WEBVTT 00:00:08.297 --> 00:00:12.989 Person-centered planning 00:00:13.114 --> 00:00:19.930 What does self-determination mean for people with profound intellectual and multiple disabilities? 00:00:20.226 --> 00:00:22.846 It is always very helpful 00:00:22.846 --> 00:00:24.906 when it is possible to 00:00:24.906 --> 00:00:28.086 develop a common code 00:00:28.086 --> 00:00:30.806 in which yes and no are understandable. 00:00:30.806 --> 00:00:34.606 That's always half or three-quarters of the battle, 00:00:34.606 --> 00:00:38.926 because a lot can be asked about it and, in fact, 00:00:38.926 --> 00:00:41.966 the very essential things can simply 00:00:41.966 --> 00:00:44.226 can actually be discussed. 00:00:44.226 --> 00:00:45.786 The challenge is 00:00:45.786 --> 00:00:47.806 if this code is not found 00:00:47.806 --> 00:00:50.048 and because these observations then 00:00:50.068 --> 00:00:52.268 offer much greater scope for interpretation. 00:00:52.268 --> 00:00:57.048 Important prerequisites for self-determination 00:00:57.048 --> 00:01:00.368 are also, for people with high support needs 00:01:00.368 --> 00:01:02.308 access to their own feelings, 00:01:02. 308 --> 00:01:04.828 needs, their own will, 00:01:04.828 --> 00:01:07.828 experiences of self-efficacy, 00:01:07.828 --> 00:01:13.028 which are always linked to the experience of resonance, 00:01:13. 028 --> 00:01:14.648 the experience 00:01:14.648 --> 00:01:17.508 that self-determination is permitted and desired, 00:01:18.594 --> 00:01:21.214 This is not necessarily the case 00:01:21.214 --> 00:01:25.274 in very caring systems. 00:01:25.274 --> 00:01:29.354 Enabling the experience of failure 00:01:29.354 --> 00:01:33.574 and, of course, the experience 00:01:33.574 --> 00:01:36.614 that self-determination is often bound, 00:01:36.614 --> 00:01:39.194 also to the self-determination or referred to 00:01:39.194 --> 00:01:41.554 the self-determination of the other person, 00:01:41.554 --> 00:01:43.874 which always plays a major role 00:01:43.874 --> 00:01:46.074 in the person-centered approach. 00:01:47.490 --> 00:01:49.090 Martha Nussbaum has 00:01:49.090 --> 00:01:51.350 developed a comprehensive concept of self-determination, 00:01:51.350 --> 00:01:52.730 which I find interesting. 00:01:52.730 --> 00:01:57.770 of central importance for a good life, 00:01:57.770 --> 00:01:58.530 she says, 00:01:58. 530 --> 00:02:00.330 is living your own life 00:02:00.330 --> 00:02:04.086 and not someone else's 00:02:04.086 --> 00:02:07. 046 and your own life in your own environment 00:02:07.046 --> 00:02:09.746 and lived in your own context. 00:02:09.746 --> 00:02:12.166 I find that exciting, 00:02:12.166 --> 00:02:13.966 so when you have self-determination, 00:02:13.966 --> 00:02:15.446 that somehow always has 00:02:15.446 --> 00:02:16.906 only to do with this yes or no, 00:02:16.906 --> 00:02:18.526 but of course it goes further than that, 00:02:18.526 --> 00:02:21.326 it's about living a good life 00:02:21.326 --> 00:02:24.486 and having the necessary skills 00:02:24.486 --> 00:02:26.466 that are also necessary for this, 00:02:26.466 --> 00:02:28.226 in addition to self-determination 00:02:28.226 --> 00:02:30.166 or as part of self-determination 00:02:30.166 --> 00:02:31.748 the development of the senses, 00:02:31. 748 --> 00:02:35.928 the development of cognitive skills, 00:02:35.928 --> 00:02:39.728 creativity, affection for things, 00:02:39.728 --> 00:02:42.308 towards people, belonging, 00:02:42.308 --> 00:02:43.548 play, laughter. 00:02:43.888 --> 00:02:46.708 Self-determination is 00:02:46.708 --> 00:02:49.988 a central need among others. 00:02:49.988 --> 00:02:53.728 There are also basic physical needs, 00:02:53.728 --> 00:02:57.768 which often form the basis. 00:02:58.690 --> 00:03:00.150 Physical well-being, 00:03:00.150 --> 00:03:03.110 Safety, protection, and contribution, 00:03:03.110 --> 00:03:05.610 being needed, appreciation, 00:03:05.610 --> 00:03:08.190 empathy, encounter, 00:03:08.190 --> 00:03:10.890 stimulation, spirituality. 00: 03:10.890 --> 00:03:19.106 The person-centered approach puts people at the center. What does that mean in concrete terms? 