Group Skill Training For Older Blind

1. Group Skill Training For Older Blind Laurie Pryor, Independent Living Program Specialist Texas Division for Blind Services

2. Early Use of Group Skill Training • The initial objective was to use group skills to relieve our limited IL staff of increasing individual visits. Our expectation was to serve more consumers at the same time and decrease the amount of time traveling to consumer’s homes. • Other objectives were to stretch case service funds and to complete services with consumers in a shorter timeframe. • Initially group skills started with bringing consumers to one location within a region for a week long group skills or “mini” training. • The “mini” training had a set curriculum that consumers rotated through during the day/week.

3. Group Skills “Mini” Training • The original “mini” training was a team effort with CCRC outreach department staff. • The set curriculum consisted of a rotation of 4 to 5 classes per day to include: O&M, Braille, Kitchen Skills, Industrial Arts and Communication Skills. • The consumers would stay at a local hotel and transportation was provided between hotel and training location.

4. What We Learned • After completion of 3 mini trainings around the state we completed a survey with IL staff and found: • Older blind consumers had a favorable response to trainingbut it was not always specific to their needs (i.e. kitchen skills & communication skills). • Older blind consumers were more aware of their options after the training and wanted more specialized training for their specific need. • The IL program did not complete services for any consumer with the use of group skill training.

5. What We Learned • IL Staff reported the group skill training with older blind to be a useful tool in providing services but it actually increased the services and time needed to meet their independent living goals.

6. Next Steps • The “mini” trainings for older blind continued in other regions of the state with some changes. • In more “mini” trainings the VR and IL programs teamed to serve consumers in both programs. This led to trainings being specific to younger IL consumers that had potential for VR. • As IL staff became more confident in conducting group skill training they began to use the group concept in new ways.

7. Expanding Group Training Concept • The IL Program continued teaming with VR to provide continued “mini” trainings. • The IL Program modified the “mini” trainings to meet specific needs for older blind (i.e. meal preparation, low vision devices). • IL Program also teamed with VR for group diabetes education training. • Many regions developed monthly group skill training classes at local sites that meet for a half day to address a specific skill such as cooking, crafts/recreation and communication. • Regions also developed group braille training classes that involved both VR and IL older blind

8. New Ideas • Adapted HKNC Confident Living Program • Adjustment to Blindness Training • Group Orientation & Mobility Class • Vendor contracts for IL Skill Group Trainings • Group trainings conducted in Spanish • Abbreviated “mini” trainings

9. Confident Living Training • Our IL program and Deaf Blind program staff teamed together to bring HKNC Confident Living Program to our consumers. • Adapted the confident living curriculum to fit our needs. • Contracted with HKNC to come to Texas and provide the training to consumers as well as staff as a train the trainer approach. • Gave IL staff more confidence in working with consumers who are hard of hearing or deaf.

10. Confident Living Training The Confident Living program that we presented was designed for senior adults who are hard of hearing and do not use sign language as their primary means of communication.

11. Confident Living Training We spent a half day with an IL Worker in-service that included: • Teaching Braille and IL Skills • Assessment for aids & devices and community integration • Communication strategies • Scheduling/working with interpreters • Issuing loaner devices and training IL Workers

12. Confident Living Training The remainder of the week our staff and HKNC staff trained consumers on the following topics: • Hearing Loss and Me • Vision Loss and Me • Introduction to Orientation & Mobility • Emergency Preparedness • Community Resources • Elder Laws • Rotation of classes (kitchen, alerting aids & devices, low vision aids & devices) • SSP Services • Evening Activities

13. Adjustment to Blindness Course • Adjustment to Blind course was developed by our IL Coordinator/Worker, Dani Grill in our Amarillo office. • Five week course that meets weekly and is attended by consumers and family member/significant other. • Homework consists of listening to Sound Solutions tapes from the Braille Institute and answering questions developed by ILW. • Class time is spent as a seminar to discuss topics and reading assignments.

14. Group Orientation & Mobility • In some areas of the state there is limited orientation and mobility services so we developed a class to provide consumers with basic training. • CCRC O&M staff or a contracted vendor traveled to conduct group O&M training with our older blind consumers.

15. Group Orientation & Mobility • O&M skills taught in training included: • Basic cane use – open palm technique, touch technique, pencil grip • Structured Discovery • Self-Familiarization to a room/home • Auditory Skills • Problem solving • Human guide

16. Vendor Contracted Group Training There have been two different vendor contracted group trainings including: • San Antonio Lighthouse provided a one week “mini” training that consumers traveled to and received training on a set curriculum. • Individual IL Skills Vendors provided training using a set curriculum and meeting with consumers locally on one day per week for 9 sessions.

17. Group Training in Spanish Our IL program found a need to conduct trainings in Spanish for consumer’s whose primary language is Spanish. • Our San Antonio office partnered with the San Antonio Lighthouse to provide this training. • Our Harlingen IL Worker has also provided a variety of group training in Spanish.

18. Abbreviated “Mini” Training • To address the needs of older blind we cut the curriculum of “mini” training down from 5 days to 3 days and decreased the number of hours of training to 9 am to 3 pm. • Provided daily taxi service rather than overnight accommodations. • Focused on IL Skill needs of the particular group rather than a set curriculum.

19. Rural vs. Urban Training • Transportation: • Urban areas have more transportation options which is helpful for ongoing weekly or monthly classes such as braille or IL skills. • Urban areas have many options for IL staff to purchase taxi services to transport consumers for abbreviated “mini” trainings. • Rural areas have limited transportation but carpooling is more effective than in urban areas. • Rural areas also have better attendance for weekend classes/events as family is typically available for transportation on weekends. • Attendance: • Predicting attendance is challenging due to health issues and transportation issues that are common with older blind. • Depending on staff ratio and type of training we plan for 6 to 20 consumers per training.

20. Rural vs. Urban Training • Day/time of training: • Urban locations lend themselves for better attendance during the week mainly due to transportation options. • Rural locations seem to have better attendance on weekends. • Family involvement: • Rural areas have had a higher level of family members participating in a training and/or providing transportation.

21. Rural vs. Urban Training • Training at existing support groups: • This has been a good option for short, focused topics. • Provides opportunity for outreach to new consumers. • Training at Assisted Living or Independent Living Facilities: • Rural areas have had greater success of involving the community outside of the ALF in these trainings. • In Urban areas this option tends to be useful for ALF that have a high number of consumers who are older blind.

22. Benefits • Confidence of consumers and staff. The more group trainings the region provides the better the outcomes of the trainings. • Builds natural supports and mentors. • Foundation for problem solving skills for consumers and provides consumers with an introduction of a variety of skills. • Increases social skills. • Assists consumers in the adjustment process. • Collaboration with VR program. • Classes can be adjusted to provide with limited funds.

23. Challenges • Transportation • Consumer’s health issues • Adequate number of staff to provide training • Training family with their loved one present • Interpreters • Collaboration with VR Program • Consumer’s typically do not master skills

24. Conclusion In Texas we’ve found that providing group skills to our older blind consumers has been a positive experience for all with lasting benefits for consumers and staff. Although our initial expectations weren’t fulfilled we have found there is an important place for group training in the IL program.