Oregon Department of Human Services Senior and People with Disabilities State Unit on Aging-ADRC In partnership with  Portland State University School of Social Work Center for Improvement of Child and Family Services 1

Introductions Check in: how is it going? Review of Options Counseling Skills for Options Counseling Assessment Model of Options Counseling Documentation 2

 Gain knowledge and practice strategies for providing Options Counseling with consumers.  Gain knowledge and practice communication tools for providing Options Counseling.  Gain knowledge and practice of strategies and approaches to support consumers in decision making.  Gain knowledge of OC documentation 3

Review:  Definition  Foundation  What OC offers  How OC is different  Core Competencies 4

Options Counseling supports informed long-term care decision making through assistance provided to individuals and families to help them understand their strengths, needs, preferences and unique situations and translates this knowledge into possible support strategies, plans and tactics based on the choices available in the community. 5

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1. What is an example of an I&R call? 2. An I&A call? 3. OC? 7

 Options Counseling is a key component of Aging and Disability Resource Centers (ADRCs)  Providing individuals support they need to make informed decisions about long term care to prevent or delay unnecessary institutionalization.  AoA’s National Vision for ADRCs  In every community  Nursing Home Diversion Program  Home and community Based Services. 8

 A supportive relationship that helps consumers and their families make informed choices about meeting current and long-term needs.  A firm foundation in quality information about state and local resources  As assessment approach that is person-centered and incorporates consumer preferences, strengths, culture and individual situations.  The skills to assist individuals and families in decision making. 9

Personalized Approach  Addressed special circumstances and needs  Considered my opinions, likes and dislikes before recommending services  Considered my family and their needs  Helped me make my own decisions  Followed up to see how I was doing 10

Information was helpful  People were able to easily access the information that they needed.  Staff was knowledgeable about a wide range of services. People felt empowered  Helped to connect people with the services he/she needed  Helped people explore the choices available to him/her  Helped weigh the pros and cons of each choice  Felt they took individual circumstance into account. 11

Guidance was provided  Explained each step clearly  Helped navigate the system  Helped with the paperwork  Went above and beyond his/her job  Cared about my needs 12

 Six Core Competencies 1.Determine the need for Options Counseling 2.Assess needs, values and preferences and cultural considerations 3.Understand public and private sector resources 4.Demonstrate respect for self-determination 5.Encourage future orientation 6.Follow-up 13

 Communication  Active Listening  Assessment  Values, needs, goals and strengths/resources  Motivation and change.  Decision Making Support  Creating person-centered plans.  Working with family and natural supports.  Clear Documentation  Goals and needs, options considered, action plan. 14

Listening looks easy, but it isn’t. Every head is a different world. -Cuban proverb Active Listening Skills  Non-verbal  Paraphrasing  Clarifying  Reflecting  Summarizing 15

Be aware of non-verbal messages. 16

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Creating a Posture of Involvement  Leaning gently towards the speaker  Facing the other person squarely  Maintaining an open posture with arms and legs uncrossed  Maintaining an appropriate distance between us and the speaker  Moving our bodies in response to the speaker, i.e., appropriate head nodding, facial expressions. 18

Paraphrasing - a brief, succinct statement reflecting the content of the speaker’s message. Clarifying - asking questions to gain information, encourage the speaker to tell his/her story, and gain clarification. Reflecting Feeling - a statement that conveys understanding of the speakers underlying meaning and emotions. Summarizing - a statement of the main ideas to show understanding. 19

Closed-Ended Questions: gather facts, check understanding, clarify agreement ◦ Do you? ◦ Have you? ◦ Will you? ◦ Could you? 20

Open-Ended Questions: invite people to think and reflect, expand on answers ◦ What? ◦ How? ◦ Why? 21

Think up Three closed-ended question Three open-ended questions 22

Challenges: Assumption of Similarities Language Difference Nonverbal Misinterpretations Tendency to Evaluate Stress 23

Active Listening Skills 24

How we deepen our understanding  Learning about a person’s values, culture and personal preferences.  Understanding the person’s needs.  Exploring his/her strengths and resources. 25

 Goals ◦ What the person wants to continue, change or accomplish.  Strengths and Resources ◦ Who this person is: values, culture, family, history ◦ The building blocks for accomplishing the goal.  Needs ◦ Why a change, action or service is needed  Options and Strategies ◦ How that need will be met.  Measurable Outcomes ◦ Results that will tell us we met the needs and accomplished the goal. These can be defined by consumer and by program 26

Mary’s Story (A) 27

Assessing Readiness for Change  Stages of Change  Motivational Approaches 28

 Pre-contemplation  Contemplation  Preparation  Action  Maintenance  Relapse 29

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 Move challenging situations toward change  Helps I & A know when to act and when to step back  Takes the I & A worker out of the perpetual “fix” mode  Work smarter, not harder  Helps remove some of the resentment that can develop with consumers who “never take our advice”. 31

Vignettes: Identify Stages of Change 32

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 Using assessment to generate options  Evaluation of ideas  Considering present and future impact of decisions  Involving family and natural supports 34

Mary’s Story (B)  What strategies, actions, services might help Mary meet her needs and accomplish her goals? Consider Mary’s strengths and resources to build on.  What outcomes will tell you the ideas and plans are working? 35

Documentation should support what you have done and reflect why a consumer made a specific decision.  ASSESSMENT ◦ Objective Data/Descriptive ◦ Needs and Strengths  PRESENTED OPTIONS ◦ Explain the choices. ◦ Reasons for decisions made.  ACTION PLAN ◦ Clear steps of what is next and who is responsible. 36

Action Plan Basics  What: Should indicate activity/service  Who: Person who will be responsible  When: Timeline for this activity 37

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 Gain knowledge and practice strategies for providing Options Counseling with consumers.  Gain knowledge and practice communication tools for providing Options Counseling.  Gain knowledge and practice of strategies and approaches to support consumers in decision making.  Gain knowledge of OC documentation 39

Questions and Comments 40