00:03:19.106 --> 00:03:22.746 Marlies Pörtner refers to Rogers, 00:03:22.746 --> 00:03:26.026 who found that 00:03:26.026 --> 00:03:30.046 even in his counseling practice 00:03:30.046 --> 00:03:34.046 all this knowledge doesn't help him much. 00:03:34.046 --> 00:03:36.206 That's in the background, 00:03:36.206 --> 00:03:40.006 but diagnoses don't help the other person either, 00:03:40.006 --> 00:03:42.926 what's important is listening, 00:03:42.926 --> 00:03:49.622 Intensive listening and then expertise 00:03:49.622 --> 00:03:52.982 for your own solutions to the other person 00:03:52.982 --> 00:03:56.202 and to provide the space 00:03:56.202 --> 00:03:59.722 for the other person to develop their own solutions. 00:04:04.834 --> 00:04:07.994 What does that mean specifically? 00:04:07.994 --> 00:04:14.634 Everyone is an expert on themselves. 00:04:14.634 --> 00:04:18.914 Everyone is different, has their own way, 00:04:18.914 --> 00:04:22.174 and that is a premise of Rogers, 00:04:22.174 --> 00:04:25.414 designed for growth 00:04:25.414 --> 00:04:28.214 and he calls this self-actualization. 00:04:29.282 --> 00:04:32.282 Everyone has their own unique abilities 00:04:32.282 --> 00:04:34.582 for change and problem solving. 00:04:34.582 --> 00:04:38.222 These abilities may be limited. 00:04:38.222 --> 00:04:41.442 But the resource for this needs to be discovered. 00:04:41.442 --> 00:04:44.262 Basically, we don't know 00:04:44.262 --> 00:04:46. 662 what is good for other people, 00:04:46.662 --> 00:04:48.262 only they themselves. 00:04:48.262 --> 00:04:51.442 Everyone must be taken seriously 00:04:51.442 --> 00:04:53.742 in their own way and manner of expression. 00:04:53.742 --> 00:04:57.022 It makes sense to the person concerned, 00:04:57.762 --> 00:05:00.122 even if we sometimes don't understand that meaning. 00:05:00.122 --> 00:05:03.522 The other person is not crazy, 00:05:03.522 --> 00:05:05.082 is not maladjusted. 00:05:05.082 --> 00:05:06.282 We must try to 00:05:06.282 --> 00:05:08.042 put ourselves in his shoes, 00:05:08.042 --> 00:05:11.862 to understand his perception, 00:05:11.862 --> 00:05:14.562 to empathize with him 00:05:14.562 --> 00:05:16.782 and this attempt alone changes something. 00:05:17.355 --> 00:05:25.046 How can the person-centered approach be implemented for people with profound intellectual and multiple disabilities? 00:05:25.634 --> 00:05:29.774 It can be implemented in exactly the same way 00:05:29.774 --> 00:05:31.214 as I have described. 00:05:31.214 --> 00:05:34.894 My counterpart is an expert on themselves. 00:05:34.894 --> 00:05:37.694 I can provide support if needed, 00:05:37.694 --> 00:05:41.194 so that she, he finds his way, 00:05: 41.194 --> 00:05:44.954 but I don't know him and I don't know him better. 00:05:47.490 --> 00:05:48.690 Marlies Pörtner says 00:05:48.690 --> 00:05:50.570 person-centered work means 00:05:50.570 --> 00:05:52.470 not starting from ideas 00:05:52.470 --> 00:05:54.110 how people should be, 00:05:54.110 --> 00:05:56.510 but rather on how they are 00:05:56.510 --> 00:05:58.670 and on the opportunities they have. 00:05:58.670 --> 00:06:01.210 So not this diagnostic, 00:06:01.210 --> 00:06:04.730 educational perspective, but 00:06:04.730 --> 00:06:08.990 not this recourse to previous experience, 00:06:08.990 --> 00:06:13.050 but actual participation. 00:06:13.762 --> 00:06:18.102 Seeking conversation and being in dialogue. 00:06:18.102 --> 00:06:27.822 Communication is something very central, 00:06:27.822 --> 00:06:31.142 even if it is alternative communication. 00:06:31.142 --> 00:06:32.882 Empathy, appreciation. 00:06:33.922 --> 00:06:36.862 These are key elements 00:06:36.862 --> 00:06:43.422 and my authenticity is also, in a way, 00:06:43.422 --> 00:06:47.342 this term is difficult and also hackneyed. 00:06:47.342 --> 00:06:49.782 Rogers calls this competition, 00:06:49.782 --> 00:06:52.302 so my authenticity also in the encounter, 00:06:52.302 --> 00:06:54.302 no pedagogical mask. 00:06:55.490 --> 00:06:59.490 Yes, that plays a role 00:06:59.490 --> 00:07:02.030 in terms of the encounter with the person, 00:07:02.030 --> 00:07:04.910 the person-centered encounter, or does it characterize 00:07:04.910 --> 00:07:08.050 the person-centered encounter with individuals. 00:07:08.050 --> 00:07:11.950 The person-centered approach also applies 00:07:11.950 --> 00:07:16.050 also be applied to groups and teams. 00:07:16.050 --> 00:07:20.550 A person-centered approach can 00:07:20.550 --> 00:07:24.832 also characterize an organization. 00:07:24.832 --> 00:07:26.392 Marlies Pörtner does this, 00:07:26.392 --> 00:07:28.052 I think, very clearly, 00:07:28.052 --> 00:07:30.432 by saying that 00:07:30.432 --> 00:07:34.452 without empowered employees, 00:07:34.452 --> 00:07:37.812 there can be no empowered clients. 