Group Activities with Older Adults

Vicki Dent

• Publisher: Routledge
• Year: 2017
• Print ISBN: 9780863883422
• eBook ISBN: 9781351688277
• Edition: 1
• Topic: Education
• Subtopic: Education General

If you have responsibility for providing activities for older adults and you aren't sure whether what you are providing is effective, or you have exhausted all your own activity ideas then this book is for you. This clear and easy-to-use resource provides the tools you require to develop and implement a range of activities that meet the needs of your group. Structured around the ten areas of activity need - cognitive, creative, cultural, educational/employment, emotional, physical, self-esteem, sensory, social and spiritual - this book is a resource of activity ideas with hints, tips and suggestions for successful planning and delivery, and guidance on recording and evaluating activity programmes. It explores some of the adaptations required to meet the needs of younger clients, those with dementia, and those with communication difficulties. It is an ideal resource for anyone working with elderly people wanting to improve on an existing activity programme, or wishing to commence one.

Part 1
Making Group Activities Work

Chapter 1
The Benefits of Groups

Social aspect

Groups serve many purposes: the coming together of like-minded individuals to achieve a goal; to share a common interest; to gain support or information; to share ideas or thoughts; to solve a problem; or simply to be.

There will be occasions when residents choose to be in the vicinity of the activity session, without wishing to take an active part. Their needs are to:

• Feel part of the group without having to risk failure, look foolish or be expected to interact or participate
• Enjoy the conversation
• Observe their peers
• Toe-dip the activity as a precursor to becoming more involved on future occasions
• Gather information that they can share with family and friends
• Participate in the group for the social elements only.

For example, the activity organiser might facilitate a knitting circle in a home lounge. Imagine the scene: there is a small group of chairs clustered around a coffee table. Three residents arrive and are seated, leaving an empty chair between each other. Another two arrive and are seated in the same manner. They each have a knitting bag containing some ongoing work. The activity organiser joins them and begins to talk to two of the residents, inviting them to begin their knitting. The session begins. There is much chatter and conversation as the activity organiser works her way around the group, taking a spare seat between two residents each time. The residents start to knit; they do a few stitches, but then encounter a difficulty. They hand their knitting to the activity organiser for her to solve the problem, and once solved she retains each resident’s knitting for a short while, knitting furiously while chatting, engaging each person in conversation. Towards the end of the session, the activity organiser goes to fetch refreshments. Later, when asked about their knitting circle, the participants speak warmly of the others and the activity organiser, expressing their enjoyment at being able to spend time with each other, while acknowledging how hard they had to work during the session. For them, the proof is there – they meet weekly to knit; their individual projects are growing and looking wonderful; they are obviously working hard.

Whether they were truly aware that the activity organiser was undertaking the majority of the work was, on this occasion, irrelevant: they were enjoying the very social nature of the activity – being together, with a common goal; a shared interest that had an external value. It must be remembered, of course, that for some residents this session would not have met their needs. If the need had been to produce work independently, no matter the standard, or if the activity organiser had hoped to develop the residents’ skills, then an alternative approach would have been required.

Groups provide an opportunity to be with others – preferably people with similar interests or backgrounds. For many this is a pleasant arrangement – being with others. For some, however, the thought of spending time with others is at best unfamiliar, at worst frightening or unwanted. Careful consideration should be given to those whose memory is poor – few people would choose to constantly spend time with strangers, and for those who find it difficult to retain information other residents and often the staff remain strangers. Equally, thought should be given to new residents. Where have they come from? What has been their recent experience? If they have moved to the care home from a hospital ward they may be more comfortable with having others around them. If they have moved from home, they may have been living alone for many years, and may have focused their lives into one or two rooms within their home. A communal setting with 20 or 30 other people will be an extreme that they may not wish to be part of – certainly not initially.

