Inservice: Strength Based Care Planning Using BASICS

Learning Objectives

Upon completion of this program participant will be able to:

  • List three (3) ways strength based care planning benefits residents and staff.
  • Explain a method for reviewing a resident's MDS to detect other changes in function caused by an identified problem.
  • Identify resident strengths as well as problems on a resident's MDS.
  • Use strength based care planning to develop effective approaches to care with measurable goals.

Time 90 Min.

Note: Some groups may take more than 20 minutes to complete and discuss all of the worksheets.

Suggestion: You may want to do a two part in-service (45 minutes each session) to allow time for staff to absorb the concepts of strength based care planning. You could do Part I at the first session and Part II during the second session. During the section where participants are asked to care plan for a resident they work with, the resident's actual MDS could be used to look for changes in function and strengths if this session was done with primary caregivers. It could be held on each unit.

  • 10 min. - Lecture on strength based care planning using BASICS
  • 20 min. - Discussion looking at a sample resident who has problems on every level of BASICS need
  • 20 min. - Break up into groups to look at how one of the sample resident's problems affects every level of BASICS
  • 20 min. - Have groups look at problem/strengths under each level of BASICS for a resident they care for
  • 20 min. - Discussion about possible care plan approaches suggested for each group's resident under each level of BASICS

Preparation

  1. Set up a flip chart (may use overhead).
  2. Set up room with chairs in six group settings according to size of group expected.
  3. Photocopy Resident Need Index (PDF, 23KB, 1pg.) to use as handout or overhead, and sample Problem Strength menus in BASICS: Biological, ADL, Societal, Interpersonal, Creative, and Symbolic to use as handouts or overheads.
  4. Photocopy Worksheet A (PDF, 23KB, 1pg.), Worksheet B (PDF, 26KB, 1pg.), and Worksheet C (PDF, 49KB, 1pg.).
  5. Review handouts and lecture on Strength Based Care Planning using BASICS to prepare for in-service. Put the lecture in your own words.
  6. Review MDS sections listed on the sample Problem/Strength menus for Gerald in Part II.
  7. Obtain information concerning care planning problems and successes with residents with dementia from charge nurses and caregivers on each unit.
  8. This information can be incorporated into the lecture and discussion.

Instructions

Part I

  1. Give the lecture in your own words using material taken from "Why do it".
  2. Use Worksheet A to demonstrate a common care planning method used in many nursing facilities as outlined in the interactive exercise in the lecture.
  3. Use Worksheet B to demonstrate Strength Based Care Planning for Gerald using BASICS.

Part II

  1. Break participants up into six groups. Give each group one of the sample Problem/Strength menus in BASICS per instructions in Part II of lecture.
  2. Put Resident Need Index on an overhead or use as a handout. Explain from the text how to review an MDS to find resident problems and strengths.
  3. Ask each group to discuss how the problem affects the level of BASICS they have, starting with Biological up to Symbolic.
  4. Ask what other strengths Gerald might have and approaches that might be used under that level of BASICS.
  5. Ask each group to fill out Worksheet C about a resident they know using the instructions under Part II of the interactive exercise portion of the lecture. (See Exercise directions below)
  6. Appoint a timekeeper to give the 10 minute and 15 minute signals to allow participants time to finish up.
  7. Discuss each group's sample resident problems and strengths, and the suggested approaches for each one.
  8. Ask what they learned from the process.
  9. Ask final discussion questions as in lecture.

Exercise: Apply strength-based care planning to a resident you know

Using Worksheet C (PDF, 49KB, 1pg.), ask each group to pick a resident they know and discuss a problem the resident has. Ask how they might use information they know from the MDS, the resident record and information they have gathered from those who know the resident well to plan approaches considering the resident's needs in light of the identified problems and strengths on each level of BASICS. Each member of the group can add suggestions from their experience with the resident. You may use the actual resident MDS to do this if this is done with primary caregivers.

Discuss using flip chart (PDF, 49KB, 1pg.).

Discussion questions about team care planning for a resident:

  1. What is your resident's problem?
  2. What does it mean to the resident and how does it effect the way the resident functions under each level of BASICS?
  3. Which strengths does the resident have under each level of BASICS?
  4. Which goals have you set?
  5. Which approaches do you suggest to meet those goals?
  6. Did you learn more about the resident than you knew before?

The strength based care planning process you have just completed follows the MDS Care Planning Process linking Assessment to Individualized Care Plans. You performed the following steps:

  • Assessment: MDS/worksheets filled out by primary care staff/ ID documentation/Resident's record (You have worked as a team to gather information from all knowledgeable sources, and persons who know the resident including the resident and his/her significant others)
  • Decision-making: ID team considers RAP and summarized information from total assessment of the resident (Because of your input the ID team, each of you as part of the ID team, and also as primary advocates for the resident, can plan better approaches that consider resident's view and preferred problem solving methods)
  • Care Plan Development: Data driven decision-making to develop plan of care (Strength based care planning with real data from those who know the resident to set goals linked to targeted approaches)
  • Care Plan Implementation: All staff is part of the process leading to care plan approaches and implementation. (Because you were part of the process, you can be a more effective caregiver)

Final discussion questions about process

  1. How was this process helpful in helping you to look at care planning in a broader sense?
  2. How do you think this method would be helpful in planning more comprehensive care for your residents?

How could it be incorporated into the present care planning process?

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