Defining Person-Centered Planning

Lesson 11

Foundations of Person Centered Planning

Defining Person-Centered Planning

At its core, person-centered planning is based on a core set of values. It is not a one time event, but an ongoing process for...

• ...learning about the whole person. This is separate from defining "deficits" and "needed services."
• ...helping people create positive visions for their futures.
• ...helping others organize around people to make these visions come true.
• ...arranging support in a way that is empowering to people and likely to move them toward their goa

Defining Person-Centered Planning

“is to listen closely to the hearts of people with disabilities and to imagine with them a better world in which they can be valued members, contribute, and belong.” (Beth Mount--p. xxi, Person-Centered Planning Research, Practice, and Future Directions.)

Defining Person-Centered Planning

Many people receiving support are defined by their "disabilities." Person-centered planning methods help others expand their view of the person. This offers insights that are both simple and profound.

Defining Person-Centered Planning

PCP starts by considering what most people want and value.

Characteristics of person-centered planning include:

• Using common language. Avoiding labels and professional jargon.
• Viewing and speaking about problems as being limits in others and communities. Recognize people need support to develop their talents and contribute.
• Helping people communicate. Assuming they know best about themselves.
• Looking at lives through the lens of valued experiences and cultural relevance to the person. Consider contribution, participation, bonds to others, and opportunities.
• Identifying how people want to be helped and the resources to make it happen.
• Using a systematic process to identify gifts, strengths, talents, and dreams. Building on strengths.

Major Influences Leading to Person-Centered Planning

Increased awareness of civil rights encourages a different look at services.

Many social changes have influenced the service system. In the past, people had to adapt to public services. Very often individual rights were ignored. Now these systems are expected to be more flexible. They are meant to meet diverse needs. There is a stronger emphasis on individual rights in services. The following have influenced this change in attitudes:

• The African-American civil rights movement.
• The feminist movement and women in the workforce.
• The disability rights and self-advocacy movement.
• The aging of the American population.
• The passage of several critical laws including:
• The Individuals with Disabilities Education Act
• The Rehabilitation Act
• The Americans with Disabilities Act

To understand more about this history and how it influences services you can review some other courses in the College of Direct Support. Good ones include: Introduction to Developmental Disabilities, Cultural Competence, and Individual Rights and Choice. Civil Rights and Advocacy would be a good choice too.

Major Influences Leading to Person-Centered Planning

Poor conditions were common in institutions prior to the 1970s.

Up until the 1970s, services to persons with disabilities were often very poor. People relied totally on family members for support. If they could not do that, they were often sent to an institution. Conditions were often terrible. Many workers at institutions tried to do what they could. However, problems of overcrowding, neglect, and abuse were common.

Major Influences Leading to Person-Centered Planning

Learning to complete basic daily routines to the best of your ability is a basic part of developing positive social roles.

Expectations for people with disabilities were very low. Few had opportunities to work, learn, or take care of themselves. For example, many people who were capable of learning to go to the toilet were kept in diapers. People who could hold a fork were left to eat with their hands. People were not taught to make eye contact or saying hello. This isolated them further from others. It increased the belief held by many that people with disabilities, especially intellectual disabilities, were not capable of participating in community life.

Having staff do things for people was a way of being efficient. In a big setting, staff did not have time to teach people to care for themselves. At this time, school was not available to many children with disabilities. In-home services did not exist. Families often did not have help to support people in learning, making friends, or finding a jo

Major Influences Leading to Person-Centered Planning

Severe limits on experiences caused people to miss crucial developmental milestones or learn unhealthy behaviors and responses.

Two people who influenced a real change were Nirje and Wolfensberger. They saw the problem of living without expectations. They understood that without opportunities, people would not reach their potential. As a result, they developed the principle of normalization in the 1960s and 1970s.

Normalization said that people needed to experience rhythms of life. They needed work and expectations. They needed holidays and rest. They needed friends and family. Nirje and Wolfensberger pointed out that without these experiences; people do not grow into their adulthood. For this reason, they encouraged providing people with experiences that were similar to others their own age. By providing these experiences, persons with disabilities are less likely to fall behind their peers. They are more likely to be able to have friends and participate in community life. In addition, they are more likely to have satisfying lives.

