I have decided to start a series of blogs that addresses each of the areas of daily living. I will provide my ideas on what interventions are helpful in these areas. These are not meant as a "how to" manual, but instead to share some ideas, and to be a starting point for discussion. I will be discussing interventions primarily related to cognitive deficits and mental health concerns, as those are the areas I have the most experience with. The majority of the people I have worked with are on a low income, so that is the perspective I am using.
Grocery shopping is an area that requires many different skills, including budgeting, using transportation, and social skills. It is therefore often an area that people have difficulty with. It is important to first assess what the issues might be, but is also important to keep an eye out for issues along the way.
When Budgeting is a Problem...
Probably the most common problem I see is that the person does not have enough money for groceries. You could start addressing budgeting on a larger scale if the person is interested. However, often the person does not really want to work on budgeting but simply wants enough food.
When budgeting for food is a problem, I usually recommend people buy groceries immediately after receiving their money. I encourage them to buy foods that can last - e.g. skim milk powder, frozen vegetables, extra bread for the freezer, oatmeal, and peanut butter. I had one client who would buy a package of wieners and a package of buns, and make sure she only ate one hot dog per day. This may not be following recommended nutrition guidelines, but she had food for almost every day inbetween her cheques. I had another client that would buy himself grocery store gift cards whenever he received his money.
Another strategy is to see if people can receive their cheques more frequently. This means less time to go without food. I can only speak for people here in Manitoba, but receiving their cheques weekly is available from Employment and Income Assistance, as well as if they are under the Public Trustee.
I usually ensure people are connected to the local food banks as well as nearby soup kitchens. This can be more difficult than you might think - just giving a person the phone number to call is often not sufficient. To connect with our food bank, people here have to call a line and wait on hold for an incredibly long time. They then have to give their information about where they live, etc. All this requires a certain level of comfort with using the telephone, and trust in giving out their information.
There are different methods for keeping track of the total cost of the shopping trip, which can be helpful when on a limited budget. Some people use a calculator, but this can be problematic if the screen is accidentally erased at any point of the trip. The method I have used and find helpful is using tally marks. Whenever you put an item into your cart, round off the price to the nearest dollar and record the same number of tally marks on the back of your list. This picture shows the tally marks for an item that costs $6.55 (rounded up to seven).
Many people have difficulty getting to the store as well as carrying their groceries home. This is sometimes due to physical problems, but also sometimes due to anxiety or psychosis e.g. difficulty taking public transit because you feel people are talking about you. Sometimes, people simply need a chance to learn and practice the bus routes.
Grocery delivery is an option with many stores. There are many stores you can phone your order into, and a few you can order online from. There is usually a small fee, and you do not have the benefit of being able to compare products and prices. Some stores require you to do the shopping in the store, but can deliver your groceries home for you. Although grocery delivery costs a little more, it is a lot cheaper than eating out.
Another option is taking a taxi. This tends to cost more than grocery delivery, but allows you to shop in person and compare prices, which also would save money as well.
When Anxiety is a Problem...
Many people experience anxiety about entering a store, and walking around with other people. Then, they either avoid going shopping, or else have difficulty thinking in the store because of the anxiety they are experiencing. I have had some success with grading the activity using "Fear Ladders" from Anxiety BC (Click to go there).
I have found that people are much less likely to want to work on their anxiety if they are able to obtain their groceries another way (e.g. friend or family member getting the groceries for them). Sometimes the key is to find a strong enough motivator. I had one client where the fear ladder did not work, but having to buy her cigarettes for herself did.
If a person is not ready to work on their anxiety around grocery shopping, grocery delivery (discussed above) is another option.
When Lack of Experience is a Problem...
This is often what we think of when we think of skills-teaching. However, it is surprising how rarely this is really the issue. The solution for lack of experience? Practice, practice, practice (in a real environment). I have used worksheets where people have to find certain products, find the price, and compare prices to find the best deal. It is helpful to point out the overhead signs, and to practice asking a store employee where an item is. It is also helpful to practice price comparison, and to use a store that has the price per unit listed on the price tag.
When Using Money is a Problem...
Occasionally, people are unable to count their money, either because they do not know how to count money or because they lack the vision or dexterity to count it. One solution is to buy gift cards, because it requires fewer cash transactions. Money skills can be learned with a lot of practice. I have found it is important to practice with real money - expecting skills learned with fake money to transfer over to real money is asking too much.
These are the ways that I have tried to address the major barriers to grocery shopping. I would love to hear what you have found helpful and/or unhelpful.