person centered thinking day 2 developed by michael smull with bill allen, marc archembault, sherrie...

Person Centered ThinkingPerson Centered ThinkingDay 2Day 2

Person Centered ThinkingPerson Centered ThinkingDay 2Day 2

Developed by Michael Smull with Bill Allen, Marc Archembault, Sherrie Developed by Michael Smull with Bill Allen, Marc Archembault, Sherrie Anderson, Mary Lou Bourne, Amanda George, Cherie Goss, Julie Malette, Anderson, Mary Lou Bourne, Amanda George, Cherie Goss, Julie Malette,

Michael Steinbruck, and Nolda WareMichael Steinbruck, and Nolda Ware

1.1.What is important to the person?What is important to the person?

2.2.What is important for the person?What is important for the person?

3.3.Is important for addressed in the context of what is important to?Is important for addressed in the context of what is important to?

4.4.Is there a “good” balance between important to and important for?Is there a “good” balance between important to and important for?

5.5.What does the person want to learn, what do we need to learn?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 learnIf the person is to get the balance described and we are to learn::

6.6.What needs to stay the same (be maintained or enhanced)? What needs to stay the same (be maintained or enhanced)?

7.7.What needs to change?What needs to change?

7 questions that you should be able to 7 questions that you should be able to answer for each person you supportanswer for each person you support

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

Not just better Not just better plans…plans…

Help people get better Help people get better liveslives


1. Why and how - develop the purpose and the process1. Why and how - develop the purpose and the process

2. Gather information2. Gather information

3. Develop a first description – 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 happenwhat we are going to do to make it happen

4. Use the description and 4. Use the description and

5. Record what you learn5. Record what you learn

Developing and using plans in 5 Developing and using plans in 5 stagesstages


QUESTIONS TO CONSIDERQUESTIONS TO CONSIDER::

• What would you like the What would you like the description to accomplish?description to accomplish?

• How can the person best How can the person best participate?participate?

• Who is in the person’s life?Who is in the person’s life?

• What is the most effective What is the most effective way to learn from those way to learn from those closest to the person?closest to the person?

Think before you planThink before you plan


Gathering informationGathering informationGathering informationGathering information

Questions to considerQuestions 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 How can you best support the person and those closest to the person in doing this work?closest to the person in doing this work?


Look for the paper that says ________ ‘s Person Centered Look for the paper that says ________ ‘s Person Centered

Description and put your name and date on the face pageDescription and put your name and date on the face page


Developing your own person centered Developing your own person centered descriptiondescription

__________’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.

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 Find your “Relationship Map” and fill it outit out

Three ways to have a conversationThree ways to have a conversation

Linear:Linear:

Branching:Branching:

Meandering:Meandering:


Morning Ritual

Amanda’s Morning RitualAmanda’s Morning RitualAmanda’s Morning RitualAmanda’s Morning Ritual7:00 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. 2006

Amanda’s Morning Ritual, Amanda’s Morning Ritual, con’t…con’t…

Amanda’s Morning Ritual, Amanda’s Morning Ritual, con’t…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


• 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 1Morning Ritual – Part 1


• 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 –

Morning Ritual – Part 2Morning Ritual – Part 2


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. 2006

Our Mantra for the ExercisesOur Mantra for the Exercises

•Going to bedGoing to bed

•TransitionTransition

•BirthdayBirthday

•Cultural/HolidayCultural/Holiday


Other RitualsOther Rituals

• SpiritualSpiritual

• VacationVacation

• ComfortComfort

• CelebrationCelebration

Bad DayGood Day

Good day Bad day

Good Day/Bad Day – Good Day/Bad Day – Part 1Part 1Take 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.


Good Day/Bad Day – Good Day/Bad Day – Part 2Part 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 Day

Important to What other peopleneed to know or do


ReputationExercise

Divide a sheet of paper in half and write ‘Positive Divide a sheet of paper in half and write ‘Positive Reputation’ on the top-left side and ‘Negative Reputation’ Reputation’ on the top-left side and ‘Negative Reputation’ on the top-right.on the top-right.

POSITIVE REPUTATIONPOSITIVE REPUTATION

Do not write on this – you can write on another Do not write on this – you can write on another person’s positive reputation, but not your own.person’s positive reputation, but not your own.

NEGATIVE REPUTATIONNEGATIVE REPUTATION

Write down 3 Write down 3 mildmild negatives, for example: negatives, for example:

•StubbornStubborn

•Directionally impairedDirectionally impaired

•WorkaholicWorkaholic


Reputation Exercise – Part Reputation Exercise – Part 11


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”.


An example using An example using ‘stubborn’‘stubborn’

Restatedas 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


Look at what others wrote on your positive listLook at what others wrote on your positive list

•What would you like to see listed on your description as your What would you like to see listed on your description as your introduction?introduction?

•Move those items that make sense to you to your planMove those items that make sense to you to your plan

•Add or change things as it makes sense to youAdd or change things as it makes sense to you

•How did that process feel?How did that process feel?



Characteristics of peopleCharacteristics of peopleI like to work withI like to work with

Characteristics of peopleCharacteristics of people I like to hang out withI like to hang out with

Characteristics of peopleCharacteristics of people I don’t like to work withI don’t like to work with

Characteristics of peopleCharacteristics of people I don’t like to hang out withI don’t like to hang out with


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


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?