Major Influences Leading to Person-Centered Planning

One way in which the principles of normalization were being applied was through Program Analysis of Service Systems (PASS). PASS was a way of measuring the quality of services. It did this in light of how well services incorporated normalization and provided these life experiences for people supported.

The people involved in PASS began to think about services and policies in a different way. Specifically they looked at services through the eyes of the person being supported. PASS looked at whether normalization was being achieved for the person. It did this without making "excuses" for the service provider.

For example, an adult being supported may not have meaningful work. There may be a lack of resources or staff. The person may have challenging behaviors or a lack of basic social skills. These things make getting a job harder. However, the review stayed focused on the impact on the person. It was not based on what the provider thought was "possible." The evaluation method required positive experiences that met high expectations be part of people's daily lives regardless of resources and needs. This was a very different way of measuring the quality of services.

Major Influences Leading to Person-Centered Planning

You're not my "father" and I "know best" for myself!

People trying to support normalization and integration were running across many barriers. One was the attitude that the services system "knew best" for the individual. Planning and services were organized around predetermined goals. They were offered in limited ways. Problems were seen as being caused by a person's disability. The focus was on "fixing" the individual. It was not on supporting the person's good life.

While many people wanted to change this, they did not know how. They started to experiment. Person-centered planning approaches helped people break out of old roles and attitudes. Person-centered planning helped return the power and focus to where it belongs: with the person. It offered an organized way to make this shift in thinking.

Comparing Person-Centered Planning (PCP) with System-Centered Planning (SCP)

Differences between person-centered planning and system-centered planning are often shown by comparing the look and feel of planning events. People consider whom they invite and when and where they have the meetings. However, the differences are more than these details. The focus of each of the two views is listed below. Review this information and go to the next page to learn more.

Person-Centered Planning

• results in a life organized around a positive vision
• goals are based on the person's desires and gifts
• opportunities are based on valued experiences and roles (relationships, employment, etc.)
• people participate now, as they are

System-Centered Planning

• is a list of interventions to improve functioning
• goals are organized around what is "wrong" with the person
• opportunities are focused on learning functional skills
• people spend time getting ready to participate in community life

Comparing Person-Centered Planning (PCP) with System-Centered Planning (SCP)

Services are often paid for by tax dollars. These have strict definitions of who is entitled to services. This ensures tax dollars are used responsibly. Systems for people with disabilities are based on deficits.

To be paid, service providers must show the following:

1. People are eligible for the services (because of their limits).
2. Services are designed to resolve the deficits identified.

As a result, service-centered planning must focus on "problems." They emphasize teaching people to overcome these problems. Some systems are changing. Alternative methods of funding and measuring services are being developed. (Sometimes called Consumer Directed Supports). However, most service plans are built around fixing problems rather than supporting people.

Comparing Person-Centered Planning (PCP) with System-Centered Planning (SCP)

"You've got a lot of problems! What you need is an IHP, an IPP and a slot in a SILS."

Common practices in service-centered planning include:

• Meeting places and times are best times for professionals.
• Meetings are rushed to meet professional deadlines. Once requirements are met, other issues are put off.
• Solutions are based on what the service provider considers "realistic" and affordable, rather than what would work best.
• Decision-making is left to the professionals. They take "input" from persons being supported and family.
• Relying on community members or doing what others would do is seen as highly risky.
• Meetings are focused on reports, written plans and details. The person's whole life rarely being considered.
• Jargon and acronyms are used and not always explained.
• Only professionals or families are encouraged to attend. Professionals fear non-professionals take the meetings "off task.

Comparing Person-Centered Planning (PCP) with System-Centered Planning (SCP)

Person-centered planning is celebration instead of humiliation.

Common approaches in person-centered planning include the following:

• The mood is often festive and time that is needed to consider an issue is taken.
• Successes and achievements are celebrated and recognized.
• The person's privacy and feelings are respected.
• Others talk with the person and not about him or her.
• People use common words to describe what they know or observe.
• The person and his or her friends and family make decisions. They take "input" from professionals.
• All things are considered. Resources are identified and solutions are creative.
• Solutions are based on what anyone would do, not what the service provider offers.
• Relying on community members is seen as desirable, not risky.
• Papers and record are used only to keep track of agreements and plans. People focused on the person's life, rather than the "report."

