The Art of Options Counseling: Person-Centered, Decision Support

Thea Griffin, LMSW

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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.

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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

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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

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Key Functions of NY Connects Information and

Assistance

Public Education

Long Term Care Councils

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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.

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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

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Options Counseling is….

Information and Assistance + Decision Support/Counseling = Enhanced Information &

Assistance!

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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 people’s 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

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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”.

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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

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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

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Defining Decision Support Prioritize the individual’s 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 don’t know…Someone told me I need… I can’t…”

Ask if she/he would like support evaluating the options and making decisions

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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.

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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

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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.

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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

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Key Questions for Options Counselors Yourself Consumers/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?

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Tools to Guide the Delivery of Decision Support

Importance and Readiness Rulers

Preferences Map Relationship Map Options Counseling Action

Plan

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Importance and Readiness RulersHelps with future planning

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Preferences MapAssess values, needs and preferences

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Relationship MapAssesses values, needs and preferences

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LTC Options Counseling Action PlanChallenges and Preferences

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Strengths and Possibilities

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Options, Next Steps and Follow Up

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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.

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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

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Tracking Options Counseling

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Additional Resources

Technical Assistance Exchange

www.adrc-tae.org Thea Griffin

T_griffin@ofa.state.ny.us

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