00:07:41.634 --> 00:07:43.254 But that also means 00:07:43.254 --> 00:07:44.914 that you somehow start from what 00:07:44.914 --> 00:07:48.194 is there, work in a resource-oriented way, 00:07:48.194 --> 00:07:52.634 clearly recognizes the frame of reference. 00:07:52.634 --> 00:07:53.394 It's not 00:07:53.394 --> 00:07:57.474 that I make the world the way I like it, 00:07:57.474 --> 00:08:01.234 but of course you always refer to realities, 00:08:01.234 --> 00:08:03.934 sometimes you have to mourn things, 00:08:03.934 --> 00:08:05.734 maybe mourn them together. 00:08:05.734 --> 00:08:09.990 When I started 00:08:09.990 --> 00:08:12.310 to work in integration assistance, 00:08:12.410 --> 00:08:15.630 I somehow didn't have 00:08:15.630 --> 00:08:17.750 a plan like this person-centered one. 00:08:17.750 --> 00:08:19.090 And I know we had 00:08:19.090 --> 00:08:24.790 then actually always had support plans. 00:08:24.790 --> 00:08:32.230 And I still remember one lady very clearly. 00:08:32.230 --> 00:08:34.549 I had been working in a residential group 00:08:34.549 --> 00:08:37.590 and we taught her 00:08:38.433 --> 00:08:40.094 that it is extremely important 00:08:40.094 --> 00:08:42.534 for her to put her socks on in the morning. 00:08:42.534 --> 00:08:46.654 And the lady, who was in her mid-50s at the time, 00:08:46.654 --> 00:08:49.174 accepted that for herself too. 00:08:49.174 --> 00:08:52.914 And she had tetraplegia and it was quite 00:08:52.914 --> 00:08:55.294 a lot of energy 00:08:55.294 --> 00:08:56.894 putting on her socks. 00:08:56.894 --> 00:09:00.534 With the result that she would sit at the breakfast table, 00:09:00.534 --> 00:09:04.494 almost fall asleep, and knock over her coffee. 00:09:04.494 --> 00:09:09.786 And yet that was in the support plan 00:09:09.786 --> 00:09:14.806 and with the paradigm of independence 00:09:14.806 --> 00:09:18.226 we continued to work there as well. 00:09:18.226 --> 00:09:20.166 That's not person-centered. 00:09:20.166 --> 00:09:24.166 You would actually look at 00:09:24.166 --> 00:09:25.926 what you want, 00:09:25.926 --> 00:09:27.906 what is important to you in the morning. 00:09:27.906 --> 00: 09:30.206 If it's putting on socks 00:09:30.206 --> 00:09:32.346 and that independence 00:09:32.346 --> 00:09:34.106 is of central importance, 00:09:34.106 --> 00:09:37.654 then you assist them in doing so. 00:09:37.654 --> 00:09:39.014 But when it comes to 00:09:39. 014 --> 00:09:44.374 start the day in a relatively relaxed manner with breakfast, 00:09:44.374 --> 00:09:47.254 person-centered assistance would be 00:09:47.254 --> 00:09:51.094 where I might put on the socks on their behalf 00:09:51.094 --> 00:09:54.874 and then just organize this breakfast situation 00:09:54.874 --> 00:09:58.254 in a resource-oriented way. 00:09:59.458 --> 00:10:07.854 When we were working at the predecessor institution of Macherei, 00:10:07.854 --> 00:10:09.674 I worked there. 00:10:09.674 --> 00:10:11.294 This is a job offer 00:10:11.294 --> 00:10:14.974 for people with high support needs. 00:10:14.974 --> 00:10:21.434 There were very detailed discussions within the team 00:10:21.434 --> 00:10:26.354 about what would be interesting for each individual, 00:10:26.354 --> 00:10:28.774 which group constellations would be good, 00:10: 28.774 --> 00:10:31.834 how we structure the weekly schedule. 00:10:33.058 --> 00:10:35.298 That's not person-centered either. 00:10:35. 298 --> 00:10:39.598 Person-centered is simply asking questions. 00:10:39.598 --> 00:10:41.958 What would you like? 00:10:41.958 --> 00:10:43.878 What interests you? 00:10:43.878 --> 00:10:47.198 Offering a choice and being person-centered 00:10:47.198 --> 00:10:50.958 then designing the weekly schedule together. 00:10:50.958 --> 00:10:55.658 Yes, I think that's key. 00:10:56.322 --> 00:10:57.622 person-centered, 00:10:57.622 --> 00:11:00.922 also to pay attention to resources. 00:11:00.922 --> 00:11:02.982 I said that at the beginning, 00:11:02.982 --> 00:11:03.902 to look at 00:11:03.902 --> 00:11:07.022 how someone wants to use their resources, 00:11:07.022 --> 00:11:08.642 how they can use them. 00:11:08.642 --> 00:11:13.042 That's why part-time arrangements are crucial for people 00:11:13.042 --> 00:11:17.802 who cannot express themselves verbally 00:11:17.802 --> 00:11:20.822 and whose yes/no we do not understand, 00:11 :20.822 --> 00:11:21.862 it's just a matter of 00:11:21.862 --> 00:11:24.262 observing closely and seeing 00:11:24.304 --> 00:11:27.084 if anyone feels comfortable anywhere. 