Transcript Document
Innovation for One Sparks Change for All: Person-Centered Change
Angela Novak Amado, Ph.D. Institute on Community Integration
We want a system where -
The people who use the service (with the support of their families) • Tell us how they want to live • Make use of public resources to have the life they want (or as close as we can determine) • Get the support they need to make the first two happen
Public funding comes with strings
We don ’t want public money spent on things that are • illegal • immoral; or • cause harm Or things that don ’t support the vision that are • Ineffective; or • inefficient
The Strings –
Some of the strings are from our history • As we learn, we don ’t stop doing the old, we just add the new • The response to abuse and misuse is rules to prevent them • The result is layers of programs and rules • Neither helps with effectiveness or efficiency
And we are in an era where –
• Demand is increasing AND • Public resources can ’t keep up with the demand
Unless we change . . .
Change what?
NEARLY EVERYTHING
• How we think about services, • • How we organize services, and How we deliver services
Moving from Service Life to Community Life
Service Life A Good Paid Life Community Life
• Important for addressed • No organized effort to address important to • To and for present • Closest people are paid or family • Few real connections TLC-PCP 2012 www.learningcommunity.us
• To and for present • Active circle of support • Included in community life
Moving from Service Life to Community Life
Service Life A Good Paid Life Community Life ‘Important to’ recognized ‘Important to’ present Focus on connecting, building relationships and natural supports
• Important for
addressed
• No organized effort to
address important to
• To and for present • Closest people are
paid or family
• Few real connections TLC-PCP 2012 www.learningcommunity.us
• To and for present • Active circle of support • Included in community life
Our work is about – Helping people get better lives
Not just better plans…
TLC-PCP 2012 www.learningcommunity.us
Discontent is the first necessity of progress.
-Thomas
Discontent is the Engine of Change
• Good plans create a kind of mirror – they reflect how people want to live • Discontent comes from comparing what is with what could be • There are 2 kinds of discontent: – Optimistic – Cynical TLC-PCP 2012 www.learningcommunity.us
Optimistic Discontent Requires –
• • • •
Trust,
based on A history of acting on things that can be changed immediately Honesty about those things that take time Signs of progress in acting on the things that take time Where change is new, trust must be created TLC-PCP 2012 www.learningcommunity.us
Cynical Discontent –
• • • One of the things that good plans do is hold a mirror up to the system and create discontent with what is… Without hope for change this level of discomfort becomes intolerable.
Without hope for change you get denial, distortion, or departure TLC-PCP 2012 www.learningcommunity.us
Helping people move –
AND stay in the community • Begins with learning how each person wants to live • Continues with learning what a good or better life would look like
The Basic Approach
Person Centered Thinking leads to Person Centered Practices which lead to Person Centered Organizations which create Person Centered Systems that support Person Directed Lives!
What is Person Centered Thinking?
• • • • Structured methods for people who are paid to provide support to
think about quality of life
the perspective of the person they support from A way to have teams pay attention to the balance between
“important to and important for”
with each person they support Tools that help with
problem solving
the right questions by focusing on It is a
person-driven
approach to services, rather than an agency-driven approach
TLC-PCP 2012 www.learningcommunity.us
Change in a Healthy Organizational Culture
• 3 levels of change
3 Levels of Change
Level 1 Any changes that results in a positive difference in the lives of people who use services or in your own work life. Level 2 Any changes an organization makes to its practices, structure or rules that result in positive differences in the lives of people.
Level 3 Any change in practice, structure and rules made at the system level. These changes have an effect on many organizations, and therefore many peoples ’ lives.
