Nursing Facility Transition and Diversion

1. Nursing Facility Transition and Diversion Module 2: Independent Living and Person-Centered Planning

2. Overview of Module #2 • Independent Living Philosophy • Adolf Ratzka • Independent Living versus Medical Model • Independent Living — Language and Etiquette • People First Language • Person-Centered Planning • What it is and is not • Values and principles of Person-Centered Planning • Essential elements for individual planning • Facilitator roles and skills • Overview of the planning

3. Independent Living (IL) Philosophy • Basis for transition work • Right & Responsibility to make choices • Live independently in the community with supports • Participate as full, equal citizens • Goals • Empowerment • Self determination • Full participation

4. Adolf Ratzka • As long as we regard our disabilities as tragedies, we will be pitied. • As long as we feel ashamed of who we are, our lives will be regarded as useless. • As long as we remain silent, we will be told by others what to do.

5. Independent Living • Philosophy • People with Disabilities of all ages: • Are the real experts on disability issues • Work for self determination, equal opportunities, and self respect • Demand the same control and choices as non-disabled people • Need to be in charge of their lives • Have the same need for recognition, love, and inclusion

6. Independent Living Problem is lack of supports and accommodations, lack of freedom and autonomy, and inaccessibility Locus of problem is the environment or interaction with it Medical Model Problem is physical or mental impairment or lack of certain skills Locus of problem lies with individual — the individual needs to be “fixed” Independent Living versus Medical Model I

7. Independent Living Individual is a participant NOT a patient Consumer is the primary decision maker Medical Model Role of Individual is a patient Physician is primary decision maker People with disabilities play the sick role People with disabilities are impaired Independent Living versus Medical Model

8. Independent Living Solutions focus on removing barriers and providing supports Medical Model Solutions are dominated by professional intervention, care and treatment Independent Living versus Medical Model

9. Independent Living – Language and Etiquette • Some basic rules of etiquette • Language is important

10. People First Language • Are you myopic or do you wear glasses? • Are you cancerous or do you have cancer? • Is a person disabled or do they have a disability? • Instead of “she is confined to a wheelchair,” say “she uses a wheelchair for mobility.” • Instead of saying “he’s a quadriplegic,” say “he has a physical disability.”

11. What is Person-Centered Planning? Person-Centered Planning is a process for planning and supporting a person’s life. The process builds upon the individual’s capacity to engage in activities that promote community life and honors the individual’s preferences, choices and abilities. Person-Centered Planning involves families, friends, and professionals, as the individual desires.

12. What is Person-Centered Planning? • Supports self-direction • Based on values and principles: • Choices and preferences will be honored • Everyone has contributions to offer the community • Maximize independence, community connections, and achievement of goals and expectations • Presuming competence • Respecting and accommodating cultural diversity

13. What is Person-Centered Planning? • Identifies goals and preferences • Plan that builds upon capacity to engage in community life • Process for planning a life and the care/services/supports needed to meet goals • May also be a plan for “end of life” care

14. What is Person-Centered Planning? • Planning with a broad scope • Consumers control the scope • Circular process, not one time only • Tracking progress of process and implementation

15. Person-Centered Planning is: • Honoring a person’s life • Choice over many aspects of life • Control over what each day includes and doesn’t include • Freedom • Assisting an individual to determine what makes life worth living for them

16. Person-Centered Planning is NOT: • Health and Safety plans or assessments • Medication or therapy compliance • Crisis stabilization

18. Role of the Professional • Ensuring the process follows expressed wishes • Supporting carrying out of roles • Providing information • Identifying resources and accessing services • Coordinating • ADVOCATING

19. Outcomes of the Process • Drive the individual’s support plan • Determine services and supports • Based on real life

20. Resources • Independent Living History • http://www.lcil.org/lcil/history/articles.htm • Disability Culture • www.adapt.org • http://www.lcil.org/lcil/history/culture.htm • Disability Etiquette • http://www.unitedspinal.org/documents/DownLoad/DisabilityEtiquette.pdf • People First Language • www.disabilityisnatural.com