00:11:27.084 --> 00:11:31.984 What impulses does someone give, where and how do we assess 00:11:31.984 --> 00:11:34.924 how do we assess this reaction? 00:11:34.924 --> 00:11:42.044 I also remember a young man in a persistent vegetative state, 00:11:42.044 --> 00:11:47.524 who then, in a very, very 00:11:50.402 --> 00:11:52.262 Yes, very clear setting, 00:11:52.262 --> 00:11:56.762 in such massage situations, the colleague had observed 00:11:56.762 --> 00:12:00.402 that the hairs on the arm stand up. 00:12:00.402 --> 00:12:01.722 And of course you then have to look to see 00:12:01.722 --> 00:12:05.602 somehow this hair standing up on your arm, 00:12:05.602 --> 00:12:07.182 is that some kind of reaction, 00:12:07.182 --> 00:12:09.002 expresses well-being. 00:12:09.002 --> 00:12:09.522 Then you can 00:12:10,690 - -> 00:12:12,430 talk to the relatives, 00:12:12.430 --> 00:12:13.950 start a conversation there, 00:12:13.950 --> 00:12:16.550 somehow well-being becomes apparent 00:12:16.550 --> 00:12:19.330 in this person and then 00:12:19.330 --> 00:12:24.050 you tailor your services accordingly. 00:12:24.050 --> 00:12:30.450 Person-centered care also means participation 00:12:30.450 --> 00:12:32.650 in organizational development or 00:12:32.650 --> 00:12:36.650 cooperation in organizational development. 00:12:36.650 --> 00:12:38.810 Here, too, I noticed 00:12:39.714 --> 00:12:43.554 that this trust 00:12:43.554 --> 00:12:46.654 of participation can initially also be perceived as unreasonable by individuals 00:12:46.654 --> 00:12:48.814 can be perceived as unreasonable, 00:12:48.814 --> 00:12:51.114 but then the organization 00:12:51.114 --> 00:12:54.254 actually develops in such a way 00:12:54.254 --> 00:12:56.014 that there is a high level of satisfaction 00:12:56.014 --> 00:13:00.414 for everyone through clear forms of participation. 00:13:00.414 --> 00:13:09.279 How important is person-centered planning for people with profound intellectual and multiple disabilities to live as independently as possible? 00:13:09.282 --> 00:13:13.782 Self-determined life planning is not possible 00:13:13.782 --> 00:13:20.982 unless the planning is person-centered. 00:13:20.982 --> 00:13:24.222 This is, of course, a major challenge. 00:13:24.222 --> 00:13:30.362 There are people with profound intellectual and multiple disabilities. 00:13: 30.362 --> 00:13:33.242 That's a broad field. 00:13:35.586 --> 00:13:39.306 I don't think anyone defines themselves that way, 00:13:39.306 --> 00:13:43.126 but they are defined that way somehow. 00:13:43.126 --> 00:13:45.806 And for individual people, 00:13:45.806 --> 00:13:49.786 who are present to me in this category, 00:13:49.786 --> 00:13:52.506 they already have very clear ideas 00:13:52.506 --> 00:13:54.346 about their future 00:13:54.346 --> 00:14:00.886 and also very clear about what their future is not 00:14:00.886 --> 00:14:04.066 within this system, and they mourned that too. 00:14:05.058 --> 00:14:08.158 That was quite a challenge 00:14:08.158 --> 00:14:11.818 and yet we looked at it together, 00:14:11.818 --> 00:14:15.758 at least in the context of work or in the context of living, 00:14:15.758 --> 00:14:20.378 how their wishes 00:14:20.378 --> 00:14:26.018 and their wills were fulfilled in relation to their own lives. 00:14:26.018 --> 00:14:29.718 Sometimes it was also very difficult for individuals. 00:14:30.370 --> 00:14:32.910 to recognize that at all. 00:14:32.910 --> 00:14:34.170 Then it was a matter of 00:14:34.170 --> 00:14:38.470 formulating wishes, sometimes against the parents 00:14:38.470 --> 00:14:42.310 and also against staff. 00:14:42.310 --> 00:14:47.022 I still remember a young man very clearly 00:14:47.022 --> 00:14:49.722 who said in a future conference, 00:14:49.722 --> 00:14:51.022 I want a TV. 00:14:51.022 --> 00:14:54.582 And the parents then said, 00:14:54.582 --> 00:14:56.162 no, no, that's not going to happen. 00:14:56.162 --> 00:14:59.282 So the first thing was to push that through 00:14:59.282 --> 00:15:02.122 and see, okay, that's it, 00:15:02.122 --> 00:15:03.682 that's what I want. 00:15:03.682 --> 00:15:08.882 With people who don't communicate verbally 00:15:08.882 --> 00:15:10.382 and whom we don't understand, 00:15:11.138 --> 00:15:13.338 or whom I don't understand, 00:15:13.338 --> 00:15:16.298 it's even more of a challenge. 