Support client self direction Support client-direction… SESSION TOPICS: • Definition of self-direction • Principles of self-directed support • Traditional care v’s self-directed support • Achieving self-direction • The unique client • Psychological, emotional, social and spiritual needs • Resources and networks Support client self-direction… SESSION TOPICS: • Risks and self-directed care • The support worker • Code of conduct • Difficulties of self-directed care • Behaviour Self Direction “ Self-direction means the interventions, training, and skills by which clients with a chronic condition, disability, or disease can effectively take care of themselves and learn how to do so”. Principles of self-directed support… • Collaborative and active partnership between client and service provider • Client-centered care • • Shared responsibility for outcomes Empowerment and enhanced capacity as goals of care • Care is lifelong Traditional Care v’s Self Directed Support… COLLABORATIVE AND ACTIVE PARTNERSHIP BETWEEN CLIENT AND SERVICE PROVIDER TRADITIONAL SELF DIRECTED SUPPORT Service provider is expert Expertise is shared and the client basically between client (expert on has little say. their life) and provider (expert on needs and care). CLIENT - CENTRED CARE TRADITIONAL SELF DIRECTED SUPPORT Care is disease and/or service centered and often standardised or generic. Care is planned around the client’s individualised circumstances, needs and preference. SHARED RESPONSIBILITY FOR OUTCOMES TRADITIONAL SELF DIRECTED SUPPORT A single service provider Responsibility for is the principle caregiver outcomes is shared and therefore responsible between the client and for outcomes. often multiple service providers EMPOWERMENT AND ENHANCED CAPACITY AS GOALS OF CARE TRADITIONAL SELF DIRECTED SUPPORT The goal is compliance with funded packages and the implementation of care along with the provision of information and advice. The goal is to empower the client and enhance their capacity to engage in activities that will improve their health and care. SUPPORT IS LIFELONG TRADITIONAL SELF DIRECTED SUPPORT Immediate needs are addressed and care is a one-time assessed activity. Long-term change and impacts are addressed and care is a continual and self-corrective process. ACTIVITY 1… Brainstorm Achieving Self Direction Achieving self-direction… • Communicate and engage effectively with clients and service providers • Conduct comprehensive, holistic assessments • Plan and provide care collaboratively • Support and empower clients • Deliver care using a variety of approaches • Possess care knowledge Achieving self-direction… • Use decision supports, information and communication management systems effectively • Identify and respond to clinical risks • Engage in continuous quality improvement activities Communication… Communicate and engage effectively with clients and service providers. Informed choices – information that is relevant. valid and accessible Ask questions to clarify – assist client put into words the situation they are facing Eg: What is happening in your life that you are not happy about or feel out of control or simply want to change Communication… Inform regarding options – list the different options or help the client list them Eg: The option for a person feeling overwhelmed might be counselling or personal development group or medication (last option) Facilitate the decision making – help the client think about the possible positive and negative consequences of each option and the risks and constraints associated with their choice/s Communication… Explain how to make the decision – explain to the client how to adopt the new behaviour or how to put the actions in place Eg: the worker might need to explain the process of receiving treatment for a mental health issue, such as being assessed by mental health professional, possibly being referred to a psychiatrist. Activity 2… Brain storm inclusions for holistic assessment Conduct comprehensive, holistic assessments… Including assessment of: client health risk factors; psychosocial concerns and supports; self-management capacity Plan and provide support collaboratively … • Collaborating with clients and other service providers to define problems, set goals and actions, and problem solve. Support and empower clients… To: 1. access appropriate information; 2. develop skills required for their self-direction; 3. develop and maintain health related behaviours; 4. use available technologies to support selfdirection; Support and empower clients… 5. access and use available self-management tools; access support networks; 6. manage health risks; 7. communicate their needs and choices; and 8. understand their strengths, areas for development, and capacity and willingness to self-manage. Deliver support using a variety of approaches… Including: • group services, • individual sessions, • telephone-based support, and • the use of other communication technologies to support care. Possess support knowledge… Awareness of: i. the interaction between factors that influence client behaviour; ii. the importance of personal, religious and cultural beliefs, and their impact on individual choices; iii. the impact of one’s own beliefs on one’s ability to support clients; Possess support knowledge… iv. the range of services and treatments available; v. the range of self-management support tools available to clients vi. the range of support networks available to clients; vii. evidence-based guidelines for care; Possess support knowledge… viii. the roles of other members of the health care team; ix. Maintain carer professional development, implement knowledge into practice. Achieving self-direction… Managerial and corporate level: • Use decision supports, information and communication management systems effectively • Identify and respond to risks • Engage in continuous quality improvement activities ACTIVITY 3… http://www.youtube.com/watch?v=X1OcfvaTjl0 The uniqueness of a client… Every client is unique, based on their: • Psychological needs • Biological needs • Social needs • Emotional needs Psychological, social & emotional needs… Traditionally carried out by family, friends, relatives or community members. • In todays world there is: • breakdown in families and extended families • loosening of links between people • community bonds are changing & weakening Psychological, social & emotional needs… • critical events – • disasters, • conflict/s, • accidents and health problems • world unrest Psychological support needs… • Time for self reflection • Counseling when needed • Do something fun • Minimise stress • Write a journal • Learn something new • Receive from others Physical support needs… • Eat regularly and healthily • Preventative medical care • Massages • Wear clothes of choice • Vacations, day trips • Dancing, swimming, walk, physical activity Emotional support needs… • Enjoyable company • Contact with friends • Read favorite books • Cry when sad • Laugh • Express outrage Spiritual care needs… • Make time for reflection • Be open to inspiration • Have faith • Go to church • Meditate • Sing • Identify what is meaningful • Contribute to causes Activity 4… Brain storm information gathering on networks, support groups, resources Required Resources… • Support Groups • Personal helpers and mentor programs • Accommodation support • Activity centres • Employment services • Counselling Services • Health services • Training and education Required Resources… • Peer worker groups • Disability support services • Child and family services Networks… A network is a structure of one or more links Generally with a common interest Social Networks – facebook, twitter, Myspace Business Networks - linkedin To give people the power to share, be more open and connected. Networks… Sexual Learning Friendship Church Group Support Networks… • Peer worker groups • Disability support services • Child and family services Risks and self-directed support… • Risks and constraints can be in the areas of: • Finance • Transport • Cognitive ability • Language • Culture • Communication Risks and self-directed support… • Duty of Care - page 22 • Anti discrimination – page 22/23 • WHS Legislation – page 22/23 • Manual Handling and risk - page 23 ACTIVITY 5… Discuss in detail the risk factors of self-directed support. The Carer… Code of Conduct… • Being accountable to the clients to deliver a safe and effective services • Giving clients choice of service options • Community inclusion • Confidentiality and privacy • Respecting the rights and dignity of the client • Equality • Empowering clients Code of Conduct… • Avoiding conflict • Caring, responsible and diligent • Positive influence • Attentive to the client • Acquiring relevant knowledge and skills • Adherence to equal opportunity, health and safety and discrimination legislation Activity 6… • In small groups discuss the difficulties you may encounter in meeting the clients needs. • How to address the difficulties. Difficulties… • Client not coping • Lack of funding • No appropriate service/s • Lack of transport • Lack of support staff • Inability to match a worker with the client • Lack of resources Difficulties… • No support worker support • Communication Barriers • Family intrusions Caring for the Support Worker …YOU!! • Time out • Rest & Relax • Socialise • Engaging in a hobby • Walk, run….. • Employee Assistance Program (CSC EAP) • Talk to you case manager Thank you… http://www.youtube.com/watch?v=9me gUfjDNSA&list=PLEED264C424422C39