Transcript No Slide Title

Fall 2008
The Plan is Not
the Outcome!
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All good plans are done in partnership
Partnerships that work have agreed upon
roles
Think about the roles from the perspective of
content experts and process experts
Who are the process experts? (Those who
know the requirements and what must be
accomplished)
Who are the contents experts? (those who
know the details of what must be captured in
the plan)
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Requires clarity of roles
Clearly defined expectations of each
person
Agreement on what is to be
accomplished
A commitment to :
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Never give up
Openly discuss issues which must be addressed
Recognize each others hard work
Be unconditionally constructive when
improvement is needed
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Experts and Roles
•Process experts know how to do it
•Write ISP’s, Write support plans
•Contents experts know what it should say
•Details that go into the plan
•Where it works there is synergy – the plan
is better than either could anticipate, or
accomplish on their own
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Those things in life that matter TO someone
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Things that people say they cannot --- or choose
not--- to live without.
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Things which, when present, are likely to
contribute to a good day, or when absent are
likely to contribute to a bad day
For example:
 people to be with
 Things to do or have
 Rhythm or pace of life
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What is important to a person includes only
what people are “saying”:
 with their words
 with their behavior
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Where what the person says is different from
what they do the bias is to rely on behavior.
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What is important for people includes –
• Issues of health
• Prevention of illness
• Treatment of illness / medical conditions
• Promotion of wellness (diet, exercise; no risky habits)
• Issues of safety
• Environment
• Well being ---- physical and emotional
• Free from Fear
• What others see as necessary to help the person• Be valued
• Be a contributing member of their community
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Reviewing the ground rules
Be Respectful
• In the meeting
• In the plan
• In future efforts
• No clinical or human service speak
(note the exceptions)
No jargon
No obsessing
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• Use everyday language
• Remember who plans are being
written with and for
• 5 minute rule
• “Parking” issues not resolved
• People are not broken
No fixing
• Good solutions are rooted in
listening
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1. Think about what you want to learn
2. Gather information
3. Develop a first plan
4. Use the plan and record what you learn
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Family
Home
and
Other
Paid
Supports
Work/
Day
Services/
School
Friends & Non-paid Relationships
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Smull & Allen
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Smull & Allen
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Moving from Information Gathering to
Plan Development
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What did you think about today’s work?
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On post- it notes:
◦ One thing you liked the most about today
◦ One most significant thing you learned today
◦ One thing you would change about today
◦ Post on the papers as you are leaving.
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Day Two
What did we try?
• From that, what did we learn?
• What are you pleased about?
• What are you concerned about ?
•
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Work with a partner
• Use your checklist
• Review the first sections of the
plan
• Edit and update each section.
•
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FROM THE PERSON’S
PERSPECTIVE
FROM OUR PERSPECTIVE
What makes sense
The “up” side
What is working right now
What does NOT make sense
The “down” side
What is NOT working right now
USE THIS
INFORMATION
TO BUILD THE
USE THIS
INFORMATION
TO BUILD THE
A
G
E
N
D
A
A
G
E
N
D
A
OF THINGS
THAT ARE TO
STAY THE
SAME
FOR THINGS
THAT NEED TO
CHANGE
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What makes sense
The “up” side
What is working right now
What does NOT make sense
The “down” side
What is NOT working right now
FROM OUR PERSPECTIVE
FROM THE PERSON’S
PERSPECTIVE
Information
Organization
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1. Everyone must feel listened to.
2. You must start with common
ground.
3. The facilitator of the discussion is
unconditionally constructive.
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Challenging and always
different
Get to meet lots of
interesting people
Opportunities to help a lot
of other people
Don’t have to “report” to an
office everyday.
No office politics to deal
with
What Makes Sense/Works
Right Now
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It’s hard to always come up
with new material –
deadlines are killers
sometimes
Not seeing friends and
family daily
Traveling is hard on my
body.
Being away from home has
made me miss some
important things.
What Doesn’t Make
Sense/Doesn’t work,
Right Now
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Mom is happy with her
work
We get to meet lots of
interesting people
Mom is home on
regular” days more
than she used to be
We don’t all rush out of
the house at the same
time every morning
What Makes Sense/Works
Right Now
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Mom is away from
home overnight
sometimes, more than
she used to be.