00:15:16.298 --> 00:15:18.298 What does life planning look like? 00:15:18.298 --> 00:15:21.878 In the meantime, there are good methods 00:15:21.878 --> 00:15:25.138 for personal future planning, 00:15:25.138 --> 00:15:29.358 which are also adapted or expanded for people with high support needs 00:15:29.358 --> 00:15:32.658 or expanded, 00:15:32.658 --> 00:15:33.738 I believe 00:15:33. 738 --> 00:15:36.178 there is also an excellent opportunity to 00:15:36.178 --> 00:15:39.720 to then use this future planning in the appropriate 00:15:39.720 --> 00:15:44.680. especially in the corresponding transition phases 00:15:44.680 --> 00:15:47.780 with the appropriate support network. 00:15:47.780 --> 00:15:50.760 So when planning, I think it's important 00:15:50.760 --> 00:15:56.320 that you always refer to the needs, 00:15:56.320 --> 00:15:58.260 approaching the needs, 00:15:58.260 --> 00: 16:02.620 which are also the reason for choosing 00:16:02.620 --> 00:16:04.360 certain strategies. 00:16:05.282 --> 00:16:07.542 You can fulfill a need 00:16:07.542 --> 00:16:10.522 with very different strategies 00:16:10.522 --> 00:16:12.482 and it's about somehow also looking at 00:16:12.482 --> 00:16:16.862 which strategy is a good one 00: 16:16:862 --> 00:16:19.682 and is appropriate in our context, 00:16:19.682 --> 00:16:24.634 so that this need can also be met. 00:16:24.634 --> 00:16:26.414 I think it's important 00:16:26.414 --> 00:16:29.614 not to get into something mechanical 00:16:29.614 --> 00:16:32.494 and not just into something that can be broken down. 00:16:32.494 --> 00:16:36.734 And it's about participation goals 00:16:36.734 --> 00:16:43.094 and not necessarily learning goals or support goals. 00:16:43.094 --> 00:16:47.654 In a person-centered approach, 00:16:47.654 --> 00:16:48.654 as I understand it, 00:16:48.654 --> 00:16:51.936 would not be support goals anyway, but at best educational goals, 00:16:51.936 --> 00:16:54.216 because only this term also 00:16:54.216 --> 00:16:57.996 this subjectivity of the other person 00:16:57.996 --> 00:16:59.796 then also represents. 00:16:59.796 --> 00:17:05.036 The challenge is that these plans 00:17:05.036 --> 00:17:07.496 are very time-consuming. 00:17:08.417 --> 00:17:12.430 With the Federal Participation Act, 00:17:12.430 --> 00:17:15.970 this life planning is part of the overall planning process. 00:17:15.970 --> 00:17:18.250 However, the time required for this is not specified. 00:17:18.250 --> 00:17:19.650 In some federal states, 00:17:19.650 --> 00:17:20.630 they have already determined 00:17:20.630 --> 00:17:22.010 it will be one hour. 00:17:22.010 --> 00:17:26.890 This means that people with high support needs 00:17:26.890 --> 00:17:29.930 out of these plans. 00: 17:32.450 --> 00:17:34.450 That is why it will be important to 00:17:34.450 --> 00:17:37.670 make this very clear, 00:17:37.670 --> 00 :17:41.250 what the goal and desire in life is. 00:17:41.250 --> 00:17:50.809 What challenges do employees face when implementing person-centered planning? 00:17:50.818 --> 00 :17:51.058 I believe 00:17:51.058 --> 00:17:54.518 it is of central importance 00:17:54.518 --> 00:17:57.358 to reflect on this dependency, 00:17:57.358 --> 00:18:01.038 to reflect on where I am dependent, 00:18:01.038 --> 00:18:03.938 what role does dependency play in my life 00:18:03.938 --> 00:18:08.198 and then to see again 00:18:08.198 --> 00:18:11.638 what role it plays, what dependence, 00:18:11.638 --> 00:18:13.898 what role dependence plays, if any, 00:18:13.898 --> 00:18:17.598 for a role for my counterpart and there 00:18:17.598 --> 00:18:20.098 to be mindful of that 00:18:20.144 --> 00:18:24.824 and always to reflect on this dependency 00:18:24.824 --> 00:18:27.964 and to consider 00:18:27.964 --> 00:18:32.764 to what extent power and, above all, domination 00:18:32.764 --> 00:18:43.544 are very subtly conveyed in part. 00:18:46.242 --> 00:18:49.302 It is important to have a high level of expertise 00:18:49.302 --> 00:18:56.702 and a high level of sensitivity, reduction. 00:18:56.702 --> 00:18:59.582 To repeatedly make it clear 00:18:59.582 --> 00:19:01.822 that the other person is part of the situation, 00:19:03.330 --> 00:19:08.090 not just a representative of their needs, 00:19:08.090 --> 00:19:12.110 to work on it again and again and very clearly 00:19:12.110 --> 00:19:15.130 that communication barriers are broken down, 00:19:15.130 --> 00:19:18.270 that there is time for communication, 00:19:18.754 --> 00:19:23.510 the willingness to understand the other person, 00 :19:23.510 --> 00:19:25.290 to understand the other, 00:19:27.458 --> 00:19:30.358 to include the other, 00:19:30.358 --> 00:19:33.118 statements, even if I don't understand them, 00:19:33.118 --> 00:19:36.838 are relevant and are significant, 00:19:36.838 --> 00:19:40.038 to try to approach it, 00:19:40.038 --> 00:19:44.298 what is being communicated there, so that 00:19:44.298 --> 00:19:46.978 a common horizon of understanding can be developed. 