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Person-Centered Supports, Services and Practices: The Cornerstone of Systems Transformation. With special thanks to leaders in the field Michael Smull, USA Helen Sanderson, UK The Learning Community. What are characteristics of person-centered practices?.

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Supports, Services and Practices:

The Cornerstone of

Systems Transformation

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With special thanks to leaders in the field

Michael Smull, USA

Helen Sanderson, UK

The Learning Community

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What are characteristics of person-centered practices?

  • The individual is at the center of the process

  • The individual’s voice is listened to

  • The individuals preferences, fears, discomfort, and choices are listened to

  • Others who know and love the individual are looked to for support in planning and carrying out the plan

  • The individual’s uniqueness is celebrated

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Why do seniors plan?

  • To maintain a life to which they are accustomed

  • To identify what they want so they can get the best out of their future

  • To stay as healthy as possible

  • To get the type of support they need when they need it

  • To avoid a crisis

  • To deal with crises that are unavoidable

  • To help their loved ones carry out their plans if they are unable to do so

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Tools that support person-centered practices

  • Appreciations

  • Relationship Maps

  • Histories

  • Important to/Important for

  • Good Day/Bad Day

  • Communication

  • Wishing

  • Working/Not Working

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Appreciation:identifies the qualities that people like and value about the person

  • Acknowledges and appreciates the qualities and strengths of the person

  • Shows the person as they really are and counters the frequent focus on what is “wrong” with older people

  • Identifies those who have a personal connection with the individual and those who really know them

  • Tells us what an individual likes and admires about himself or herself

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Things we like

about Helen

Helen’s gifts

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Relationship Map: identifies who is important in the individual’s life

  • Captures who is most important to the individual and in what ways

  • Helps to identify the network of relationships that an individual has

  • Helps to clarify with whom to speak when trying to learn about the individual and develop a plan

  • Gives a fuller picture of the relationships that must be strengthened or supported in the individual’s life

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Relationship Map



church, mosque,



local shops

home and

other paid


day services

friends and

non paid


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Developing your own relationship map

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Histories: give people the opportunity to know and appreciate the individual in new ways and to develop different relationshipswith the individual

  • Provides a picture of the individual in the context of his or her own story

  • Identifies things that an individual has in common with others

  • Helps in designing support that makes sense for the individual

  • Allows people to move on from appreciation to learning what is important in an individual’s life

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Helen’s Story

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Importantto/Important for

And finding a good balance between the them

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Important to is what makes a person happy, content, fulfilled.

It may include:

  • people, pets

  • daily routines and rituals

  • products and things

  • interests, hobbies

  • places one likes to go

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are those things that usually involve

  • staying healthy, safe and well

  • maintaining value in the community

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The challenge

maintaining a balance between…

Important toImportant for

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Three ways to have a conversation

  • Linear

  • Branching

  • Meandering

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Example: Amanda’s morning ritual

7:00 am Alarm goes off. Music ONLY, no buzzer. Hit snooze once or twice (depending on how late I want to sleep) Get up at

7:09 or 7:18. If up late, skip breakfast

Stand in closet, with door shut so light won’t wake my husband and decide what I am going to wear for the day.

7:15 am Take clothes to bathroom, turn on water in shower to get

hot, remove p.j.s, get in shower. 1st wash body with Dove

soap, then hair with Paul Mitchell awapui,

7:25 am Get out of shower using 2 100% cotton towels-1 for hair, 1

for body. Put Cetaphil lotion on arms, and legs. Neutrogena face lotion on face. Put on underwear and top and jewelry. Brush through hair.

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Amanda’s ritual continued

7:45 am Go to kitchen fix breakfast: coffee, Jif peanut butter on 2 pieces of Nature’s Own toast. Piece of fruit. Eat breakfast in den watching the Today show.

8:00 am Feed Annie & Eleanor, the cats. 1/4 cup Iams each.

8:05 am Go back to bathroom. Brush hair again. Floss teeth. Brush teeth with electric toothbrush and Crest toothpaste.

8:12 am Put on pants and shirt. Socks and shoes.

8:20 am Kiss husband good morning. Pour another cup of coffee. Start making husband’s breakfast.

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Activity: Morning Ritual

  • Write down your morning ritual

  • Include as much detail as you are comfortable with

  • Start with how you wake up and end with leaving for work or when you feel your morning is over

  • Indicate the times

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Activity: Morning Ritual cont’d

  • Work in pairs. Look each other’s morning ritual and learn what is important to your partner

  • Take sheet of paper that has What is important to _______

  • Read your partner’s routine and then:

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Our Mantra

  • GUESS: look at what your partner wrote and guess in your head

  • ASK: ask your partner if your guess is correct, have a conversation

  • WRITE: write down what you learn

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Other Rituals

  • Going to bed

  • Transition

  • Birthday

  • Cultural/Holiday

  • Spiritual

  • Vacation

  • Comfort

  • Celebration

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Getting to know Arthur

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What is important for Arthur?

What is important to Arthur?

What else do you need to learn/know?

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Arthur’s answer slide

What is important to Arthur?

Staying in his home

People sit and talk with him

Hot meals

Eating with someone

What is important for Arthur?

Have his walking stick nearby

Sticking to routines

Not going out alone

What else do you need to learn/know?

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Good Day

Bad Day

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How to best support

  • We all have good days and bad days.

  • What defines a good day for one may be someone else’s bad day.

  • When we do have a bad day, we need ways to comfort or take care of ourselves.

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Good Day/Bad DayIt is a work day, start with getting up, end with going to bed. Write down a composite of all good moments & all bad moments you have had on a work day.

Good Day

Bad Day

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Good Day/Bad DayWork with your partner. Read their Good Day/Bad day list. Arrange your paper’s to look like this. Use the guess, ask, write process to add to the Important to and ask, “Is there something that other people need to know or do to support you with that?”

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Communication Chart

  • Gives people choice and control

  • Especially helpful when behavior communicates more clearly than words

  • Allows a person to be better supported in a variety of situations

  • Helps us focus on person’s communication whether they use words to speak or not

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Wishing: helps individuals to think about what is important to them and to begin moving towards this

  • Helps to enrich the individual’s life and increase choice and control over what happens to them

  • Helps to personalize the support an individual receives in order for them to have a good quality of life

  • Helps to build confidence and boost low moods

  • Assists in identifying individual’s goals and supports needed to move towards them

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My Plan

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Working/Not Working

  • Identifies areas to build on and what needs to change

  • Identifies what support an individual wants or needs

  • Engages people who are in the person’s life and allows them to contribute to improving it

  • Helps people stand back and look at a situation and tryto change what needs to be changed

  • Helps resolve problems and concerns

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  • Helen Sanderson Associates

    along with Older People’s Programme

  • Michael Smull

    and the Learning Community logo