¶ … Group Process and Skill Selection Recent developments at the medical industry increase the life expectancy. Census reported that 36.3 million Americans were 65 and over in 2004 and 71.5 million Americans will be 65 and over in 2030 (see, census.org). Therefore, the age related diseases and related industry (i.e. eldercare) have been taking an important part of the American society. Taking care of a person with memory loss, dementia and Alzheimer's disease is a demanding task as it requires mental and physical strength. Social supports groups are very helpful to deal with mental and physical distress for Alzheimer's patients' caregivers. In this brief document, a social group session is discussed.

ANALYZING GROUP PROCESS AND SKILL SELECTION

Introduction

Garvin, Gutierrez, and Galinsky (2004) describe the social work groups in which the social workers participate as part of their professional activities either as participants or facilitators. The interaction between social workers and group incorporates groups that individuals exchange their issues, improve their life, enhance their functionality, refine their methods to deal with challenges and evaluate the social justice. In the same book, Garvin et al. (2004) point out two important factors -the personal boundaries and mutual respect- that form the quality of mutual interaction between group members. In this aspect, the social worker, as a facilitator, should facilitate the value of each individual and emphasize on interactive help between group members. The latter would help individuals to understand the importance of interdependence. This interdependent relationship between the group members would provide the positive and the negative aspects of their experiences. However, there might be a disadvantage that some group members would not like to work together as they would feel a competition or vulnerability. Although there is not a common way to degrade the group member's hesitations to interact, the more suitable model for a particular group would improve the outcomes of the social work. The well-known models are mutual aid and cognitive-behavioral models. The motivation of mutual aid model is the processes that occur among the group members whereas the cognitive-behavioral model focuses on the behaviors and thoughts that differ within the group members. Northen and Kurland (2001) took these two models as a whole and let the group define their model. The example their used was an environmental group highlighting the importance of mutual respect.

Why is the Alzheimer work group? How do group members sit around the table?

Recent developments at the medical industry increase the life expectancy. Census reported that 36.3 million Americans were 65 and over in 2004 and 71.5 million Americans will be 65 and over in 2030 (see, census.org). Therefore, the age related diseases and related industry (i.e. eldercare) have been taking an important part of the American society. Taking care of a person with memory loss, dementia and Alzheimer's disease is a demanding task as it requires mental and physical strength. The physical work caregivers undertake is very hard including bathing loved ones, feeding them, running errands and trying to understand what the loved ones really need. The results of this long-term care are exhaustion, anxiety and depression (Molsa, Marttila, Rinne, 1995). These effects would be traumatic and would last long time after stopping to take care of the person (either patient's death or sending the patient to a nursing home). Moreover, at some cases it could cause neglect and elderly abuse (see, http://www.nia.nih.gov/Alzheimers/Publications/caregiverguide.htm).

Taken all together, this paper aims to focus on Alzheimer's disease caregivers in Miami, Florida. Maintaining social contacts and peer support are an important safeguard for caregivers' wellness and happiness. This work group aim to develop a mutual support system sharing the positive and negative aspects of being Alzheimer's caregiver.

The supportive and accepting atmosphere reduces the stress and facilitates self-expression and willingness to share ideas and behavior. In this context, the facilitator tried to create such an atmosphere that everybody is included in the group and respected in the aspects of their individual faith and belief and personality. The eye contacts and facial expressions are given privileges. Therefore, the skilled facilitator took a chair to e able to observe each member's face expressions and body signs (Figure-1). In this particular group, the caregivers C. And D. are the first individuals entered in the room together. They, both, went to the same college to study nursing and working for the same company as the...

They were talkative and making jokes when other caregivers entered to the room. Caregivers A and B. also knew each other from their caregiving career in Century Senior Community. They were both K-12 graduated and Caregiver B. started her career after taking care of her mother who suffered from Alzheimer's for a long time and passed away almost 7 years ago. The last three people sitting on the right side of the table are the relatives who take care of their significant ones. E mentioned that she is part time caregiver for her mother suffering from Alzheimer's disease whereas F. And G. are full time caregiving their husband and father, respectively.
Figure 1. The seating diagram.

The structural factors impacting the group and members' dynamics

The most significant structural factor is the members' cultural background. They all have Hispanic background and are able to speak Spanish. One of the reasons is that 60% of population of Miami is Spanish Speaking with 52% Hispanic background (see, census.org, 2000). The group meets in a small room assigned for the meetings in a Church in Miami Dade County with moderate furniture. The group members heard about the group at their community and informed each other.

Definition of the group members

The younger college educated group is more open to talk about their experiences, emotional and physical issues whereas two older professional caregivers with certification are more silent and gave an impression that they feel jeopardized by the younger ones. At a certain moment, all the group members shared some important positive aspects of caregiving. They agreed that the meaning of life and purpose were changed such as their existing relationship with their family members got stronger while they started to build stronger ties with new people. The person G. was the wife of an Alzhemer's patient who has been taking care of his husband for three years. Her testimony was touchy for all group members. She feels that this is the meaning of lifelong commitment. The F. sitting on the other side of G. told that it is her duty to give back what she got from her family. Person E. noted that she tries to protect the balance between her private life and the loved one's needs. Although she visits her mother everyday she would not spend more than 3 hours per day with the mother.

Norms and rituals

The most significant norm of this group is that they thought that it would be appropriate to discuss about the beliefs because of the religious diversity of the groups. This suggested that nobody wanted to be excluded from the group because of their beliefs. As it is mentioned before the ethnical background of this particular group is Hispanic. Norms of this particular group tended to be tacitly established and maintained through body language and non-verbal communication between people.

The group members were very respectful to the each other's experiences and feelings; however, there was a conflict about the nursing home idea. Person G. has recently started to think about a nursing home as she thinks that it will decrease her anxiety and depression. Moreover, she was afraid of the long-term effects of the distress caused by the parent's random behavior. She mentioned that her parent was always a very calm and understanding person until the diagnosis of Alzheimer's disease, but he became angry at a point that she cannot control him. The wife disagreed that nursing home would be a lonely and harsh place to leave the loved one. The argument was stopped by the elder male caretaker A who told his experiences with two patients. His first experience was with a military commander who forgot English but his mother language, Spanish. His wife and his children did not want any professional caregiver or nursing home for a long time; however, they could not communicate with him as they cannot speak in Spanish. He was angry the fact that he could not recognize them and could not express himself. Finally, they decided to hire him as a main caregiver. The second experience was with another elderly man who forgot everything but a sort of checker game. Therefore, a nursing home with other elderly people helped him to increase quality of his last years.

Since this was the first session people were very careful not to hurt each other's feeling and not to look foolish. Therefore, they did not share a lot of personal feelings other than the general emotions and feelings which could be shared by any social group under distress.

Expression of feelings

In this group, the most emotional person was the wife; however, it could not be the accurate observation from the first session. She was trying to block the negative feelings of…