Sometimes she is here
in the house, but is
working and we need
to leave her alone.
Mom can’t always
come to things we
want her to come to.
What Doesn’t Make Sense/
Doesn’t work, Right Now
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Determine what needs to change, what needs to
remain the same by considering:
 What makes sense, what is working, what
is the upside of this issue, right now?
 What doesn’t make sense, is not working,
what is the downside of this issue, right
now?
 Each person contributes his/her
perspective
 These become the “seeds” of thought for
outcome statement development
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If the team is stuck, use focused questions
to get more detail: For example – What
Makes Sense /Doesn’t Make sense
regarding:
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Who the person spends time with
What the person’s interests are
How the person spends his/her days
How the person has fun
What the person wants to learn.
Where and with whom, the person lives
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Before developing outcome statements, the
team should figure out:
 How
does this relate to
What Is Important TO the
person?
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What’s Working/Not Working Right Now
Outcome Statement
Actions Needed to
accomplish this?
(Specific steps required,
in detail, concrete)
Who will do
it?
(who is
responsible?)
By
When?
(due
date?)
How we will know we are making progress:
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What
What
What
What
do
do
do
do
we
we
we
we
need to learn?
want to learn next?
want to maintain?
need to change?
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Describe for People:
 The expected outcomes
 What will be done (specific steps)
 Who will do it/who is responsible
 When it will be completed (timeframes)
 For waiver, you can include frequency and
duration information here.
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Developing plans: Getting started, keeping them alive
Talk with the
person about:
Choose 1 of 8+
ways to gather
information
• the purpose of
the plan
• ground rules
• ways to gather
information
Develop a 1st
plan, 2nd plan,
etc.
Figure out how to
have and record
ongoing learning
Reflect, organize,
synthesize
Record the
learning
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 Please
consider how you will use
the information from these two
days of training in your daily
work?
 What will you do differently when
you return to work?
 Is there anything that is in your
way?
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Follow Up, Day Three
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(what would you do
again?)
What Worked? What
made sense?
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(what would you do
differently?)
What did not work? What
did not make sense?
What is ha ppening
does
We think it means
And we should
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Brittany’s Communication Plan
What is happening
______ does
We think it means
We should
Sad song is playing
or slow melody
Puckering her lips
She doesn’t like
the song-making
her sad/feel bad
Change the
station or song
People are talking
around her
Screaming out loud
Frustrated-people
aren’t 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
Full-wants a
different food
Help her try
something else or
give choice
Move to different
bed or to floor
Meal time
Pushing her spoon
away and turning
her head
Kicking side of
bed or pulls pillow
over head
Grabbing at
things around hermessing things up
Spitting food
Someone is trying to
show or tell her
something
Looking off –out
window- no
attention person
Boredom-already
heard this,
already know this
Cramping or cannot
sleep
????
Need different
position-need to
move
Need something
better to do-she
is bored
Talk to me as I
eat
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Be creative-make
fun activities
Tell funny stories, or
share her memories
with her
Be creative, new
ideas and activities,
involve a friend
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What is Happening
You are
pushing
Rhonda
Rhonda does
We Think It Means
And We Should
Locks her
chair
I don’t want to Figure out
with Rhonda
go there
where she
wants to go
Rhonda is at
Help her
Kicks the door I want to go
outside (unless
the front door
out
there is too
much pollen,
about to rain,
etc.)
Rhonda has
Catches your
I’m done
Take leftovers
stopped eating eye, pulls down eating
away now
napkin
You didn’t
Rhonda sweeps I told you I
Clean up and
remove her
the food off
was finished
do better next
and you didn’t time
food
her tray
listen
© The Learning Community for Essential Lifestyle Planning, Inc. 2006
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Communication Plan
What is happening
______ does
We think it means
We should
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© The Learning Community for Essential Lifestyle Planning, Inc. 2006
Communication Plan
When this is happens
#3
 In the world
around us – the
environment
 What’s just
gone on
 The “trigger”
I do this
#1
(or 2)
 What the
person actually
does – the
actions
 What others
notice
It ususally means
#2
(or 1)
 What the
person means
by what he/she
does
 What the
emotions and
 Can be seen,
feelings are
heard, and felt
by others
 What’s going on
inside
© The Learning Community for Essential
Lifestyle Planning, Inc. 2006
And I want you to
#4
 What other
people should
do in response
 Or not do…..