00:19:48.066 --> 00:19:52.606 With people who communicate alternatively, 00:19:52.606 --> 00:19:54.386 whom I may not understand, 00:19:54.386 --> 00:19:57.606 this requires intensive observation. 00:19:57.606 --> 00:20:01.486 Also, both in relation to these communicative settings, 00:20:01.486 --> 00:20:05.466 but also when it comes to pain, for example, 00:20:05.466 --> 00:20:08.806 in order to classify behavior. 00:20:08.806 --> 00:20:13.286 A high level of competence is required 00:20:13.286 --> 00:20:16.006 in terms of care and health. 00:20:16.048 --> 00:20:21.348 There is only basal stimulation, etc., 00:20:21.348 --> 00:20:26.668 there are central concepts and skills 00:20:26,668 that are necessary. 00:20:28,508 Then there is the skill of breaking down barriers to participation. 00:20:33.688 --> 00:20:37.048 Enabling experiences, 00:20:37.048 --> 00:20:39.088 Enabling self-efficacy, 00:20:39.088 --> 00:20:41.168 enabling social recognition. 00:20:41.168 --> 00:20:45.790 Professionalism means 00:20:45.790 --> 00:20:52.390 that professionals see themselves as assistants. 00:20:52.390 --> 00:21:00.090 The employer is the person who needs support 00:21:00.090 --> 00:21:03.130 and that means that this reversal of power is put into practice. 00:21:04.066 --> 00:21:08.346 And professionalism also consists of 00:21:08.346 --> 00:21:12.206 participatory structures and processes or, 00:21:12.206 --> 00:21:15.506 as you say, cooperative structures 00:21:15.506 --> 00:21:21.306 and processes in the institution. 00:21:21.306 --> 00:21:24.426 The challenge lies in 00: 21:24.426 --> 00:21:28.706 that this expertise is hardly recognized, 00:21:28.706 --> 00:21:32.706 that it is underpaid. 00:21:32.706 --> 00:21:40.833 How important is cooperation for the implementation of person-centered planning? 00:21:40.834 --> 00:21:43.914 Cooperation is of central importance 00:21:43.914 --> 00:21:46.974 with the client. 00:21:46.974 --> 00:21:51.554 Without successful cooperation, it will not work. 00:21:51.554 --> 00:21:53.874 And if there are conflicts, 00:21:53.874 --> 00:21:56.774 it's just important to look at 00:21:57.794 --> 00:22:01.174 what different needs are there in the room 00:22:01.174 --> 00:22:04.954 and how can we best achieve 00:22:04.954 --> 00:22:08.854 to realize these different needs. 00:22:08.854 --> 00:22:12.174 Sometimes it's also about conflict, 00:22:12.174 --> 00:22:18.014 also about seeing self-efficacy, 00:22:18.014 --> 00:22:20.094 how the other person reacts. 00:22:20.094 --> 00:22:23.554 That is perhaps central 00:22:23.554 --> 00:22:25.614 and that also needs space. 00:22:26.786 --> 00:22:33.330 It requires cooperation throughout the entire setting, 00:22:33.330 --> 00:22:35.310 especially with people 00:22:35.310 --> 00:22:38.350 who need a lot of support 00:22:38.350 --> 00:22:42.570 you are dependent on exchange, 00:22:42.570 --> 00:22:46.990 very close cooperation with the primary caregivers, 00:22:46.990 --> 00: 22:51.250 in order to be able to build on these early experiences, 00:22:51.250 --> 00:22:52.870 to understand 00:22:52.870 --> 00:22:56.350 what, for example, does this hair standing on end mean, 00:22:56.850 --> 00:22:59.692 What does this vocalization mean? 00:22:59.692 --> 00:23:04.392 So there are usually already forms of communication, 00:23:04.392 --> 00:23:06.552 which are not immediately noticeable 00:23:06.552 --> 00:23:08.352 and they also have to be reported, 00:23:08.352 --> 00:23:09.312 can perhaps, 00:23:09.312 --> 00:23:10.812 cannot be transferred, 00:23:10.812 --> 00:23:14.892 but you can then get closer to understanding 00:23:14.892 --> 00:23:18.232 and better assess the situation. 00:23:21.442 --> 00:23:23.842 You cooperate and at the same time look 00:23:23.842 --> 00:23:25.542 but in cooperation, 00:23:25.542 --> 00:23:28.802 that areas of participation are also separate. 00:23:28.802 --> 00:23:34.222 So, despite all cooperation, differences must be possible, 00:23:34.222 --> 00:23:36.162 different behavior 00:23:36.162 --> 00:23:40.762 of people in different situations, 00:23:40.762 --> 00:23:42.162 with different people, 00:23:42.162 --> 00:23:46.102 but also in different areas of participation. 