Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-18T14:26:06.396Z Has data issue: false hasContentIssue false
  • English
  • Français

Language-based communication strategies that support person-centered communication with persons with dementia

Published online by Cambridge University Press:  19 June 2015

Marie Y. Savundranayagam  and
Kelsey Moore-Nielsen
Marie Y. Savundranayagam*
Affiliation:
School of Health Studies, Western University, London, Ontario, Canada
Kelsey Moore-Nielsen
Affiliation:
School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
*
Correspondence should be addressed to: Marie Y. Savundranayagam, PhD, School of Health Studies, Faculty of Health Sciences, Arthur & Sonia Labatt Health Sciences Building, Room 219, Western University, London, ON Canada N6A 5B9, Canada. Phone: (519) 661-2111 x82215. Email: [email protected].
Get access

Abstract

Background:

There are many recommended language-based strategies for effective communication with persons with dementia. What is unknown is whether effective language-based strategies are also person centered. Accordingly, the objective of this study was to examine whether language-based strategies for effective communication with persons with dementia overlapped with the following indicators of person-centered communication: recognition, negotiation, facilitation, and validation.

Methods:

Conversations (N = 46) between staff-resident dyads were audio-recorded during routine care tasks over 12 weeks. Staff utterances were coded twice, using language-based and person-centered categories. There were 21 language-based categories and 4 person-centered categories.

Results:

There were 5,800 utterances transcribed: 2,409 without indicators, 1,699 coded as language or person centered, and 1,692 overlapping utterances. For recognition, 26% of utterances were greetings, 21% were affirmations, 13% were questions (yes/no and open-ended), and 15% involved rephrasing. Questions (yes/no, choice, and open-ended) comprised 74% of utterances that were coded as negotiation. A similar pattern was observed for utterances coded as facilitation where 51% of utterances coded as facilitation were yes/no questions, open-ended questions, and choice questions. However, 21% of facilitative utterances were affirmations and 13% involved rephrasing. Finally, 89% of utterances coded as validation were affirmations.

Conclusions:

The findings identify specific language-based strategies that support person-centered communication. However, between 1 and 4, out of a possible 21 language-based strategies, overlapped with at least 10% of utterances coded as each person-centered indicator. This finding suggests that staff need training to use more diverse language strategies that support personhood of residents with dementia.

