Objective: To date, there have been no studies defining strategies that are helpful in facilitating support groups for persons with early stage dementia. The purpose of this study is to present strategies as well as describe training implications. Researchers have only recently focused on the needs of the person with early stage dementia. There have been many studies on caregiver needs, and on behavioral management of persons with middle and late strage dementia. Studies on support groups for persons with early stage dementia (Yale, 1995; Labarge & Trtanj, 1995; Morhardt & Johnson, 1998; and Snyder, et.al, 1999) and on the subjective experience of dementia, (Sabat, 2000; Menne, et al., 2002; Claire, 2002; and Harris, 2002) provide professionals with information about the subjective experience of dementia. The group studies describe how persons with early stage dementia are able to appreciate the cohesiveness and universality that the groups provide. No matter what the format, (8 week or long-term) the issues are very complex, and there is a need for highly skilled professionals to conduct these groups.
Design/Method: The present study is an exploratory study in which verbatim audio taped recordings were transcribed and analyzed from a long term open-ended support group for persons with early stage dementia. Twelve 1 1/2 hour tapes were randomly selected from a total of 50 taped sessions. The group was led by a social worker and a psychologist/psychiatric nurse. The analysis focused on group leader interventions and evaluation of the strategies that helped facilitate group process.
Results: Preliminary analysis has defined strategies used by the group leaders which include: 1) refocusing tangential topics offered by group members into a common theme 2) assisting the group to balance the use of humor between a helpful coping strategy and an unhelpful distraction from feelings, 3) restating comments made by persons with language problems so that they feel heard, 4) controlling group member behavior that distracts from other members feeling heard and respected, 5) responding to group member comments in a manner that is "psychodynamically informed but not interpretive", (Bibring, 1947) and 6) employing strategies to facilitate persons moving out of the group when it is no longer appropriate.
Conclusions: Multiple skills are necessary to conduct a long term process group with persons with early stage dementia. Not only is there a requirement for extensive knowledge of early dementia, but also knowledge about group process, the ability to detect latent as well as manifest content,and an ability to interpret complex messages that are often presented in a confused manner due to the disease process. The study provided evidence of the need for co-leaders due to the complexity of the group issues.
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