Role definition

Generally, everyone likes to feel they have a part to play, a place where they belong, a role to undertake. Group work provides the opportunity for individuals to undertake one or more of a number of established roles. For example, the information-giver, tutor or leader – a resident who is an experienced traveller could share their information and knowledge with their peers via a slide show or discussion, reinforcing past hobbies and interests, validating their knowledge and their own sense of self worth and value. The parent, spouse, carer, or giver role can be encouraged in the more able residents who could assist those less able, sitting with them, helping them to undertake the activity, writing down answers for them. Residents who continue to enjoy ‘doing’ can have their value reinforced through assisting with the session – calling out the numbers at Bingo; asking the questions during a quiz; helping with the tea during a break and so on. The resident who prefers to be ‘done for’ can sit back and allow others to ‘support’ them in the manner in which they may have become accustomed!

There will be issues relating to residents undertaking a role: potential conflict when more than one resident wishes to play a certain role, and when other residents may not welcome them undertaking that role. Good communication, awareness and understanding should help overcome these kinds of difficulties, but what of health and safety? There are likely to be risk implications of residents helping out, but it is generally accepted that taking informed risks is good for psychological health and wellbeing. Residents often respond to the unintentional messages that are given out – for example, ‘Just have a seat, I’ll do that for you’, can be perceived as ‘you are not capable’. This message of ‘you are not capable’ combined with the need to move into a care facility, reinforces an individual’s difficulties and disabilities. Taking informed risk can reinforce people’s abilities, boosting self-esteem and self-worth and psychological wellbeing. Good risk assessment should not be about preventing things from happening, but about anticipating risk and taking the necessary steps to avoid harm and injury. If a resident wishes to help out with the tea trolley, helping to pour the tea carries a high risk; however, passing round the biscuits, collecting up the cups, or helping a member of staff to push the trolley carries less risk, while allowing the resident to retain a sense of being useful and helpful.

Role modelling

As well as providing individuals with an opportunity to undertake a role, groups can provide an ideal opportunity for role modelling – an approach whereby a task is demonstrated for others to follow. This ‘demonstration’ may be overt – ‘copy what I do’. In these circumstances residents will be able to acknowledge that they do not know, or cannot remember how to do something. The activity organiser is then free to lead, guide and actively demonstrate. In many more circumstances, the residents will be unwilling or unable to admit to a lack of memory or lack of knowledge. Then the role modelling should be much more subtle. Residents will often attempt to compensate for difficulties: if they cannot remember how to do something, they will first look around to see what others are doing. Think about some common, anxiety-provoking group-setting situations, for example, having a meal in a restaurant and being unsure of which knife to use, or whether it would be OK in the present company to pick up the chicken and eat it. The solution – look around to see what others are doing. This is a subtle form of role modelling that can enable individuals to retain and sometimes relearn skills without the anxieties of having to admit to difficulties. Cooking, baking, gardening, brass-polishing, laying the tables, folding the laundry – skills that will have been very familiar – may be slipping away. Providing these activities as part of the programme enables an individual to work alongside the activity organiser or another resident, providing them with the opportunity to ‘copy’ others undertaking those tasks. This will go some way towards ensuring a ‘failure free’ activity, leaving the resident feeling positive about the activity experience.

Partnership approach

Working in a group can provide the opportunity for partnership – partnership between all members, whether staff, families or residents. The sayings go ‘Two heads are better than one’ and ‘Many hands make light work’. At times when an individual would perhaps struggle to undertake an activity independently, working with another might facilitate success. As with all activity-planning, successful partnerships need careful thought and consideration. Knowledge of the group members should help in identifying the skills and strengths of individuals, and through careful matching, these strengths can be pooled to ensure failure-free outcomes.

The key skill essential to ensuring a successful partnership approach is being able to identify the component parts of an activity, and then matching the parts to the skills and abilities of the individuals who wish to participate.

For example, flower arranging. What are the component parts? Gaining an overall understanding of the task in hand; selecting a receptacle for the arrangement; selecting a range and variety of flowers and greenery; cutting, trimming and placing the flowers in the receptacle, and then deciding on where to display and how to maintain the arrangement. Knowledge of the individuals within the group will identify those who have the cognitive ability to fully understand the task in hand; those who have the physical strength and dexterity to cut, trim and place the flowers; those who have the creative flair for selecting the colours, variety and style of flowers that make an effective arrangement. Some of the residents may be able to undertake this activity independently; others will need a partnership approach. By allocating each individual a role to play based on their strengths – somebody to select the flowers; somebody else to cut and trim; another person to arrange the display – the group can achieve, through partnership, a successful outcome.

