Frontline Initiative: Health and Wellness

The Key to Successful Health Care Appointments through One-page Descriptions

Author

LeAnn Bieber is a parent and Person-Centered Thinking trainer/planner in Rochester, Minnesota. LeAnn also supports her daughter, Melissa, in attending doctors’ appointments.

Melissa is a woman smiling, with reddish-blonde hair. She is wearing a royal blue tee-shirt with a logo that reads "Byron Bellas," cut-off jean shorts, and a pink sweatshirt that is unzipped. She is sitting on a huge rock beside a lake. Across the lake is a forested hillside and there are mountains in the distance. There are trees near her. She holds a water bottle in one hand and a snack in the other.

Melissa taking a water and snack break in the beauty of the mountains.

Medical and dental appointments can be stressful for all of us. We naturally find ways to cope with the stress and anxiety. While waiting for appointments, people may cope by playing a game on a phone or tablet, checking email, reading a magazine or newspaper, people-watching, or writing a to-do list. During the appointment, people might bring a list of questions, take deep breaths before the provider arrives, or maybe close their eyes for needlesticks or other procedures.

A one-page description (sometimes referred to as one-page profile) with a Health Care Person-Centered Profile are tools that provide medical and dental providers with vital information before entering an examining room.

For some people, knowing and waiting for appointments can be overwhelming. It is a fear that triggers our fight-or-flight response. Direct support professionals (DSPs) should support people to ensure a successful visit for their health and well-being. A quick, positive introduction on how best to support the person could be key to a successful appointment. You as a DSP can provide this! A one-page description (sometimes referred to as a one-page profile ) with a Health Care Person-Centered Profile PDF is a tool that provides medical and dental providers with vital information before entering an examining room.

A one-page description has at least three sections:

  1. What people like and admire about me (which describes a person’s strengths, gifts, and talents)
  2. What is important to me, and
  3. How best to support me.

Talking about what is important to a person and how they want to be supported during their appointments helps the person and the medical provider know what to expect.

Knowing the person’s strengths, gifts, and talents helps with that small talk with the health care provider. This can be calming and reassuring during the appointment. Talking about what is important to a person and how they want to be supported during their appointments helps the person and the medical provider know what to expect. A person may have more than one provider or even a team of people. The one-page description is a great, quick introduction for everyone on the team.

Melissa’s One-page Description

I am sharing with you my daughter Melissa’s one-page description as an example of the type of information that you may provide the health care provider for the person you support. Sharing this type of information can really help the appointment go smoothly for everyone. On Melissa’s one-page description, we included a photo of her. In the photo, you see Melissa: a sweet, happy person who makes people smile when she walks into a room. She likes talking and connecting with others and will do so if the provider gives her extra time to answer a question or respond. Using visual options helps Melissa respond quickly.

My Health Care Person: Melissa Bieber

What people appreciate about me:

  • I know what I like and want
  • My smile, my laugh, my dance moves and my appreciation for music
  • Melissa is a woman smiling, with reddish-blonde hair. She is wearing a royal top. She is in a horse barn with windows behind her.

What is important to me

  • Having people I know around me
  • Being included even when I may not say anything
  • Having something in my hands, a bottle, picture, paper

Things I like to do:

  • Watch movies
  • listen to music
  • Look at pictures
  • Color and art projects sometimes

How to best support me:

  • Inform me of choices, visual is best for a quicker response
  • Know I need time to answer questions. Three times what you might take, I may or may not respond
  • I like to laugh. Sometimes I need extra support to understand why I am laughing. Please see my communication chart to know whom to support me.
  • I do NOT like shouting or sudden noises. Sometimes I struggle with children crying, being loud, or being extra active.
  • Sometimes what I pick up may not be mine or be something others may think I should have. Support my choices: If it is something that belongs to someone else or a safety concern, encourage me to find something else or give me something else.

This Health care person-centered profile was completed by:

  • Me
  • Someone else (specify name and role)

Logo for CMS

A Blue and a yellow half circle starting at low left to the upper right around Large blue letters CMS

Logo for ACL

Three Icons of a person holding their arm up as if they were holding a big sign, Image of their arms and head. Each is a different color, blue, yellow, and red. The three icons meet in the center with the heads being the farthest away from the middle.

Logo for NCAPPS

Curricular image with the left half being yellow, the upper right being blue and the lower left being red. In the middle of the circle is a white diamond-like shape.

Visit ncapps/aci.gov for tips on filling out this form.

Melissa's health care person-centered profile.

Melissa loves to carry things – her most famous is a coffee cup. She will also pick up bottles, paper wrappers, etc., so bringing her own things can sometimes prevent her from picking up things that are not hers. The coffee cup, a movie, or a book are great communication starters. Like cell phones may be for others, these items provide comfort and positive control for her. Working around these items or asking her to put things down temporarily will work for her. She needs to be asked and shown where, knowing she will get them back quickly.

Some creative thinking can help support her. She becomes scared if asked to lay down or walk into some mechanism that limits her personal space, or if an examination chair is moved higher or back. Finding alternative, and sometimes creative, ways to perform the task might be needed. She has had many unsuccessful appointments when this hasn’t happened.

