The Art of Options Counseling: Person-Centered, Decision Support
Thea Griffin, LMSW
1
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
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
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
Key Functions of NY Connects Information and
Assistance
Public Education
Long Term Care Councils
5
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
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
Options Counseling is….
Information and Assistance + Decision Support/Counseling = Enhanced Information &
Assistance!
8
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
9
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
10
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
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
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
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?”
14
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
15
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
16
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
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
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
19
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
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
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?
22
Tools to Guide the Delivery of Decision Support
Importance and Readiness Rulers
Preferences Map Relationship Map Options Counseling Action
Plan
23
Importance and Readiness RulersHelps with future planning
24
Preferences MapAssess values, needs and preferences
25
Relationship MapAssesses values, needs and preferences
26
LTC Options Counseling Action PlanChallenges and Preferences
27
Strengths and Possibilities
28
Options, Next Steps and Follow Up
29
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
Discussion
What will you bring back with you? What was most/least useful? What would you like more information about?
31
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
Tracking Options Counseling
33
Additional Resources
Technical Assistance Exchange
www.adrc-tae.org Thea Griffin
34
Recommended
