Families In Care Families In Care

PlanningPlanning::Building a TeamBuilding a Team

Alzheimer Society of Manitoba Conference Alzheimer Society of Manitoba Conference

March 5, 2007March 5, 2007

Peter S. Silin, MSW, RSWPeter S. Silin, MSW, RSWDiamond Geriatrics, Inc.Diamond Geriatrics, Inc.

www.DiamondGeriatrics.comwww.DiamondGeriatrics.com

““We have to include We have to include families in care families in care

planning.”planning.”

The way to include families The way to include families in care planning is to build a in care planning is to build a

strong team of which strong team of which families are a part.families are a part.

Joining the Team: The Joining the Team: The IntroIntro

What is it What is it like to walk through the door to walk through the door Moving to ParisMoving to Paris

The Admission ProcessThe Admission Process

What What happens when coming into care when coming into care DisempowermentDisempowerment Role changes and lossRole changes and loss Emotional crisisEmotional crisis Relief, comfort, securityRelief, comfort, security

The Nature of the relationshipThe Nature of the relationship 3 way relationship3 way relationship Dual role for the family Dual role for the family

The Development of The Development of Care:Care:

From Care SideFrom Care Side

Confirm infoConfirm info Develop an initial care planDevelop an initial care plan Degree of Intervention and formsDegree of Intervention and forms Blood pressures and temperaturesBlood pressures and temperatures TourTour

Stage Setting: The FamilyStage Setting: The Family

Care Maps: built before admissionCare Maps: built before admission Most people have no experience of careMost people have no experience of care Stereotypes of what will happenStereotypes of what will happen ExpectationsExpectations

Families play by their rulesFamilies play by their rules Previous caregiving historyPrevious caregiving history Who they are and what they’ve beenWho they are and what they’ve been

Stage-setting: The HomeStage-setting: The Home

OrganizationOrganization Mission statements /actualizing missionsMission statements /actualizing missions Rights and responsibilitiesRights and responsibilities Policies, procedures, regulations Policies, procedures, regulations

CareCare What is our framework/approach model?What is our framework/approach model? Relationship Model: a meta model of careRelationship Model: a meta model of care Team model of careTeam model of care

Building Teams Pre-Building Teams Pre-AdmissionAdmission

Education Education Individual tours and meetingsIndividual tours and meetings

Team DevelopmentTeam DevelopmentHow Teams are BuiltHow Teams are Built

Develop new teamsDevelop new teams Join existing teamsJoin existing teams Integrate teamsIntegrate teams

What are we doing What are we doing (really)?(really)?

Set up is for families to join care teamSet up is for families to join care team Care team is joining the caregiver’s teamCare team is joining the caregiver’s team Ideal is to meld two teams Ideal is to meld two teams

Why is it difficult?Why is it difficult?

Duality: client and colleagueDuality: client and colleague Power and knowledge difference: we Power and knowledge difference: we

know how the game is playedknow how the game is played RulesRules LanguageLanguage Short cutsShort cutsCulture Clash Culture Clash What is our cultureWhat is our culture What is theirsWhat is theirs

Team DevelopmentTeam DevelopmentHow Teams are BuiltHow Teams are Built

Theory of group developmentTheory of group development Norms, roles, relationships Norms, roles, relationships Forming, storming, norming, performingForming, storming, norming, performing Task and processTask and process Cultures and historyCultures and history

Job One: Work on Job One: Work on RelationshipsRelationships

Trust Trust Time and evidence based:Time and evidence based: Reputation and care mapsReputation and care maps EmpathyEmpathy Pay attention to our interactions and patternsPay attention to our interactions and patterns Congruency: what we do Congruency: what we do

Awareness of our needsAwareness of our needs What is going on between usWhat is going on between us

Integrating Teams: Integrating Teams: RelationshipsRelationships

How do we get them to teach usHow do we get them to teach us Social HistoriesSocial Histories Psychosocial AssessmentsPsychosocial Assessments Family assessmentsFamily assessments Ongoing assessment from the whole teamOngoing assessment from the whole team

Have them shareHave them share Care mapsCare maps What they think will happenWhat they think will happen What they need to knowWhat they need to know What role do they want to playWhat role do they want to play What caregiving has looked like What caregiving has looked like

Building Team: Building Team: informationinformation

Teach system functioningTeach system functioning What is their roleWhat is their role Information flowInformation flow Limits and problemsLimits and problems

Teach care functioningTeach care functioning Care plan developmentCare plan development Care conferencesCare conferences Staff roles, responsibilities, limitsStaff roles, responsibilities, limits Explain and show chartsExplain and show charts Show them care plansShow them care plans

Building Team Building Team

Ask them to write a care planAsk them to write a care plan Make sure to include themselvesMake sure to include themselves Charting to include their notesCharting to include their notes Encourage ongoing inputEncourage ongoing input

AdvocacyAdvocacy Reporting observationsReporting observations Update on family processUpdate on family process Share knowledge and experience of homeShare knowledge and experience of home

Ongoing Team Ongoing Team MaintenanceMaintenance

Care conferencesCare conferences Communication flow Communication flow Trigger points for communicationTrigger points for communication

What do they needWhat do they need MedicationsMedications RecreationRecreation Falls/Change in conditionFalls/Change in condition From family to staffFrom family to staff

Team Functioning Team Functioning ProblemsProblems

Breaking trustBreaking trust Limiting informationLimiting information Lack of information integrationLack of information integration Unclear team mandates, limits, rolesUnclear team mandates, limits, roles Not enough attention to processNot enough attention to process

Healthy Functioning Healthy Functioning TeamsTeams

What do they look like?What do they look like? How do they feel?How do they feel? How do we know when they are off?How do we know when they are off? What do we do about it?What do we do about it?

Respect, conflict resolution, problem Respect, conflict resolution, problem solving: task and processsolving: task and process

Hope and DespairHope and Despair

What is our job?What is our job? The limitations of knowledgeThe limitations of knowledge The Anatomy of HopeThe Anatomy of Hope On miraclesOn miracles We are their dreamersWe are their dreamers