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Molly’s Sample Communication Chart
How Molly Communicates:
What is happening…
Molly does this…
Group of people talking, everyone all Talks to herself
at once, but no one is talking to
Molly
We think it means…
She is having trouble keeping
up with the conversation
Or
And we should…
Try to slow down the
conversation
Include her in the conversation
is feeling left out
Someone is repeatedly telling her
what to do or is demanding
A party around her, but no one
talking to her
Acts defiant, OR
tunes out
Says “I’m tired”
She is angry, or frustrated, or
insulted,
Explain her choices to her, and
let her make the decision
She doesn’t want to be
“bossed” around
Ask her, don’t tell her, what to do
She’s not happy
If you’re old: Try to introduce
her to new people to talk with
Feeling left out
Feeling lonely
During school time
Molly stops working,
begins to talk to
herself
She may feel overwhelmed by
what she is doing
Or
Someone has just given her multi
step instructions
Begins to talk to
herself
If you’re young: Welcome her to
join your conversation
Talk to her and ask her if she
can tell you why she’s not
working. Help her break it
down to individual steps.
She may be bored if it is a
repetitive task
Ask if she would like to try
another activity (i.e. work that
still needs to be completed)
She is over whelmed with too
many steps
Break it down into one step at a
time, let her try it before adding
more
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Begin with the aim of the outcome: Using
person’s name followed by an action verb or
phrase.
Only use “I” if you are absolutely sure the
person would say it in the same way.
If the team finds it helpful, Complete the
statement with how it will make a difference
using “so that/in order to”
◦ “Jacob lives in Johnsonburg….. Cynthia walks in her
neighborhood….. Suzanne works at Pizza Hut….”
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Jacob lives in Johnsonburg…..so that he can
see his family every week.
Cynthia walks in her neighborhood…..in order
to stay connected to her neighbors.
Suzanne works at Pizza Hut…. So that she
makes enough money to pay her bills, and so
that she does not have to take a bus to work.
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2006
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Examples of what IS NOT AN OUTCOME:
 I want to attend MNO day program.
 Sue goes to physical therapy.
 I want speech therapy.
 Joe attends the workshop.
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2006
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Washing hair
Setting the table
Making a sandwich
Using a fork
Tying shoes
Brushing teeth
Combing hair
Shaving
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Getting dressed
Staying on task
Counting money
Toileting
Doing laundry
Using zippers
Dialing the phone
Applying deodorant
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2006
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Judy will take a shower with physical guidance 6/7 days a
week by 12/01. I look nice when I go to school, so that
other kids talk to me and invite me to join them at lunch.
Fay will exercise three times a week with verbal prompts
for 6 consecutive months by 12/01. Fay practices her
karate so that she earns her orange belt and she stays fit.
Anna will participate in 1 social/recreational outing a week
with staff supervision until 12/01. Anna participates in
City Garden Club in her town and is an active member this
year, so that she is not bored and meets new friends.
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2006
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Interpersonal skills
Ambulates independently
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Verbal cues or prompts
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Auditory monitoring
distance
Off task behavior
On task behavior
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Easy to get along with
Walks on her own (do
you need to say this?)
Remind her by saying
XXX
Within Earshot
Distractions
Pays attention
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2006
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Going on a date- Learn Social Skills
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Learn Self Defense - Increase physical activity
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Looking great for school- Improve personal hygiene
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Getting a job- increase vocational skills – will increase
productivity to 87%
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Participate in Community Organizations (Garden Club) Improve
social skills- will not interrupt conversations……..
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Put together a photo album- Increase fine motor or Increase
attention span- on increase on task behavior
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Visit my family- improve social and emotional expressions,
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2006
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Bikes with the Woods club:
Takes computer lessons:
Actively participate in senior citizens center:
Ride my bike to the store:
Listen to live music:
Works at the Hair Salon:
Attend meetings of the Eagles fan club:
Hosts a BBQ:
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Small Groups,
Come up with three ideas you could try
Replace current activity, rather than add on
top of old.
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What have you learned that is likely to be
most helpful to you and your team?
What do you appreciate about someone here,
or something you learned?
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