TLC-PCP 2012 www.learningcommunity.us
Core Concept
• • Important to
and
Important for
Important to –
• What is important to a person includes only what people are “saying” – with their words – with their behavior • When words and behavior are in conflict,
listen to the behavior
Important to –
Those things in life which help us be
satisfied, content, comforted and happy
. It includes: • People to be with/relationships • • • • • Things to do Places to go Rituals or routines Rhythm or pace of life Things to have
Important to –
Includes what matters the most to the person – their own definition of quality of life
Important for –
This includes only those things that we need to keep in mind regarding: 1. Issues of health or safety • • Physical health and safety, including wellness and prevention Emotional health and safety, including support needed 2. What others see as important to help the person be a valued member of their community
Balancing Important TO and FOR
• • • Sequence matters: learning about what matters the most to the person first (a critical aspect) It is not about either/or: paying attention to health, safety and valued social roles is critical, but alone it is insufficient if not in the context of “important TO” Risk management techniques currently often focus on assuring safety or health at the cost of what creates satisfaction for the person; we need to change our frame of reference to believe that both can co-exist
If I had an hour to save the world, I ’d spend 55 minutes defining the problem.
-Albert Einstein
Terminal Irritation * Used with permission from Dave Coverly, Speedbump Comic
Definition of Hell
• To be dependent on someone who does not see me as a person, who only sees me as a service recipient
Discovery/Learning Tools • • • • • •
Rituals and Routines Good Day/Bad Day Matching Staff Communication Chart What Makes Sense/Doesn ’t Make Sense 4 + 1 Questions
Morning Ritual
Other Rituals • • • •
Going to Bed Transition Birthday Cultural/Holiday
• • • •
Spiritual Vacation Comfort Celebration
Good Day Bad Day
© TLC-PCP 2012
Good Day/Bad Day
• What would be a good work day for YOU?
• What would be a bad work day for YOU?
Characteristics of people I like to work with Characteristics of people I like to hang out with Characteristics of people I don’t like to work with Characteristics of people I don’t like to hang out with
© TLC-PCP 2012 www.learningcommunity.us
Wrkbk pg 60
What is happening
Communication Chart
I Do It Means You Should © TLC-PCP 2012 www.learningcommunity.us
Description pcd pg 6
Communication Chart for Rhonda What is Happening
You are pushing Rhonda
Rhonda does
Locks her chair Rhonda is at the front door Kicks the door
We Think It Means
I don’t want to go there I want to go out
And We Should
Figure out with Rhonda where she wants to go 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 You didn’t remove her food Rhonda sweeps the food off her tray I told you I was finished and you didn’t listen © TLC-PCP 2012 www.learningcommunity.us
Take leftovers away now Clean up and do better next time
After a Change in Seizure Medication…
Nothing • We think she’s dizzy and afraid of falling • She can’t walk as well as she did before the new medicine • She’s often angry • She doesn’t have seizures • Generic medicine is less expensive than brand name medication • She is getting aggressive • She’s not herself – no longer a sweet person • She’s afraid to walk, seems fearful of falling • Behaviors started after changing seizure med from brand name to generic – We think the generic isn’t working like the brand name did TLC-PCP 2012 www.learningcommunity.us
© TLC-PCP 2012 www.learningcommunity.us
7 Questions
Questions you should be able to answer for each person you support: 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?
Person Centered Thinking
• is a 2-day, interactive training • exposure to/learning these tools
Person Centered Planning
“Picture of a Life” • Is aimed at re-location, or moving • Asking, in a new home − What should it look like?
− What support will the person need?
• Is done with a “co-trainer” − − Someone who uses services Let us know if you have someone!
More about this training
PERSON CENTERED THINKING training is a pre-requisite for PERSON CENTERED PLANNING training
Priorities for training
Money Follows the Person, now known as
Moving Home Minnesota
• Certified assessors • ICF ’s and others who are moving people using MFP money (down-sizing/closing) • Crisis services • Managed Care Organizations (MCO ’s)
Other possibilities
Can be used for organizational and systems change – • Internal coaches • Leadership teams • Executive teams (to implement Level 2 and 3 changes)
PCT/PCP Project
• • • • • Dates for Person Centered Thinking July 22 in Duluth August 19-20 in Shoreview August 19-20 in Willmar August 21-22 in New Brighton October 9-10 in Minneapolis
PCT/PCP Project
• • Dates for Person Centered Planning June 27-28 in Shoreview October 7-8 in Minneapolis
Training Resources
If you are interested in knowing more about us, our projects or other training possibilities for the future, please contact:
Angela Novak Amado, Ph.D.
651-698-5565 [email protected]
Anne Roehl
612-624-7558 [email protected]