Applying Strength Based Care (Part I)
Part I - Deficit-based vs. Strength-based care plans
Worksheet A (PDF, 23KB, 1pg.) illustrates a common care planning method used in many facilities:
- a problem or RAP trigger is identified through MDS assessment
- the ID team sets a goal they would like to see achieved
- approaches are then planned by the ID team and/or nursing staff many times without consulting the resident, primary caregivers on every shift, the family, or significant others who could provide valuable information into what the problem behavior indicates about the resident's attempts to cope, and the corresponding strengths that could be used to outline the resident's preferred approaches using BASICS.
This method plans approaches that the interdisciplinary team thinks will be effective without considering the resident's viewpoint and preferred problem solving methods retained from the past.
In this example, Gerald's MDS assessment shows that a critical problem (RAP) was triggered under every level of BASICS. The goals are listed. Gerald needs help! RAP's signify that Gerald is at risk for serious functional decline. How can we plan effective approaches so Gerald can meet the set goals? We need to look further into Gerald's MDS and daily life to identify Gerald's strengths to plan approaches that work for him.
Worksheet B (PDF, 26KB, 1pg.) demonstrates Strength Based Care Planning using BASICS for Gerald which lists information staff acquired from the MDS, the resident record, talking to the resident and all who know him, and by observing the resident in his daily life.
- What other approaches might be used for each problem considering Gerald's identified strengths?
- Do you think this method of care planning can develop more resident centered approaches to care than the care planning methods discussed with Worksheet A?