00:23:46.102 --> 00:23:47.882 I'm interested in 00:23:47.882 --> 00:23:49.122 I need to be at work 00:23:49.122 --> 00:23:51.484 necessarily interested in how the morning 00:23:51.484 --> 00:23:54.084 was in the residential group, 00:23:54.084 --> 00:23:57.664 that may be relevant, but it doesn't have to be, 00:23:57.664 --> 00:23:59.804 because sometimes I'm also in a bad mood in the morning 00:23:59.804 --> 00:24:03.004 at the breakfast table and then pull myself 00:24:03.004 --> 00:24:06.224 together at work, or vice versa. 00:24:06.224 --> 00:24:11.044 That also plays a role, and it's also about rights, 00:24:11.044 --> 00:24:14.764 including the right to informal self-determination. 00:24:16.962 --> 00:24:18.942 Yes, challenges. 00:24:18.942 --> 00:24:21.502 Where are the challenges in relation 00:24:21.502 --> 00:24:23.902 to this cooperation 00:24:23.902 --> 00:24:26.942 and conflict-prone challenges? 00:24:26.942 --> 00:24:29.802 On the one hand, one challenge is 00:24:29.802 --> 00:24:33.382 maintaining a consistently person-centered approach, 00:24:33.382 --> 00:24:36.742 that you have to work on again and again. 00:24:36.742 --> 00:24:38.122 So you don't have that. 00:24:38.122 --> 00:24:41.382 You have to reflect on it again and again, 00:24:41.382 --> 00:24:44.042 you need clear feedback structures. 00:24:44.944 --> 00:24:46.744 Internal feedback, 00:24:46.744 --> 00:24:48.444 but also external feedback, 00:24:48.444 --> 00:24:52.344 in order to control these dependencies 00:24:52.344 --> 00:24:54.044 and 00:24:54.044 --> 00:24:58.124 because, in some cases, people with disabilities 00:24:58.124 --> 00:25:00.504 do not provide this feedback directly. 00:25:00.504 --> 00:25:02.024 That's why it's important. 00:25:02.024 --> 00:25:06.164 And yes, often 00:25:07.234 --> 00:25:11.094 this idea of caring is so strong. 00:25:11.094 --> 00:25:15.054 And also, yes, you do that, 00:25:15.054 --> 00:25:16.994 or yes, not somehow, 00:25:16.994 --> 00:25:18.294 because you're evil, 00:25:18.294 --> 00:25:19.614 but somehow because you think 00:25:19.614 --> 00:25:20.774 you're doing the best thing. 00:25:20.774 --> 00:25:23.994 And to say, okay, that's good, 00:25:23.994 --> 00:25:25.614 but better, is simply asking. 00:25:25.614 --> 00:25:26.974 And you don't know. 00:25:26.974 --> 00:25:29.934 That's often a challenge, 00:25:29.934 --> 00:25:33.634 to make that change in attitude 00:25:34.530 --> 00:25:36.850 and to make it clear 00:25:36.850 --> 00:25:38.710 and to manage 00:25:38.710 --> 00:25:40.650 and to keep getting it right. 00:25:40.650 --> 00:25:48.590 Another challenge is 00:25:48.590 --> 00:25:51.670 especially when it comes to 00:25:51.670 --> 00:25:55.490 the duty of care and the duty of diligence. 00:25:55.490 --> 00:26:01.322 What is it like when a person 00:26:01.322 --> 00:26:04.382 engages in self-harming behavior, 00:26:04.382 --> 00:26:06.042 how do you cope with that, 00:26:06.042 --> 00:26:11.582 when someone behaves in a way that is harmful to others, 00:26:11.582 --> 00:26:14.102 that's not acceptable either, 00:26:14.102 --> 00:26:16. 162 there also need to be limits. 00:26:16.162 --> 00:26:18.342 What alternatives can we find, 00:26:18.342 --> 00:26:21.362 what alternatives can we offer, 00:26:21.362 --> 00:26:25.582 develop alternative courses of action 00:26:25.582 --> 00:26:28.062 and it is simply essential 00:26:28.062 --> 00:26:32.604 to have external moderators lead support conferences 00:26:32.604 --> 00:26:37.004 and, in certain situations, to also work with 00:26:37.004 --> 00:26:40.044 ethical councils, for example. 00:26:40.044 --> 00:26:44.744 So the question is, what works? 00:26:44.744 --> 00:26:46.164 Well, I believe 00:26:46.164 --> 00:26:51.864 that success is not necessarily in harmony, 00:26:51.864 --> 00:26:52.484 but 00:26:53.282 --> 00:26:56.562 success can also simply be in friction, 00:26:56.562 --> 00:26:58.482 can be in conflict. 00:26:58.482 --> 00:26:59.602 For me, I think, 00:26:59.602 --> 00:27:01.242 much more likely to succeed. 00:27:01.242 --> 00:27:03.502 Success is also 00:27:03.502 --> 00:27:05.262 when different opinions 00:27:05.262 --> 00:27:06.802 can coexist, 00:27:06.802 --> 00:27:09.002 you can also take different paths 00:27:09.002 --> 00:27:11.682 and thus also have different possibilities 00:27:11.682 --> 00:27:15.662 have different possibilities and points of reference. 