MOSQUITO

Look at the list that you createdLook 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 Write those that need to be present and those that

need to be absent in your descriptionneed to be absent in your description

CHARACTERISTICS I WANT IN CHARACTERISTICS I WANT IN PEOPLE WHO SUPPORT MEPEOPLE WHO SUPPORT ME


• Take a look at what you and your partner wrote, your descriptionTake 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, Cover page, relationship map, introduction, important to, characteristics, and know and do to supportcharacteristics, 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 descriptionLooking at your description


Learning personality ‘characteristics’ thatneed to be Present or Absent in supportersLearning personality ‘characteristics’ thatneed 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

neededSkills needed

Personality Characteristics

Needed

Shared interests

(nice to have)

Matching StaffMatching Staff


Sad song is playingSad song is playingor slow melodyor slow melody

Puckering her lipsPuckering her lips She doesn’t like She doesn’t like the song-making the song-making her sad/feel badher sad/feel bad

Change the Change the station or songstation or song

People are talking People are talking around heraround her

Screaming out loudScreaming out loud Frustrated-people Frustrated-people aren’t talking to aren’t talking to herher

Go back to last Go back to last sentence and tell sentence and tell her –direct to herher –direct to her

Someone is doingSomeone is doingsomething she something she wants to trywants to try

Tight reflex Tight reflex (tight fists or head (tight fists or head turning)turning)

She is mad or She is mad or upsetupset

Involve her or Involve her or lead her awaylead her away

Eating Eating Pushing her spoon Pushing her spoon away and turning away and turning her headher head

Full-wants a Full-wants a different fooddifferent food

Help her try Help her try something else or something else or give choicegive choice

Cramping or cannot Cramping or cannot sleepsleep

Kicking side of Kicking side of bed or pulls pillow bed or pulls pillow over headover head

Need different Need different position-need to position-need to movemove

Move to different Move to different bed or to floorbed or to floor

Cramping or cannot Cramping or cannot Sleep Sleep (other possibility)(other possibility)

Grabbing at Grabbing at things around her-things around her-messing things upmessing things up

Need something Need something better to do-she better to do-she is boredis bored

Be creative-make Be creative-make fun activitiesfun activities

Meal timeMeal time Spitting foodSpitting food Talk to me as I Talk to me as I eateat

Tell funny stories, Tell funny stories, or or share her memories share her memories with herwith her

Someone is trying Someone is trying to to show or tell her show or tell her something something

Looking off –out Looking off –out window- no window- no attention personattention person

Boredom-already Boredom-already heard this, heard this, already know thisalready know this

Be creative, new Be creative, new ideas and activities, ideas and activities, involve a friendinvolve a friend

Brittany’s Communication PlanBrittany’s Communication Plan

What is happening ______ does We think it means We should


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


Communication PlanCommunication Plan

What is happening ______ does We think it means We should


In the In the environmentenvironment

What’s just What’s just gone ongone on

The “trigger”The “trigger”

The behaviorThe behavior

What others What others noticenotice

Can be seen, Can be seen, heard, and heard, and felt by othersfelt by others

Meaning of Meaning of the behaviorthe behavior

What the What the emotions and emotions and feelings arefeelings are

What’s going What’s going on insideon inside

What other What other people should people should do in do in responseresponse

Or not do…..Or not do…..

Communication PlanCommunication Plan

When this is happens I do this It ususally means And I want you to

#1 #1 (or (or 2)2)

#4 #4 #3 #3


#2 #2 (or (or 1)1)

THINGS WE NEED TO COMMUNICATE WITH KYLEWe want to let Kyle

knowTo 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 havehis 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.


What works/makes senseWhat doesn’t work/make

sense

Communication

•People who support Eric listen and try to understand what he is saying

•Eric sending and receiving e-mail 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

Communication

•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

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

Eri

c’s

Pers

pect

ive

What works/makes senseWhat doesn’t work/make

senseCommunication

•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 e-mail

•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

Communication

•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

Being Comfortable

•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

Pers

pect

ive o

f Eri

c’s

Sta

ff

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?


Recording learning for Eric What we have learned about what is:

IMPORTANT TO IMPORTANT FOR

For people to listen/understand what he For people to listen/understand what he sayssays

Help Eric maintain and enhance his Help Eric maintain and enhance his current range of motion by wearing current range of motion by wearing splints, using crawligator, spending splints, using crawligator, spending time out of his chair, and following his time out of his chair, and following his positioning schedulepositioning schedule

To not wear his splintsTo not wear his splints

Family (staying in touch with them via Family (staying in touch with them via email)email)

To be part of what’s happening, not miss To be part of what’s happening, not miss out out

Stay in his chair, not on the crawligatorStay in his chair, not on the crawligator

A quiet life (without sudden/loud noises)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 email 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?


Tools for building Person Centered DescriptionsTools for building Person Centered DescriptionsTools for building Person Centered DescriptionsTools for building Person Centered Descriptions

Learning Logs

4 + 1 ?s

RitualsGood Day/ Bad Day

Reputation

Working/Not Working

Matching Staff

Communication

Chart

Relationship Map


Person Centered DescriptionPerson Centered DescriptionPerson Centered DescriptionPerson Centered Description

PersonCentered

Description

Important to

Important for

Like and Admire

Instructions for

Supporters

Characteristicsof

Supporters

Things to Figure

Out


Learning WheelLearning WheelLearning WheelLearning Wheel

Person CenteredDescription

ActionPlanning

What needs to stay the same?What needs to change?

Implementation& Learning

PCT Tools


In pairs4 minute turns for all 4 questionsListener gives good attentionThinker talks 4 minutesSwapShare ‘freshest thinking’ with the group in a roundPost 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 TalkShared Talk

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 Questions4 Questions


www.elpnet.newww.elpnet.nett

for more information go to:for more information go to:

Michael Smull

[email protected]

410-626-2707

3245 Harness Creek Rd

Annapolis, MD 21403

or contact:

person centered thinking day 2 developed by michael smull with bill allen, marc archembault, sherrie...

Documents

essential lifestyle

learning community

morning ritual slide

person centered thinking

dates description

nolda ware slide

best way

dry hair