Core Principles of

Texas OASIS HCBS

Module 1 - Lesson 2 of 4

Introduction

Every approach to caring for persons living with dementia is based on a combination of values, evidence, and assumptions. These are often grouped together as guiding principles. The guiding principles of Texas OASIS HCBS stress the importance of the following: quality of life for both people who receive services and those who provide them; language; using what works; and seeing behavior as a communication to be understood.

Warm Up

Language matters. Unfortunately, terms like 'walkie-talkie', 'whiner', 'feeder', 'exit-seeker' and 'behavior resident' are all too common in some care facilities. This kind of labeling is disrespectful and dangerous. It limits your ability to see the person and to give person-centered care. Labeling is a bad habit of care providers and it's time to 'kick the habit!'.

For example, instead of calling someone 'sweetie' simply speak to them by name.

Or, for example, instead of asking if someone wants a diaper, you can ask if they want a disposable brief.

Exercise

  1. Read the list of label examples below.
  2. Write down a word or phrase you can use instead to convey more respect.
  • Wanderer
  • Feeder
  • Sweetie
  • Bibs
  • Toilet resident
  • The elderly
  • Wheelchair-bound

Dig In

Core Principles

There are four core principles in Texas OASIS HCBS Dementia:

  • Language matters
  • Person-directed care matters
  • Evidence matters
  • Caregivers matter

Let's take a brief look at each of these.

Language Matters

Language not only tells others what we think, it actually shapes how we think.

For example, describing a person with schizophrenia as 'a schizophrenic' makes us focus on the disease, rather than on the person. Using person-first language fosters a culture of person-centered care.

Using person-first language can be as simple as reversing common phrases to put the person first and some characteristic second. For example, 'a wheelchair-bound resident' becomes 'a person who gets around with a wheelchair'.

Person-Directed Care Matters

Texas OASIS HCBS uses the term person-directed to signal that the drivers of care are the individual person’s goals, dreams, and wishes, not just their needs. In other words, the focus is on who a person is, not just what they have.

In person-directed care, challenging behaviors are viewed as communication of unmet needs. For example, when faced with challenging behavior, you do not ask, How can I get them to stop? Instead, ask the following:

  1. "What is this person trying to tell me?"
  2. "What needs to change to meet their needs?"

You'll further explore this concept of 'behavior is communication' in future lessons.

Evidence Matters

Policy makers, medical directors, and other leaders are more willing to adopt new practices when they are based in something other than personal preferences or beliefs. Texas OASIS HCBS builds on a growing body of knowledge about what does and does not work. This evidence-informed approach helps achieve the twin goals of quality care and quality of life in long-term service and support settings.

Caregivers Matter

Texas OASIS HCBS embraces the idea that better jobs equal better care. OASIS recognizes that caregivers bring valuable knowledge and experience to every encounter. We recognize people are doing the best they can with what they know and provide additional tools so they can do even better. Future lessons will show how to enhance self-care and provide tools for stress reduction.

Wrap Up: Lesson 2

Consider the core principles: Language Matters, Person-Directed Care Matters, Evidence Matters, and Caregivers Matter. Write down at least one action you can take for each core principle. Tell a peer, colleague or supervisor what your action steps are so they can support you. Schedule the action on a calendar or add it to a reminder app to help you track progress.

Here are a few example steps to help you get started. Use one of these, or make one of your own.

Language Matters

I will use person-first language.

I will not use slang.

Evidence Matters

I will use best practices rather than rely on my personal beliefs or assumptions.

Person-Directed Care Matters

I will learn one new, non-medical fact about one of the people in my care.

Caregivers Matter

I will share something I learned with a co-worker.