00:27:18.978 --> 00:27:20.578 At the same time, 00:27:20.578 --> 00:27:22.138 especially when 00:27:22.138 --> 00:27:23.198 when you realize 00:27:23.198 --> 00:27:29.478 okay, we can't find a good setting 00:27:29.478 --> 00:27:31.778 or the setting is no longer good, 00:27:31.778 --> 00:27:36.698 then of course you have to sit down together 00:27:36.698 --> 00:27:38.538 and also deal with it 00:27:38.538 --> 00:27:43.374 investigate possible causes, 00:27:43.374 --> 00:27:45.934 preferably together with another person 00:27:45.934 --> 00:27:49.174 and then see what it is. 00:27:49.174 --> 00:27:53.134 And first of all, it's always about 00:27:53.134 --> 00:27:57.722 especially with difficult behavior 00:27:57.722 --> 00:28:00.262 or problematic behavioral changes, 00:28:00.262 --> 00:28:01.602 where you realize, okay, 00:28:01.602 --> 00:28:04.242 someone is also acting against themselves 00:28:04.242 --> 00:28:07.862 and that's just not good for them, 00:28:07.862 --> 00:28:12.082 to rule out physical causes first. 00:28:12.082 --> 00:28:13.802 Fortunately, there are 00:28:13.802 --> 00:28:16.442 developments with these MZEBs, 00:28:16.442 --> 00:28:19.062 where you can actually take 00:28:19.062 --> 00:28:21.742 a completely different diagnostic approach, 00:28:23.266 --> 00:28:26.346 and then perhaps also 00:28:26.346 --> 00:28:28.986 with a metal educational exercise 00:28:28.986 --> 00:28:30.666 ETC again, 00:28:30.666 --> 00:28:33.446 that someone's needs are being met. 00:28:33.558 --> 00:28:38.082 Basically, I believe 00:28:38.082 --> 00:28:39.642 so I am completely convinced 00:28:39.642 --> 00:28:42.142 of this person-centered approach, 00:28:42.142 --> 00:28:44.182 because you have far fewer conflicts 00:28:44.182 --> 00:28:46.222 than is usual. 00:28:46.222 --> 00:28:47.662 Because I don't, 00:28:47.662 --> 00:28:49.802 people have to, so to speak, 00:28:49.802 --> 00:28:53.562 behave according to my ideas. 00:28:53.562 --> 00:28:57.422 You don't have to have any anachronisms either. 00:28:57.422 --> 00:28:58.722 In the residential groups, you 00:28:58.722 --> 00:29:01.702 often have table situations, 00:29:01.702 --> 00:29:02.682 somehow I never 00:29:02.682 --> 00:29:03.942 saw that at my parents' house. 00:29:03.984 --> 00:29:06.504 They're anachronisms. 00:29:06.504 --> 00:29:08.904 I don't know what they're playing there, 00:29:08.904 --> 00:29:11.064 I mean, what plays they are, 00:29:11.064 --> 00:29:15.024 what kind of performance they're putting on 00:29:15.024 --> 00:29:17.204 and what kind of performance they're being forced into. 00:29:17.204 --> 00:29:19.064 And of course, people 00:29:19.064 --> 00:29:21.144 don't feel like doing that at all. 00:29:21.144 --> 00:29:24.544 For me, success is also 00:29:24.544 --> 00:29:27.244 when people decide for themselves 00:29:27.244 --> 00:29:31.024 how much energy they put into what 00:29:31.024 --> 00:29:33.212 and if that is not possible, 00:29:33.212 --> 00:29:34.572 if they can't do it themselves, 00:29:34.572 --> 00:29:37.032 check it on their behalf. 00:29:37.032 --> 00:29:41.932 Because that's also the case in many daycare centers in particular, 00:29:41.932 --> 00:29:44.492 so I actually think it's a disaster 00:29:44.492 --> 00:29:46.112 when someone is totally tired 00:29:46.112 --> 00:29:48.032 and then somehow 00:29:48.032 --> 00:29:49.932 has to get through a leisure program 00:29:49.932 --> 00:29:51.592 or can somehow recover, 00:29:51.592 --> 00:29:53.452 by somehow nodding off at the table. 00:29:53.452 --> 00:29:56.292 Well, I don't relax at work. 00:29:56.292 --> 00:29:59.012 If you do things differently, 00:29:59.012 --> 00:30:01.260 introduce a part-time program, working time regulations, 00:30:01.260 --> 00:30:03.920 then a lot can be achieved. 00:30:03.920 --> 00:30:09.100 And also in relation to daycare centers 00:30:09.100 --> 00:30:11.520 or work-oriented services, 00:30:11.520 --> 00:30:14.680 if that can be tested 00:30:14.680 --> 00:30:16.120 and that can also be done, 00:30:16.120 --> 00:30:19.740 whatever I feel like doing, and then I realize, 00:30:19.740 --> 00:30:21.420 okay, so that interests me 00:30:21.420 --> 00:30:23.340 and I want to develop myself further in that area, 00:30:23.340 --> 00:30:27.820 then there's no need for motivational work at all, 00:30:29.048 --> 00:30:32.448 which is extremely relieving, 00:30:32.448 --> 00:30:35.568 because, ideally, everyone does 00:30:35.568 --> 00:30:39.008 what interests them.