Fall 2008. 2 The Plan is Not the Outcome! 3 All good plans are done in partnership Partnerships that...

Fall 2008

2

The Plan is Not the

Outcome!

3

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 :

◦ 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

Things that people say they cannot --- or choose not--- to live without.

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

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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Be Respectful• In the meeting• In the plan• In future efforts

No jargon

• No clinical or human service speak -(note the exceptions)

• Use everyday language

• Remember who plans are being written with and for

No obsessing• 5 minute rule

• “Parking” issues not resolved

No fixing• People are not broken

• Good solutions are rooted in listening

Reviewing the ground rules

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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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Homeand Other Paid Supports

Work/DayServices/School

Friends & Non-paid Relationships

Family

1204/10/23 Smull & Allen

Moving from Information Gathering to Plan Development

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What did you think about today’s work?

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.

Day Two

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• 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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USE THIS INFORMATION TO BUILD THE

AGENDA

OF THINGS THAT ARE TO STAY THE SAME

What makes senseThe “up” sideWhat is working right now

USE THIS INFORMATIONTO BUILD THE

AGENDA

FOR THINGS THAT NEED TO CHANGE

What does NOT make senseThe “down” sideWhat is NOT working right now

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What makes senseThe “up” sideWhat is working right now

What does NOT make senseThe “down” sideWhat is NOT working right now

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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.

What Makes Sense/Works Right Now

What Doesn’t Make Sense/Doesn’t work, Right Now

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

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 Makes Sense/Works Right Now

What Doesn’t Make Sense/ Doesn’t work, Right Now

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

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.

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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:◦ 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?

What’s Working/Not Working Right Now

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Outcome Statement

Actions Needed to accomplish this?

Who will do it?

By When?

(Specific steps required, in detail, concrete)

(who is responsible?)

(due date?)

How we will know we are making progress:

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What do we need to learn? What do we want to learn next? What do we want to maintain? What do we 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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Talk with theperson about:

• the purpose of the plan

• ground rules

• ways to gather information

Choose 1 of 8+ ways to gather

information

Develop a 1st plan, 2nd plan,

etc.

Figure out how to have and

record ongoing learning

Record the learning

Reflect, organize,

synthesize

Developing plans: Getting started, keeping them alive

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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?

Follow Up, Day Three

What Worked? What made sense?

What did not work? What did not make sense?

(what would you do again?)

(what would you do differently?)

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What is ha ppening does We think it means And w e should

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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

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

Someone is trying to Someone is trying 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

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

MaryLou

changes made to row six

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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


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Communication PlanCommunication Plan

What is happening ______ does We think it means We should


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In the world In the world around us – around us – the the environmentenvironment

What’s just What’s just gone ongone on

The “trigger”The “trigger”

What the What the person person actually does actually does – the actions– the actions

What others What others noticenotice

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

What the What the person means person means by what by what he/she doeshe/she does

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 people should do in should 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 2)(or 2)

#4 #4 #3 #3


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

MaryLou

changes made to all three columns

Molly’s Sample Communication Chart

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How Molly Communicates:

What is happening… Molly does this… We think it means… And we should…

Group of people talking, everyone all at once, but no one is talking to Molly

Talks to herself She is having trouble keeping up with the conversation

Or

is feeling left out

Try to slow down the conversation

Include her in the conversation

Someone is repeatedly telling her what to do or is demanding

Acts defiant, OR tunes out

She is angry, or frustrated, or insulted,

She doesn’t want to be “bossed” around

Explain her choices to her, and let her make the decision

Ask her, don’t tell her, what to do

A party around her, but no one talking to her

Says “I’m tired” She’s not happy

Feeling left out

Feeling lonely

If you’re old: Try to introduce her to new people to talk with

If you’re young: Welcome her to join your conversation

During school time Molly stops working, begins to talk to herself

She may feel overwhelmed by what she is doing

Or

She may be bored if it is a repetitive task

Talk to her and ask her if she can tell you why she’s not working. Help her break it down to individual steps.

Ask if she would like to try another activity (i.e. work that still needs to be completed)

Someone has just given her multi step instructions

Begins to talk to herself

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….”


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.


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.


Washing hair Setting the table Making a sandwich Using a fork Tying shoes Brushing teeth Combing hair Shaving

Getting dressed Staying on task Counting money Toileting Doing laundry Using zippers Dialing the phone Applying deodorant


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.


Interpersonal skills Ambulates

independently

Verbal cues or prompts

Auditory monitoring distance

Off task behavior On task behavior

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


Going on a date- Learn Social Skills

Learn Self Defense - Increase physical activity

Looking great for school- Improve personal hygiene

Getting a job- increase vocational skills – will increase productivity to 87%

Participate in Community Organizations (Garden Club) Improve social skills- will not interrupt conversations……..

Put together a photo album- Increase fine motor or Increase attention span- on increase on task behavior

Visit my family- improve social and emotional expressions,


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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