Minnesota has a “positive supports rule” to improve the quality of life of people who receive DHS-licensed services. It requires providers to avoid use of procedures that may cause pain or humiliation and instead to use a person-centered approach and positive support strategies with people they serve. The strategies build on people’s strengths and teach them skills to communicate and to manage their emotions. The goal is always to maintain a person’s dignity and enhance their well-being.

Duluth Regional Care Center has modeled this approach with “Dan,” who has lived in group homes most of his adult life. Since childhood, Dan had worn a soft helmet when he became upset and expressed his frustrations by banging his head on hard objects. When the Duluth agency acquired the group home where Dan was living, staff saw opportunities to help Dan express himself better and to eliminate the helmet.

The process included help with various assessments, planning and training from the Minnesota Department of Human Services and the Speech and Language Department at the University of Minnesota Duluth

Other, simple actions also had positive results.

“You don’t have to have a Ph.D. in behavioral analysis to find ways to change or eliminate concerning behaviors,” said Michelle Hooey, DRCC program manager. “Sometimes the simplest things have the most impact.”

A digestive problem means that after eating Dan needs to sit up for several minutes, which tests his patience. Now a colorful visual timer helps him understand the passage of time, which reduces anxiety and confusion. Dan can follow a daily routine with a picture calendar showing tooth brushing, range of motion exercises and other things Dan does when he wants to do them. Freedom to pick jeans over khakis, a favorite TV show over a cooking class or sleeping until 11 a.m. on a Saturday leads to a sense of empowerment and satisfaction.

Dan still expresses anger and discontent and may even move toward a wall to try to hit his head. But staff have tools to redirect, to express that they understand his frustration, to help him work through what is bothering him and to offer other choices to make his day the best it can be.