Egan

Group Work Planning.

As we age, our inclination and ability to adapt to new situations tend to lessen, and our motivation to satisfy our needs may diminish. These limits are often imposed by the expectations of others and by ourselves. Many people believe, as they grow older they become a burden. This is reinforced by the negative perception society places on older individual's achievements, reinforcing their perception of significance of worth. What we define as 'ageism'.

Hughes and Mtezuka (1992:220) describe ageism as "the social process through which negative images of attitudes towards older people, based solely on the characteristics of old age itself, result in discrimination".

When older people go into residential care facilities they often become more dependent on others. This is due to the fact that during our lives we develop strategies that help us cope with and adjust to change and loss. These strategies are distinctive and personal to each individual. A change to an unfamiliar social and physical environment can therefore become disabling by the undertaking of routine activities that reinforces a sense of dependence and infirmity.

Underpinning the development of the idea behind reminiscence has been the general acceptance that we all, when unable to look after ourselves, have the fundamental right to lead as good a quality of life as is realistically possible.

Unmet emotional needs have a negative effect on our physical well-being and our ability to cope. While it is important to provide good physical care for older people, more is needed. A strong sense of personal worth and identity, with a belief or feeling that essential aspects of life are still under their own control, can also influence how an individual ages.

In order to begin to understand why someone is as they are now, we need to know something about what has gone on before and the meaning the person has attached to their life experiences. Reminiscence is a productive way of learning about such experiences and its personal meaning.

Butler (1963:66) refers to reminiscence as "The act or process of recalling the past".

Reminiscence can therefore assist older people to review, rework and re-evaluate their own lives, and to help them develop new perspectives and become more accepting of their present situation.

However, research suggests that sometimes staff member's assume they know best who is suitable and unsuitable for reminiscence group work (Gibson, 1998). This can result in residents who are different or have special needs to be denied the opportunity to participate. All too often "Older people do not have a voice and decisions are made on their behalf" (Davies 2000)

In order to avoid this, I liaised with senior care staff within the unit and obtained a list of clients who would be present on the day chosen for the group work. I personally approached the residents, introduced myself and explained the nature of the prospective group sessions.

Following the identification of unmet need in relation to social stimulation the client group will be comprised of individuals 65+ who have various levels of cognitive functioning. The clients accessing the group are the residents in a residential unit.

Coulshed and Orme (1998:1967) outlined five stages when planning the group, which I have embraced in my preparation.

WHO: - Redl (1951) suggests when a group can be formed an ideal balance is "homogenous enough to ensure stability and heterogeneous to ensure vitality" this highlights a number of issues for me. Due to the vastly different number of female residents in relation to male it was impossible for me to have the same amount of males and females. In addition, ages and religions would differ also.

HOW MANY? - Brown (1992) suggests a group's size should be "large enough for stimulation, small enough for participation and recognition".

I wanted the group members to be comfortable in the room we were using and I thought that it would hold seven people comfortably, taking their walking aids into consideration too. I also thought this was a manageable number as there would be enough to participate and get involved but yet would be small enough to be comfortable.

Ironbar and Hooper (1989) state that generally smaller groups with six to ten members plus the leader are more effective in therapeutic and educational settings because:

Relationships, hence trust and cohesion develop more quickly.

It is easier to maintain face to face communication.

Opportunities for participation and individual recognition are greater.

Group leaders are able to give more effective direction, to monitor group processes and give more valid feed back.

HOW LONG? - Preston - Shoot (1987:43) suggests when deciding the length of the group, the leader needs to balance their needs with what is in the best interests for the group. He continues "I suspect that often greater weight is given to the constraints on the group workers, such as the length of the student placement, other work commitments..."

Whilst I am aware that I have a limited amount of time in this placement, the group which I will be undertaking has an introductory session and an ending session with four in between. This period of time should be sufficient for the group, as the members are already familiar with each other and so should develop trust quicker than a group of strangers. Preston - Shoot (1987:42)

The group will meet once weekly for a period of six weeks. Each session will be time limited (40 mins). I have decided to hold the sessions on a Friday afternoon; this benefits the unit as on this day there are no day care facilities available, and most of the residents will be present in the unit.

In addition, it was decided to commence the group work at 3pm., this allows the members sufficient time to rest after lunch and their personal hygiene needs to be catered for. Therefore, hopefully the session will not be interrupted.

The first session of the group will also include the senior day care worker, who at my behest will monitor my intervention with the group. As this is my first attempt at group work I am apprehensive and anxious about the benefit and content of what I am aiming to do.

I intend to attempt to finish each session by clarifying what we have discussed and then reminding