Comparing Person-Centered Planning (PCP) with System-Centered Planning (SCP)

The written documents that come out of person-centered plans will look different from system-centered plans. These are things more common to a person-centered plan:

• A person's strengths and unique preferences are easily identified.
• It's easy to tell what is important to the person and how they prefer assistance to be organized and presented.
• The plan will describe the situation and goals in common terms. It will describe things in ways we describe our own lives. For example, "Steve is lonely. He has no friends or family who visit and spends time only with paid staff. He has a wonderful smile and knows a lot about baseball. He has time to volunteer."
• The plan will list goals and next steps.
• It will list who is responsible for completing the steps, and by when.
• Anyone can help: paid DSPs, friends, family, coworkers, classmates, etc.
• Specific ideas are listed. However, the goal can be achieved in any way that works.
• Gathering to update and celebrate are planned but can be changed base on real needs.
• Progress is tracked only as needed to problem-solve and move forward.

Comparing Person-Centered Planning (PCP) with System-Centered Planning (SCP)

Person-centered planning can help break through the wall between the person and the community.

In person-centered planning, connections to community are seen as essential. A lot of thought goes into relationships. When a friend or peer can offer support, it is encouraged. People who help are considered friends not volunteers. Ways in which the person with disabilities can contribute are explored.

Benefits and Challenges to Person-Centered Planning

Often organizations believe they provide person-centered supports. However, the day-to-day lives of people may show a different picture. Person-centered planning may have taken place. However, there may be little attention to the deeper wishes of the person. Often, the long-term dreams of the person are not supported by direct support professionals.

Reasons given for this often include:

• Fears of legal problems if the person gets hurt
• Limits in money or resources
• Expectations of guardians
• Previous failed attempts (to find work, to make friends, etc.)
• Regulations
• Challenging behaviors or other missing skills.

Person-centered services expect that barriers be overcome. They should not be permanent.

Benefits and Challenges to Person-Centered Planning

This promise should be granted to ALL children: to be loved; to be valued; to be supported to make as much as he or she wants of life.

Person-centered planning holds the key to inclusive communities. By committing to this process as it was intended and is described, service providers can become part of the change, not barriers to change.

Attributes of a Champion

The champion emerges naturally from the person-centered planning process. The champion cannot be assigned, hired, or designated. (Although a professional advocate can be hired to assist with a specific purpose.) Champions often know the person's story. They have compassion and care for the person. They are the people who will remember "little" things, like the person's favorite treat. Champions get their strength from within. They believe passionately in the person's better life. They may be lifelong champions (often family). Or, they may be strongly with the person for a time and fade as circumstances change.

Good champions:

• Are able to work effectively with others but are clear in their allegiance to the person.
• Care deeply about the person and his or her life.
• Are willing to put time and energy toward change
• Knows what works for the person.

Benefits and Challenges to Person-Centered Planning

The results are worth it!

Person-centered planning can be challenging. It requires risks and effort. It requires change and growth. This change is needed in individuals. However, policy and structures need to change too.

Positive things can happen through even small actions in the right direction. As a direct support professional, you can make daily changes, like those in lesson 3 and 4 of this course. These changes require only your commitment and creativity. Through your personal decision to help people have better lives, you can do this important work.

As you progress in your understanding, you will have good ideas for your employer. You can help clarify how policies and structures affect person-centered supports. You can help the organization on its journey too.

Foundations of Person-Centered Planning

Lesson Review:

• Person-centered planning is an organized way of identifying barriers to valued social roles, meaningful inclusion, and personal achievement.
• Methods of looking at services through the lens of normalization principles such as PASS, showed how often the service system stood in the way of valued social roles.
• Service-centered planning focuses on problems. It uses jargon and relies on professionals to define what is "good" for the person. It assumes the person needs to be "improved" before community will welcome him or her. Person-centered planning uses common language to look at a person's strengths and dreams. It identifies barriers to achievements of dreams. It assumes that community connection is a possible goal with or without significant changes in the person.
• Success in person-centered planning takes more than one session. Using a trained, experienced, and dedicated facilitator improves the quality of what is discovered. Having at least one unpaid person who cares deeply about the success for the person is helpful in keeping this process moving forward