1. Families In Care Planning : Building a Team Alzheimer Society of Manitoba Conference March 5, 2007 Peter S. Silin, MSW, RSW Diamond Geriatrics, Inc. www.DiamondGeriatrics.com www.DiamondGeriatrics.com

2. “We have to include families in care planning.” The way to include families in care planning is to build a strong team of which families are a part.

3. Joining the Team: The Intro  What is it to walk through the door  What is it like to walk through the door  Moving to Paris

4. The Admission Process  What when coming into care  What happens when coming into care  Disempowerment  Role changes and loss  Emotional crisis  Relief, comfort, security  The Nature of the relationship  3 way relationship  Dual role for the family

5. The Development of Care: From Care Side  Confirm info  Develop an initial care plan  Degree of Intervention and forms  Blood pressures and temperatures  Tour

6. Stage Setting: The Family  Care Maps: built before admission  Most people have no experience of care  Stereotypes of what will happen  Expectations  Families play by their rules  Previous caregiving history  Who they are and what they’ve been

7. Stage-setting: The Home  Organization  Mission statements /actualizing missions  Rights and responsibilities  Policies, procedures, regulations  Care  What is our framework/approach model?  Relationship Model: a meta model of care  Team model of care

8. Building Teams Pre-Admission  Education  Individual tours and meetings

9. Team Development How Teams are Built  Develop new teams  Join existing teams  Integrate teams

10. What are we doing (really)?  Set up is for families to join care team  Care team is joining the caregiver’s team  Ideal is to meld two teams

11. Why is it difficult?  Duality: client and colleague  Power and knowledge difference: we know how the game is played  Rules  Language  Short cuts Culture Clash  What is our culture  What is theirs

12. Team Development How Teams are Built  Theory of group development  Norms, roles, relationships  Forming, storming, norming, performing  Task and process  Cultures and history

13. Job One: Work on Relationships  Trust  Time and evidence based:  Reputation and care maps  Empathy  Pay attention to our interactions and patterns  Congruency: what we do  Awareness of our needs  What is going on between us

14. Integrating Teams: Relationships  How do we get them to teach us  Social Histories  Psychosocial Assessments  Family assessments  Ongoing assessment from the whole team  Have them share  Care maps  What they think will happen  What they need to know  What role do they want to play  What caregiving has looked like

15. Building Team: information  Teach system functioning  What is their role  Information flow  Limits and problems  Teach care functioning  Care plan development  Care conferences  Staff roles, responsibilities, limits  Explain and show charts  Show them care plans

16. Building Team  Ask them to write a care plan  Make sure to include themselves  Charting to include their notes  Encourage ongoing input  Advocacy  Reporting observations  Update on family process  Share knowledge and experience of home

17. Ongoing Team Maintenance  Care conferences  Communication flow  Trigger points for communication  What do they need  Medications  Recreation  Falls/Change in condition  From family to staff

18. Team Functioning Problems  Breaking trust  Limiting information  Lack of information integration  Unclear team mandates, limits, roles  Not enough attention to process

19. Healthy Functioning Teams  What do they look like?  How do they feel?  How do we know when they are off?  What do we do about it?  Respect, conflict resolution, problem solving: task and process

20. Hope and Despair  What is our job?  The limitations of knowledge  The Anatomy of Hope  On miracles  We are their dreamers