Medical and dental providers know that step-by-step instructions can help the patient to know what to expect. However, Melissa can get caught up on the first step and become afraid. Instead of telling her each step, completing the task quickly is a better approach. With a one-page description, the provider knows what is best for Melissa. It helps make the visit more successful.

It is important to Melissa to be included in conversations, although she knows her mom will provide the answers. It is also important to her to know when processes are not going to happen. For example, she currently receives weekly blood draws. Walking into the clinic can trigger anxiety from other experiences. If you tell her, “today we are just going to talk,” it lowers her stress level. However, being up-front and honest is important. If she is having a blood draw, saying nothing allows her to prepare herself. Then, encouraging words remind her that the procedure is quick.

Support During the COVID-19 Pandemic: Health Care Person-centered Passport

During the COVID-19 pandemic, many people with disabilities had to visit practitioners alone, without support from a DSP or family member. Two organizations—Support Development Associates (SDA) and the National Center on Advancing Person-Centered Practices and Systems (NCAPPS)—introduced the health care person-centered passport or profile that is added to a one-page description. This additional page shows the pertinent medical information that the health care providers should know about the person’s symptoms. The other page is a quick read to remind a care team how best to support the person during a stressful time. It includes things like how to help someone get calm, who is important to them, who they can call if needed, and what not to do or say. Again, when shared or posted for everyone on the team to read, it provides the pertinent information from one place. NCAPPS provides Instructions and an Example of the Health Care Person-centered Passport or Profile.

Melissa’s One-Page Description Image

Melissa is a woman smiling, with reddish-blonde hair. She is wearing a royal blue top. She is in a horse barn with windows behind her. Under her photos, it says Melissa during her appointments.

My strengths.

  • I know what I like/want
  • Dance moves
  • Collector
  • Artist
  • Personable
  • Creative in expression

Photo of a brown horse from the front and side view, with a light-colored mane.

Things I like to do.

  • Watch movies, especially about horses,
  • Color, Art projects,
  • cook, bake,
  • dance, listen to music,
  • watch tv,
  • hang out with friends.

What is important to me?

  • Spending time with friends and family
  • Having choices throughout my life
  • Being independent, being active
  • Being included
  • Time (more than you think) to do activities
  • Something in my hands

How to best support me.

  • I need choices and time to decide (more than you think, if you interrupt that time the pause starts over),
  • I respond quicker to visual options if available,
  • I know the things I like to carry can sometimes be in the way. If I need to set them down, ask me. If I know I will get them back, I will be fine.
  • I don’t do well with equipment that moves me or laying down. Finding creative ways to do what is needed helps me.
  • I struggle with shouting, loud noises or people abruptly in front of me. Keep a calm atmosphere so I don’t become overwhelmed.
  • Although telling me everything is respectful sometimes just doing what you need to do is more successful.
  • Music can be calming to me.

Photo of six different colored brown horses running in the same direction.

Melissa’s one-page description.

Covid-19 Passport: Your Name Here. See reverse for health care person-centered profile.

First name: Melissa

Nick name

Last name DOB or Age

Street address

City, state, zip

Emergency contact: LeAnn Bieber

Emergency Contact Phone/email

Parent/Legal Representative: Curtis Bieber

Parent/Legal Representative Phone / Email

Insurance Information

Pharmacy Information (most commonly used)

Primary Care Provider Contact Information: Olmsted Medical Center SE Clinic

Specialty Care Provider Contact Information: Mayo Clinic Psychiatry

Current symptoms / risks factors

Current Covid-19 Symptom When it started

Temp over 100,4F

Dry Cough

Malaise / Fatigue

Shortness of Breath

Nasal Congestion

Diarrhea

Loss of Smell/ Taste

Sore Throat Low Blood Oxygen

Headache

Covid-19 Severity Risk Factors (check all that apply)

Long-term care resident

Transplant

COPD/Emphysema/Asthma

Current/former Smoker

Liver Disease

Intellectual disorder

Heart disease

Corticosteroid use

Mental illness / substance use

Cancer

Age 65 or older

Pregnant

Severe obesity (40=BMI)

HIV/AIDS

Kidney disease

Homeless

Other

Note: Information on this form may not be complete:

Heath Condition List

Medication List

200 mg AM 200 mg PM

One tablet in morning / extended cycling

½ capful in morning with juice

Allergies

Person has do not resuscitate (DNR) order – Location if known

Person has advance directive – location if known

Person has psychiatric advance directive or other advance crisis planning tool and or has a designated heath care proxy decision-maker – location of document and or contact information if know:

Important – Health care Person-centered profile on reverse side

Melissa's health care person-centered passport.

Melissa is a young woman wearing a riding helmet and green tee-shirt with a name tag. She is wearing blue jeans and sitting on a practice horse as she is getting used to the feel of the saddle. She has long brown hair, and brown eyes, and is beaming with joy and confidence.

Melissa beams with joy and confidence as she gets ready to ride a horse.

Health care providers appreciate any tips they can use to best support their patients. Providing them with these tools creates unity that is vital for successful, effective appointments. As a DSP, you are part of that solution!

Resources

National Center on Advancing Person-Centered Practices and Systems (NCAPPS)

Helen Sanderson & Associates One-page Profiles

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A Closer Look

In episode 2 of this podcast, host Chet Tschetter talks with author Leann Bieber about healthcare person-centered profiles.

Listen to all episodes here, or anywhere you get your podcasts.