Text of The Art of Options Counseling: Person-Centered, Decision Support Thea Griffin, LMSW 1
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The Art of Options Counseling: Person-Centered, Decision
Support Thea Griffin, LMSW 1
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Prerequsite for Options Counselors Complete the NY Connects
Information and Assistance Training that provides the necessary
core competencies and communication skills instruction. This
includes active listening and interviewing techniques, empowering
callers and handling difficult situations. 2
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Learning Objectives Define Options Counseling Distinguish
Options Counseling from Information and Assistance Apply
Person-centered interviewing techniques Empower individuals to make
decisions Track Options Counseling 3
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NY Connects: Choices for Long Term Care An essential part of
NYS effort to rebalance the long term care system A central
component of federal long term care reform initiatives for both the
AOA and CMS, and functions as NYS Aging and Disability Resource
Center (ADRC) Streamlines access to information and assistance
about long term care services, reduces fragmentation and empowers
individuals to make informed choices 4
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Key Functions of NY Connects Information and Assistance Public
Education Long Term Care Councils 5
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Aging and Disability Resource Center Grant Two NY Connects
programs awarded the federal ADRC grant award in 2009. Improving
access to long term care and improving transitions in care aimed at
reducing preventable re-hospitalizations. 6
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Defining Options Counseling An interactive and individualized
process whereby consumers are assisted in evaluating all of their
long term care options and are supported in making a decision based
on their values, needs and preferences and cost. A distinct and
specialized service offered by Aging and Disability Resource
Centers 7
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Options Counseling is. Information and Assistance + Decision
Support/Counseling = Enhanced Information & Assistance! 8
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Goals of Options Counseling To provide people with the
information they need to make informed choices To provide guidance
by matching peoples needs and preferences with available services
and supports To help plan for the future To help improve the
quality of life of people receiving long term care services 9
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Person-Centered Planning: The Foundation of Options Counseling
An approach that generated from the Disabilities Rights Movement
Consistent with direction of NY Connects Focuses on the individual,
not on fitting the person into available services Highlights
strengths, capacities, preferences, and desired goals of individual
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Importance of Self-Determination Each person determines what is
necessary and desirable to create a meaningful life. Options
Counselors give individuals control to create the results they
want. What do you need to help you make this decision? What will
help you make this decision better? Counselors letting go of the
need to resolve the problem. 11
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Elements of Options Counseling Identifying consumer and family
needs, values, and preferences Providing information on public and
private resources Connecting consumers with resources Assisting
consumers in deciding course of action and allowing for self-
determination Counseling and support through the process Following
up 12
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Distinguishing Features of Options Counseling Takes more time
than I & A Is a process, not an event Involves multiple
conversations Occurs in person and involves the family, as
appropriate and feasible Encourages future planning Provides
decision support, including action steps Requires documentation and
tracking 13
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Defining Decision Support Prioritize the individuals needs and
wants Identify their preferences and values Identify options
available Help individuals weigh the pros and cons of different
choices What might happen if you decide not to take any action?
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Decision Support Continued. Helps anticipate and plan for
future needs What would you like to do when your daughter
(caregiver) goes back to work full time? Develop an Action Plan
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Getting the Information Needed to Provide Options Counseling
Ask individual to tell their personal story Ask open-ended up
questions: What type of assistance are you looking for? How would
you describe your current situation? Listen for cues that the
person is at the point of decision making: Maybe I I dont
knowSomeone told me I need I cant Ask if she/he would like support
evaluating the options and making decisions 16
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Individuals Who Would Benefit from Options Counseling
Individuals with immediate long term care needs (e.g. after major
life changing event) Individuals who are planning for future needs
Caregivers who need help in caring for their loved one Individuals
who are transitioning from one setting to another, such as from the
hospital to their homes. 17
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When Might Options Counseling Not Be Helpful? During a crisis
When individual does not have the capacity to make decisions When
individual only wants a referral or telephone number 18
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Examples of Components of an Optional Counseling Session
Individual/Family Needs and Preferences Personal history and
preferred lifestyle Functional limitations and capacities Support
system Financial situation Exploration of Choices and Options
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AoA Distinctions Benefits Counseling Provides accurate and
objective information on public benefits and entitlements, such as
that provided by the HIICAP coordinator. Futures Planning Focuses
on planning for anticipated long term care needs. 20
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Skills of an Options Counselor Received I&A training
Understanding of person centered planning Respect for
self-determination Ability to provide counseling and support
Knowledge of all available resources, public and private, and their
cost Active listening skills Ability to work with families 21
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Key Questions for Options Counselors YourselfConsumers/Family
Feelings What bias do I bring? Do I have a strong opinion about
what they should do? Where are they in their ability or willingness
to make a decision? Are they anxious or laid back? Knowledge Do I
have a handle on all the potential resources in the community that
may be useful to this family? Who else should I consult? What
information have they received already? How much information can
they handle right now? What do they see as options? Skills What
clinical skills are most important in this situation? What
strategies have they already tried? How likely are they to follow
up after discussions? 22
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Tools to Guide the Delivery of Decision Support Importance and
Readiness Rulers Preferences Map Relationship Map Options
Counseling Action Plan 23
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Importance and Readiness Rulers Helps with future planning
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Preferences Map Assess values, needs and preferences 25
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Relationship Map Assesses values, needs and preferences 26
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LTC Options Counseling Action Plan Challenges and Preferences
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Strengths and Possibilities 28
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Options, Next Steps and Follow Up 29
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Challenges Faced by Options Counselors Dealing with family
dynamics and handling conflicts Helping individuals who have
limited options Working with individuals who do not qualify for
public programs and have limited resources Repeat callers who
refuse to accept services Letting individuals take risks. 30
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Discussion What will you bring back with you? What was
most/least useful? What would you like more information about?
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Programmatic Requirements for Implementing Options Counseling
Track and document Create methods for continued staff competence
Develop and implement operational protocols, including referral
procedures with hospital discharge planners 32
