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Posted: July 06, 2005

Professional Caregiving

Groups That Work -- A Guide for Professionals

Facilitating groups for caregivers over many years, I have collected pearls of wisdom from my own experiences, those of colleagues and others in the field. Some tips will give you ways to incorporate new topics successfully into your groups, others are more focused on group dynamics and group leadership.

Use of Role Play and other Communication techniques

  • Role playing can be used in many circumstances, to help caregivers practice communication in a variety of difficult situations. Issues such as interacting with medical professionals, developing solutions for talking to family members involved in caring for a loved one, engaging with new roommates.
  • When interacting with the physician, it may be helpful for the care recipient to use a diagram of the body to communicate pain the location of pain.
  • Plan communication/questions with the physician before the appointment. Write out questions and practice getting back on topic, if the physician or healthcare professional digresses. Make sure you get responses to your questions and dont leave the doctors office without all the information you need to follow his/her recommendations.
  • Sometimes reversing the role in a role play gives the caregiver a different perspective and helps them see how some questions just cannot be answered-such as "When will he get better?" "Will he have a difficult recuperation?" You can still discuss these scenarios, but dont think the physician is avoiding telling you "the truth" when there is no way to know, other than waiting and seeing how it goes in your particular situation.
  • If you, the professional, are doing the role play with your client, resident, etc. give helpful pointers that come up during the role play. Your insights will be most appreciated by the client.

Group Facilitation Issues - i.e. support groups, peer led groups, discussion groups

  • Suggestions for ground rules
    • Indicate that what is shared is confidential and when sharing stories, do not use names.
    • Clearly define agenda and visibly display agenda in the room (possibly on a flip chart).
    • Use a ball of yarn to pass among a circle of participants when providing the one word to describe their caregiving experience to produce a "web" - a metaphor for connection.
    • Use humor and comic relief -- they create a positive environment, and are great stress reducers.

Group member issues

  • Quiet/nonverbal group members
    • Need facilitation techniques that promote trust and set the tone for a safe group.
    • Break the group into small group interaction to increase comfort level in first sessions.
    • If there are participation segments, break process down into small action steps that more reserved group members might be comfortable performing.
    • Talk with the quiet member one-on-one during the break to find common ground.
  • Dealing with dominating group members
    • Develop ground rules - e.g., use a timer, a talking stick, etc.
    • Use empathy ("Sounds like this is an important issue to you") and redirect ("How can we relate this issue to our current topic?").
    • Use of the "parking lot" -- using sticky notes to write down a topic to be discussed later. The note is attached to the wall, board i.e. the parking lot if time allows. Acknowledge the importance of the topic, but keep on target with today's topic.
    • Call on the rest of the group to participate.

Dealing with "sidebars"

  • Establish ground rules around side conversations
    • Try to assess why the side bar is occurring - what might be happening in the workshop that is related to these side conversations?
    • Stand by the people who are talking
    • Look at the people who are talking

Dealing with emotions that may come up

  • Have referrals to give people who may need follow-up services.
  • Take a break and talk with the person who has become upset.
  • Use empathy, acknowledging and accepting the emotion.
  • At the beginning of the workshop, indicate that although the material may bring up emotions the focus is on thinking and developing solutions.
  • Do a self-assessment and reflect on your own capacity to deal with participants as well as your own emotional involvement with them.

Caregiver Pearls of Wisdom

  • When a new patient is admitted or transferred to a facility on sudden notice, make a "Who Am I?" sheet so the facility knows who the person is aside from their illness and medical needs (include an old photo if possible). Preferences, dislikes, family names, and other information can give the professionals caring for the person a quick inside picture of the personality and lesser known details to facilitate familiarity.
  • Create emergency resource file.
  • Remember: there are only four kinds of people:
    1. you have been a caregiver;
    2. you are a caregiver;
    3. you will be a caregiver;
    4. you will need caregiving.
    This helps keep things in perspective!
  • In problematic hospital discharge, remind caregivers that they can appeal discharges.

_____

Sylvia Nissenboim is a licensed clinical social worker and who has been working in the field of adult day services in the St. Louis area. She is the director of four adult care and enrichment centers for the American Red Cross and also operates a personal and professional coaching firm, LifeWork Transitions, specializing in caregiving concerns, adult day care management and other aging services, such as virtual coaching and family care giving support groups. She co-authored The Positive Interactions Program, is a national speaker, and has served as president of the Missouri Adult Day Care Association and as a member of the Missouri Governor's Advisory Council on Aging..

© 2005 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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