As with all activities, there may be problems along the way – in particular the resident who does not see the need for a partner; who feels able to undertake the activity independently, despite limited abilities. On these occasions, knowledge of the individual involved will be essential. How important is the finished article likely to be to that individual? Often the taking part – being involved in the process – is much more important than the finished article. Are they likely to be able to achieve a finished article that is of an acceptable standard to them? If yes, then there is no problem. If no, consider how best to support them so that they can work independently and achieve the finish that they will find acceptable. There is no easy answer to this one: the activity organiser may be able to help along the way, perhaps making subtle adjustments after the session has finished. Alternatively, this may be an activity that is not suitable or appropriate for the resident to participate in, due to the risk of disappointment that they may face.

When not to use groups

For many residents, group activities will be a successful route to active involvement and engagement within the community of the care facility; however, for a small number of individuals, group activities pose a large threat to their sense of wellbeing. As mentioned above, residents may well have spent many years alone, with few friends or family. They may have naturally shied away from communal events and overt socialisation. Their recent life experience may have been limited to activities within their own home – watching television, reading, receiving an occasional visitor. Obviously, it is difficult to generalise about people’s response to the change in environment: for some, there may be huge interest in attending activities; doing things that they have been unable to do; being able to spend time with others. For others, the idea of attending group activities in large communal spaces, often at some distance from their room, may be at best anxiety-provoking, at worst threatening. For these people, a ‘softly softly’ approach may be successful – ensuring that the individual is aware of the activities on offer, without pressuring them to join in. They may become aware of the enjoyment that participating can bring through discussion with others; through seeing the evidence of activities – work that has been produced; hearing music and laughter coming from the lounge; viewing photographs that have been taken of activities in progress. The key to the ‘softly softly’ approach is to stay in touch with the resident; acknowledge their anxieties; keep them informed; keep open their option to attend, while always respecting their choice not to attend.

Knowledge of the individuals within the home may identify residents, or more likely a combination of residents, who when brought together will cause distress, upset and angry confrontation. Differing abilities and difficulties can cause frustration. For example:

• The lady who wants to attend the church service, but insists on shouting throughout, may cause upset to others attending.
• The gentleman who likes to call out the Bingo numbers but does so too fast (or too slowly) for the liking of those playing. Different perceptions of the way things should be done can cause frustration and anger.
• The dominoes player who insists on certain rules that are unfamiliar to other players.
• The retired fitness instructor who dislikes music being played during an exercise session, because ‘exercise should be taken seriously!’

These are all possible scenarios that challenge the group approach. The answer, as always, is never easy. Here are some questions to help think the situation through:

• Is there the option of running sessions twice, aimed at different ability levels, in different styles?
• Is it possible to sit down with the resident whose behaviour is causing upset to others, to talk through the problem and come up with a solution?
• Should the individual be excluded from certain activities?
• Are there alternative activities, or perhaps roles within the activity, that may divert from the problem?
• Is there someone who might be able to join the group to support certain residents, thereby enabling them to participate fully without causing disruption?

Needs of the individual

Having looked at the difficulties that can occur through participating in groups, it becomes apparent that there will be residents for whom group activities are not a feasible option, and for whom an individual approach is required. This can be time-consuming, so careful thought is needed. Having identified the residents who need one-to-one input, try to identify the kind of individual activities that they would enjoy – one-to-one does not have to be simply chatting to people. Card games, dominoes, board games, crosswords, reading the newspaper, taking a walk, receiving communion, reading the Bible, listening to music, receiving a hand massage (to name just a few), are all activities that can be offered on a one-to-one basis. Having identified the activities that the resident would like to participate in, think about the frequency of input required: some may need one-to-one time every day; others may be content with weekly or monthly sessions. This will be very dependent on their ability to meet their own activity needs, and the access that they have to others – family and friends, for example. Having identified the kind and frequency of one-to-one activities required, these sessions should be planned into the programme in ...

Table of contents

• Cover
• Title
• DEDICATION
• Contents
• Acknowledgements
• Introduction
• Part 1: Making Group Activities Work
• Part 2: Group Activities
• Appendixes
• Index of Activities