Inservice

Learning Objectives

The participants will be able to:

1. List three benefits residents may derive from attending the Tea Group.
2. Describe the type of resident that the Tea Group was designed for.
3. List 4 important parts of the ritual of the Tea Group.
4. Demonstrate 1 communication technique used in the Tea Group.

Time: 45 Min.

• 10 min. Introduction
• 20 min. "Tea Group"
• 15 min. Discussion of benefits of "Tea Group" and residents that might benefit from the program using questionnaire.

Preparation

1. Read Guidelines (previous sections) and Troubleshooting for "Tea Group. Copy questionnaire (PDF, 282.82, 1pg.)
2. Make up individual "invitations" for members, guests and silent observers.
3. Gather supplies for formal tea service. Set up room.
4. Post inservice flyer. (Could make it in the form of a formal invitation):

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Instructions

1. Give the introduction to the program: objectives and purpose of the program. Explain roles of facilitator, members, guests and non-participating members (silent observers).
2. Give out invitations or folded pieces of paper with Tea Group "member," "guest" or "silent observer" written on them to participants. (Could use real invitations with invitation to tea for members and guests, and invitation to be a silent observer for the other participants.
3. Tea Group members and guests will follow the roles outlined in the Tea Group guidelines. These can be written on their invitations. (Each person who is to be a member could have instructions for the role of a resident with dementia in the facility- sample on page 3; or in a small facility each "member" could be asked to think of a resident with dementia they care for or know and assume the amount of disability for that resident. One member's invitation should have instructions to try to leave early, allow himself to be persuaded to stay and then try to leave again in 10 minutes. Another should have instructions to refuse to go to the group.)
4. The inservice can be done with a small group in each unit or department where all participants can experience the "Tea Group".
5. If done with a large group 6-10 participants could be picked to take part in the Tea Group and the rest would be designated as guests and silent observers whose observations and comments would be discussed after the "Tea Group".
6. Get into the "Tea Group" facilitator role. From here on act as the facilitator of the "Tea Group" and treat all of the participants as guests.
7. Instructions to participants: "From now on, I will act with you the same way we will act with residents during the "Tea Group" program. You will receive the same greeting and directions they will receive. This is the best way to learn the program. Please take this seriously and help by assuming the role of a Tea Group member, guest or "very" silent observer according to the invitation you received.
8. Members and the facilitator will be the active participants in the Tea Group. Guests will assume the role of guest at a formal tea and act appropriately following the lead of the facilitator.

Instructions to Silent Observers

• We will be very interested in the observations and suggestions of the silent observers after the Tea Group. Please do not talk during the Tea Group. Try to experience what it will be like for "difficult" residents to be treated as competent and likeable people once again. Silent observers will sit in the chairs outside the Tea Group.
• If a participant who is invited to be a member does not wish to participate in that role, the facilitator will encourage the person to come for a trial only and feel free to leave the Tea Group at any time. If the person still chooses not to participate, the facilitator tells him/her that their presence will be missed and their regrets will be relayed to the group, just as it would be said to a resident who refused. It would then be pointed out to the group, that no one is ever coerced to attend against their wishes. Another person could be invited to attend or not, depending on the size of the group and the willingness of the participant asked. If no one refuses, then the member invitation with instructions to refuse to go to the Tea Group, will be given out to the last invited member. The facilitator will then play out the role with that invited member.

Announce

• "We will now follow the ritual of the Tea Group."
• The ritual of the Tea Group will be followed each time the group meets. It is important to follow the same ritual each time because regular consistent and predictable cues help residents with dementia to establish a routine which gives them a sense of control and promotes group bonding.

The Tea Group Ritual Is Started and Followed According to the Guidelines

• Chosen members of the "Tea Group" are then greeted cordially, with the ritual greeting. Each "member" is then escorted separately to the dining area. They are told that it is nice to have them in the group and to have their help in preparing the tea. ("Guests" will escort themselves to the Tea Party.)
• Ask the first member to be escorted to the "Tea Room" to help the facilitator who was waiting in the room to help greet members and guests as they come in and talk to them about making tea or coming to the group, until all members and guests have arrived.
• Anyone who received an invitation and chose not to participate in the tea party, could be mentioned as the absent member: "John could not be with us today. We will miss him and hope he can come another time."
• When one member wants to leave early, as cued on the invitation, the facilitator encourages the member to stay. In ten minutes, when the member wants to leave again more adamantly: "I really have to go now." Everyone is asked to say goodbye to the guest: "Mary, has to leave now. Goodbye, Mary. (Shakes Mary's hand.) Mary would you like to go around and say goodbye to John and Alan and Rose and Alice?"
• A half cup of tea and a cookie are taken to " a member who couldn't come" in the audience. (This could be a person who chose not to participate or this role could be built into the scenario). The facilitator tells this "absent guest" that he was missed and that each person by name: "John and Mary and Alan etc. missed you at the Tea Group and we all hope you can come next week when we are serving herbal tea and gingersnaps." Then a recap of the actual meeting is given to the "absent guest."
• Discussion of feelings experienced by members, guests and silent observers follows.
• Suggestions and questions on the questionnaire are then discussed.

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Sample "Guests" at Tea Party for Inservice on Tea Group

ANNA:

• In wheelchair- able to talk and do simple tasks with cueing.
• She becomes upset with peers who are slow or have repetitive speech.

SAM:

• In wheelchair- able to talk, confused at times, able to do simple tasks with cueing if in the mood.
• He becomes agitated if told what to do instead of being asked and cajoled into doing things.

MAIME:

• In walker- responds slowly in one word answers.
• She can do simple tasks with cueing if a familiar person stays right with her, otherwise she becomes anxious.

JIM:

• In wheelchair- confused. He can do simple tasks if cued by someone he trusts.
• He has a low frustration level and a short attention span if not involved 1:1 in a task.

MARY:

• Ambulatory but unsteady.
• She can do simple tasks if cued 1:1. but becomes agitated when she cannot accomplish a task the way she used to.

VI:

• Ambulatory-unsteady at times. She is always looking for something to do and is able to do tasks with cueing.
• She becomes angry if told she cannot do something she wants to do.

ROSE:

• In wheelchair- able to talk. She is able to do simple tasks with cueing, but becomes verbally abusive with staff and other residents if she does not receive attention when she asks for it.
• She becomes jealous of time staff spends with other residents.

LEO:

• In wheelchair- not able to hear well. He is impulsive and needs tactful cueing to slow down and follow directions to do simple tasks.
• He becomes verbally abusive if asked to change tasks or accept any change in routine.