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A picture is worth a thousand words; how maps of people and services can help people share and communicate.

Visual approaches used in other related fields of health and social care (e.g.Intellectual Disabilities) could be helpful in many ways.

Photo of Chris Lawes
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Person Centred Planning has been used for many years within the field of Intellectual Disabilities across the international community.  The usefulness of this approach is that, as part of this, a simple way has been developed to show visually who is involved with the person, and in what way. This helps everyone to know who is involved - and who is doing what.  It also creates a 'living' document that people can work together on and share ideas in a common space - and create together a way forward.

My experience as a son, with my dad, and for my mum who is his main carer, and for my siblings - is that end of life is a whole new world - with no map.  Or perhaps there are maps - but they don't show our lives.  It is made worse in that the landscape is constantly changing, we experience a whole host of services and people who work for different agencies, and do new and different things.  All of whom are talking using different professional languages  at a time when we as a family are under considerable mental and emotional stress.  It is hard to speak to people who provide care and help when it is a foreign territory, and we haven't been there before.

Visualisation approaches of mapping people who are important in our lives and what they do is a well established procedure.  A template is provided, sometimes with an example of another map.  In addition there is training, but often a set of questions is sufficient to ask who is involved, what they do, how they can help...all set within the context of what is important to, and for the person at the centre of the care - or plan for their lives.  The visual map is a one page A4 sheet - and becomes a centre piece of discussion about who is visiting and what they do.  The wider plan, and planning process is a way  of pulling together everyone involved in the care - together with the person and family at the centre to think what is important for them and to plan jointly. Although it gives a picture of who is involved and where they are - it also gives a common way of talking - and a language to share.  So in many ways it becomes a way of mapping a common territory, which is done together - and enables conversations to be had that might not otherwise have occurred.

Following a really helpful comment to this post, I have added two websites, the first I am familiar with, and  which I have used can be found at www.helensandersonassociates.co.uk. You can download  free templates from this site.  I used the relationship template when thinking about my family.  It can be modified by changing the groups of professionals, identified by service areas (e.g. health in the community, hospital, social care, voluntary and care provider agencies).  A second website is one based in the USA is www.allenshea.com.  They discuss the application of person centred planning in the US, as well as the UK experience, and describe how they have extended this approach to people with other disabilities for end of life work, and also in an immensely personal way those trained apply this to their own circumstances. The web site states that "Leigh Ann Kingsbury is currently working on a curriculum to train all parties involved in the communication of end-of-life wishes, using ELP as the foundation for the sharing of that information."


What is a provocation or insight that might inspire others during this challenge?

Drawing maps of services and all the people who are important to the person who is at the end of life - provides a way of talking, sharing, and working together in an area which may help provide a way of drawing together threads of a person's life that might be lost otherwise.

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Photo of James Senior

Maps can be really helpful for patients, caregivers, as well as medical professionals and even peripheral people. Sometimes this is called a multi-actor diagram. I have found that even the act of researching and drafting a multi-actor diagram can allow us to see situations from different perspectives. User Experience Designers can be helpful in visualizing dynamic relationships, especially when the focus is on capturing what is exchanged between each of the people. Thanks Chris!

Photo of Chris Lawes

Hi James,  I absolutely agree.  I haven't used maps in the way that you speak of...but there are so many things to think about I find when using maps. What I like about person centred planning is  that it places the person and their dreams, goals and concerns at the centre, in a respectful and thoughtful way.   I think it is how the process of enquiry occurs that makes so much of a difference  - as well as the negotiated purpose of the process - but maps are so great in freeing up space to think and wonder and create as well as hold issues, in different ways and settings. I haven't come across  multi-actor diagrams before! Thank you - I am learning a lot from this! Chris

Photo of Chris Lawes

Hi James, one further thought - a great value of maps (or diagrams) for me is that it can enable a distanced space to be co-created which means that difficult issues can be thought about safely. Chris

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