reach Agreements 6. Summarize the plan in writing (documentation) 30

The Hartman Family 31

Follow-Up  Check in on what decisions have been made  Outcomes of referrals  Services started  Additional follow-up needed  Ask if the Options Counseling was helpful. 32

 What is working well as Options Counseling is implemented?  What areas need improvement?  List major challenges and ideas. 33

Wrap Up and Evaluations  Questions  Next steps 34