1. Active Treatment & Quality Enhancement Ann Seisa, R.N.

2. Agenda What is Active Treatment? Who, when, and how is it provided? How do you know when Active Treatment is taking place and when its not? What is Quality Enhancement? - What is the Principle of Universal Enhancement?

3. What is Active Treatment? It is the consistent, aggressive, continuous, and accountable application of (habilitative) interventions by caregivers of persons with developmental disabilities

4. What is Active Treatment? It is founded on the principle that each individual is capable of continued change and can benefit from participation in individually designed programs.

5. What is Active Treatment? Programs are carried out in structured & unstructured settings and are focused in improving each person’s developmental progress throughout his or her life.

6. Active Treatment All people who support persons with disabilities should provide Active Treatment It is the means by which we help our clients “get a life” You must know your client as an INDIVIDUAL – his or her likes, dislikes, and preferences

7. Quality Enhancement It is raising the value in achieving excellence.

8. Quality Enhancement VALUE OF LIFE QUALITY VALUE OF LIFE QUALITY – Characteristics of a person’s life that include those things that the person feels are most important, like good friends, good health, and a safe and comfortable place to go to or to live in.

9. Focus on the Individual What is important to the individual? What will increase his/her quality of life?

10.  Enjoy a safe, comfortable environment and exercise greater control of his/her environment & his/her daily experiences.  Be and stay healthy with the least amount of medication to appropriately manage health conditions.

11.  Learn ways of expressing & communicating their wants & needs – without being self-injurious or disruptive.  Choose and participate in hobbies, leisure interests, social & recreational activities that they enjoy.

12.  Look their best on daily basis, and be as self-sufficient and independent as possible in completing their activities of daily living.  Be good neighbors and citizens with valuable contributions to make in the community.

13. When does Active Treatment take place?

14. Who is critical to providing Active Treatment? STAFF  Day-long interaction  Must work together as a team  Are among the first to notice changes in the client ADMINISTRATOR  Pulls the Inter- Disciplinary Team (IDT) together  Trains the staff  Supports the staff

15. Importance of DSP Staff They are a critical component of the support team. They are able to negotiate, counsel, and provide positive support training to clients explaining the responsibilities, consequences and options to these individuals.

16. Importance of DSP Staff They act in a professional, positive and friendly manner at all times. High expectations are expected of them and will hold them accountable for meeting those expectations.

17. How do you implement Active Treatment? Start with RESPECT Show how to complete a task Link with interests Focus on what the client CAN do Motivate Behavior is a form of communication - always work on increasing client’s ability to express self Remember choices

18. Principle of Universal Enhancement Getting a life for people and coaching them into it to improve the quality of their life.

19. Universal Enhancement What are ways to support people: Listen and hear our voice – we’ve got a lot to say. Treat us like you want to be treated - with respect and dignity. Ask us how we feel about stuff. Take time to explain things if we don’t understand something. Put yourself in our shoes – walk our walk. Be good to yourself – we want you to be healthy and energized.

20. Universal Enhancement When engaging with a client, keep the noise level to the minimum and your voice down (at conversation level). Gain their permission before holding their hands. Holding hands without permission encourages dependence. Encourage the person to hold your arm instead. Do not tow. Do not talk about people in front of others. Encourage the individuals to participate in household chores, in all routines.

21. How do you know when Active Treatment is taking place?

22. INCREASED SKILLS! Self Help Can brush own hair Pulls up his pants Uses the toilet when need arises Behavior Communicates wants or needs verbally or gesturally Makes choices Social/Recreational Goes to watch a movie with his favorite actor in the cast Independent Living Makes her own snacks Cleans her bedroom Washes her clothes

23. Indicators that Active Treatment is NOT taking place Lack of client progress No activities in sight Behaviors Clients pacing Staff in one area and clients in another Clients have no energy Staff are bored Clients told what to do Maid/butler service TV with no interaction

24. Active Treatment – It’s an ATTITUDE! We are teachers and mentors, not caretakers Focus on abilities, not disabilities Options and choices for everyone It’s not our job to say “No” but to show a better way Self-esteem and independence go hand in hand

25. Active Treatment – It’s an ATTITUDE! Maximize positive contacts Don’t take it personally – break the chain The best prompts are non-verbal and subtle The best training environments are natural Remember to reinforce desired/positive behavior

26. Active Treatment – It’s an ATTITUDE! Staff make it happen Watch body proximity (e.g. don’t stand over the person) Watch body language (open hands, don’t cross arms, etc.) Power struggles mean you lose RESPECT ourselves, each other, and the people we serve

27. “Excellence can be attained if you… Care more than others think is wise… Risk more than others think is safe… Dream more than others think is practical… Expect more than others think is possible.”

28. Questions