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Disability Sector Case Studies

Case Study - Person Centred Approaches

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Preface

The case study that is presented here is about the way in which person centred approaches have been undertaken in a day service for people with disabilities. Person centred approaches are not limited to this type of service. Any service delivery for people with a disability, or for older people, or anyone at all in the community services and health sector, can be shaped to be based upon person centred approaches.

Introduction

People with a disability have usually had less power than other members of the community. Other people have had control of their lives. This means that paid staff or family members may have control over how a person with a disability spends their time, where they live, what they wear, whether or not they are listened to, what they eat. In fact the more dependent a person is upon someone else’s assistance, the less powerful they are.

Person centred approaches is a phrase used to describe ways of listening carefully to what a person has to say. To find out about what is important to a person, what they want to achieve, their dreams, hopes, fears, needs and wishes. It also includes what a person does not want to have happen for them. Family members, and people who are important in the lives of the person with a disability can be included in the discussions.

A person centred plan may be developed for the individual, covering all aspects of the person’s life. However, this is only one part of person centred approaches. The approaches are a way of thinking about putting the person at the centre of decision making. A person centred approach is about listening carefully and responding.

Person centred approaches in action – Eastern Access Community Health

Eastern Access Community Health (EACH) is a service in Ringwood that provides day programs for people with a range of disabilities. Jackie Kelly (Service Manager, Community Inclusion and Support) has lead the change to make the delivery of services more person centred.

Training

The staff undertook two days of training in Person centred thinking, run by Sherrie Anderson from the Person Centred Learning Centre. Everyone who works in the disability group at EACH took part in the training. This included administration and finance workers as well as volunteers and all the direct program staff. The aim was to bring about an approach shared by all staff. This approach is all about asking people with a disability what they want, and developing services from that.

EACH also organized a 12 month consultancy with Sherrie Anderson so that she could keep on helping them to get it right.

The case study – one program

The Visions program for older people with a disability is an example of how person centred approaches have been implemented.

What was happening

Two years ago, the day programs they were running were taking place in halls in the community.

Jackie Kelly could see that there were big problems with this:

  • the people were attending programs in the community, but not part of the community
  • people had a choice of activities but they only had a choice from what other people had decided would be available
  • they were operating on an old model of 5 days a week, with people of mixed ages, the older people were becoming very tired and therefore less and less involved and able to be interested
  • people were isolated in small groups with other people with disabilities, dependent on workers to pick them up in buses and take them to and from their houses

One of the main objectives of person centred approaches is that people get to plan for themselves, and undertake activities that suit them, when they want to. To assist with this, Jackie employed Jane Ludtke who is a community development worker. Her role has been to make genuine links to the community for people with a disability. She started with a small group of people who are ageing.

What they did

The organization made a terrific start by employing a community development worker. To establish genuine links in the community, workers need to be resourced and supported in paid time to actually go out into the community make enquiries, find out what exists and start to forge the links.

Jane set about looking at ways to provide activities that would be flexible, and give choice. She worked with a small group of individual clients, asking questions and listening to answers about what they would like to do. What she observed and heard from clients was that the genuine links with the community were non existent. As a result, she actively went out into the community and gathered information about a vast range of programs and activities that were available in their area. Jane then met with the small group and talked to them about what she had found. She used pictures to help people understand what a place or an activity looked like. She involved the older people in discussions and listened carefully to their questions, what they thought they might like to do, their fears or worries.

The next step was to write up a weekly timetable for each of the clients for a period of eight weeks. This timetable included morning and afternoon activities, depending upon what suited each individual.

The people all lived in supported accommodation with 24 hour support. This meant that if someone was tired or ill they did not have to go to the activity but could stay at home. This is an unusual but fortunate situation, that there was this flexibility available. In many other situations or organizations this opportunity might not exist and careful planning for alternative arrangements would need to occur.

Examples of activities that people have become involved in include:

  • programs at University of the Third Age
  • local senior citizens including activities such as carpet bowls, scrapbooking
  • morning melodies at a local venue
  • Neighbourhood house programs
  • Programs run at a local aged care facility including Tai Chi, singing, lawn bowls

The clients all tried out the ideas and the timetables were changed to suit participants.

Results and benefits

EACH have been very impressed with the responses from the people involved in the programs. People can participate in activities when they feel like it, and not when they are told to. They do not have to be in a group. They do not have to travel on an EACH bus. They have a choice about what they participate in, and it all takes place in the community.

They are:

  • Happier
  • More chatty
  • More relaxed
  • Far more involved in choices in their lives
  • Keen to give their opinion

This is now being used as a pilot program for expanding the opportunities for many other client groups. A Focus Group is now run by Jane for clients across programs to start meeting and talking about activities that are available.

The program for 2007 will be based upon the results of the surveys that have been developed by this focus group to find out what people want to try.

In the three months that this focus group has been operating the changes that Jane and Jackie can see in the people involved are really clear. Jackie says “They have become much more verbal, more prepared to talk and generally chat.” People feel encouraged, not staff directed but client directed.

Links

Person Centred Learning Centre at EW Tipping foundation – a not for profit organization that provides training, resources etc www.pcls.org.au.

Helen Sanderson and Associates – a development agency exploring how person centred planning can contribute to changing lives, organizations and communities found at www.helensandersonassociates.co.uk.

An inclusive overview of Person centred planning and thinking is provided by Helen Sanderson in her Person Centred Planning: Key features and Approaches (2000) found at http://www.familiesleadingplanning.co.uk/index.htm. Click on Things To Read at the bottom of the page to find the article.

Some terrific articles and resources exist on the Paradigm website: www.paradigm-uk.org.
On the first page enter the website at the line marked at the bottom of the page. On the home page use the top menu and click on Articles in the Information box. Then click on Person Centred Planning and here you can select from a range of articles.
Also try the direct link to Pat Black’s article “Why aren’t person centred approaches and planning happening for as many people and as well as we would like?” at www.paradigm-uk.org/pdf/Articles/patblackpaper.pdf.

A very comprehensive report on The Impact of Person Centred Planning is available at http://valuingpeople.gov.uk. Click on Resources on the masthead menu, scroll down to Person Centred Approaches and click on that button. Scroll down the page to find the article.

An American website with some interesting articles and newsletter is run by the Association for the Development of the Person Centred Approach. Go to www.adpca.org and follow links to articles and newsletter.