Keywords

person-centered communicationlanguage strategiesstaff caregiversdementialong-term care
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Special Issue 10: Psychosocial and Ethical Aspects of Dementia , October 2015 , pp. 1707 - 1718
Copyright
Copyright © International Psychogeriatric Association 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bourgeois, M. S., Dijkstra, K., Burgio, L. D. and Allen, R. S. (2004). Communication skills training for nursing aides of residents with dementia: the impact of measuring performance. Clinical Gerontologist, 27, 119–138.CrossRefGoogle Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-Mental State.” Journal of Psychiatric Research, 12, 189–198. doi:10.1016/0022-3956(75)90026-6.CrossRefGoogle ScholarPubMed
Hallberg, I. R., Norberg, A. and Eriksson, S. (1990). A comparison between the care of vocally disruptive patients and that of other residents at psychogeriatric wards. Journal of Advanced Nursing, 15, 410–416.CrossRefGoogle ScholarPubMed
Hamilton, H. E. (1994). Conversations with an Alzheimer's Patient: An Interactional Sociolinguistic Study. New York: Cambridge University Press.CrossRefGoogle Scholar
Hummert, M. L., Garstka, T. A., Ryan, E. B. and Bonnesen, J. L. (2004). The role of age stereotypes in interpersonal communication. In Nussbaum, J. and Coupland, J. (eds.), The Handbook of Communication and Aging (pp. 91–114). Mahwah, NJ: Erlbaum.Google Scholar
Kemper, S. and Harden, T. (1999). Experimentally disentangling what's beneficial about elderspeak from what's not. Psychology and Aging, 14 (4), 656.CrossRefGoogle ScholarPubMed
Kim, E. S. and Bayles, K. A. (2007). Communication in late-stage Alzheimer's disease. Alzheimer's Care Quarterly, 8, 43–52.Google Scholar
Kitwood, T. (1997). Dementia Reconsidered: The Person Comes First. Bristol, PA: Open University Press.Google Scholar
Medvene, L. J. and Lann-Wolcott, H. (2010). An exploratory study of “nurse aides” communication behaviours: giving “positive regard” as a strategy. International Journal of Older People Nursing, 5 (1), 41–50.CrossRefGoogle ScholarPubMed
Orange, J. B. (2001). Family caregivers, communication, and Alzheimer's disease. In Hummert, M. L. and Nussbaum, J. F. (eds.), Aging, Communication, and Health: Linking Research and Practice for Successful Aging (pp. 225–248). Mahwah, NJ: Lawrence Erlbaum.Google Scholar
Perkins, L., Whitworth, A. and Lesser, R. (1998). Conversing in dementia: a conversation analytic approach. Journal of Neurolinguistics, 11, 33–53.CrossRefGoogle Scholar
Ramanathan, V. (1997). Alzheimer Discourse: Some Sociolinguistic Dimensions. Mahwah, NJ: Lawrence Erlbaum.Google Scholar
Ripich, D. N., Ziol, E., Fritsch, T. and Durand, E. J. (1999). Training Alzheimer’s disease caregivers for successful communication. Clinical Gerontologist, 21, 37–56.CrossRefGoogle Scholar
Rousseaux, M., Sève, A., Vallet, M., Pasquier, F. and Mackowiak-Cordoliani, M. A. (2010). An analysis of communication in conversation in patients with dementia. Neuropsychologia, 48, 3884–3890.CrossRefGoogle ScholarPubMed
Ryan, E. B., Byrne, K., Spykerman, H. and Orange, J. B. (2005). Evidencing Kitwood's personhood strategies: conversation as care in dementia. In Davis, B. H. (ed.), Alzheimer Talk, Text, and Context: Identifying Communication Enhancement (pp. 18–36). New York: Palgrave Macmillan.CrossRefGoogle Scholar
Ryan, E. B., Giles, H., Bartolucci, G. and Henwood, K. (1986). Psycholinguistic and social psychological components of communication by and with the elderly. Languange and Communication, 6, 1–24.CrossRefGoogle Scholar
Ryan, E. B., Hummert, M. L. and Boich, L. H. (1995). Communication predicaments of aging: patronizing behavior toward older adults. Journal of Language and Social Psychology, 14, 144–166.CrossRefGoogle Scholar
Sabat, S. R. (1991). Facilitating conversation via indirect repair: a case study of Alzheimer's disease. Georgetown Journal of Languages & Linguistics, 2, 284–296.Google Scholar
Sabat, S. R. (2001). The Experience of Alzheimer's Disease: Life Through a Tangled Veil. Massachusetts: Blackwell Publishers.Google Scholar
Sabat, S. R., Napolitano, L. and Fath, H. (2004). Barriers to the construction of a valued social identity: a case study of Alzheimer's disease. American Journal of Alzheimer's Disease and Other Dementias, 19, 177–185. doi:10.1177/153331750401900311.CrossRefGoogle Scholar
Santo Pietro, M. J. and Ostuni, E. (2003). Successful Communication with Persons with Alzheimer's Disease: An Inservice Manual. St. Louis, MO: Butterworth Heinemann.Google Scholar
Savundranayagam, M. Y. (2014). Missed opportunities for person-centered communication: implications for staff-resident interactions in long-term care. International Psychogeriatrics, 26, 645–655. doi:10.1017/S1041610213002093.CrossRefGoogle ScholarPubMed
Savundranayagam, M. Y. and Orange, J. B. (2014). Matched and mismatched appraisals of the effectiveness of communication strategies by family members of persons with Alzheimer's disease. International Journal of Language and Communication Disorders, 49 (1), 49–59.CrossRefGoogle ScholarPubMed
Schrauf, R. W. and Muller, N. (2014). Dialogue and Dementia: Cognitive and Communicative Resources for Engagement. New York: Psychology Press.Google Scholar
Small, J. A., Gutman, G., Makela, S. and Hillhouse, B. (2003). Effectiveness of communication strategies used by caregivers of persons with Alzheimer's disease during activities of daily living. Journal of Speech, Language, and Hearing Research, 46, 353–367.CrossRefGoogle ScholarPubMed
Small, J. A., Kemper, S. and Lyons, K. (1997). Sentence comprehension in Alzheimer's disease: effects of grammatical complexity, speech rate, and repetition. Psychology and Aging, 12, 3–11.CrossRefGoogle ScholarPubMed
Small, J. A. and Perry, J. (2005). Do you remember? How caregivers question their spouses who have Alzheimer's disease and the impact on communication. Journal of Speech, Language, and Hearing Research, 48, 125–136.CrossRefGoogle Scholar
Smith, E. R.et al. (2011). Memory and communication support in dementia: research-based strategies for caregivers. International Psychogeriatrics, 23 (2), 256–263.CrossRefGoogle ScholarPubMed
Tang-Wai, D. and Graham, N. (2008). Assessment of language function in dementia. Geriatrics and Aging, 11, 103–110.Google Scholar
Tappen, R. M., Williams-Burgess, C., Edelstein, J., Touhy, T. and Fishman, S. (1997). Communicating with individuals with Alzheimer's disease: examination of recommended strategies. Archives of Psychiatric Nursing, 11, 249–256.CrossRefGoogle ScholarPubMed
Vasse, E., Vernooij-Dassen, M., Spijker, A., Rikkert, M. O. and Koopmans, R. (2010). A systematic review of communication strategies for people with dementia in residential and nursing homes. International Psychogeriatrics, 22, 189–200. doi: 10.1017/S1041610209990615.CrossRefGoogle ScholarPubMed
Ward, R., Vass, A. A., Aggarwal, N., Garfield, C. and Cybyk, B. (2008). A different story: exploring patterns of communication in residential dementia care. Ageing & Society, 28, 629–651.CrossRefGoogle Scholar
Watson, C. M., Chenery, H. J. and Carter, M. S. (1999). An analysis of trouble and repair in the natural conversations of people with dementia of the alzheimer's type. Aphasiology, 13 (3), 195–218.CrossRefGoogle Scholar
Wilkinson, A. M. (1993). Dementia care mapping: a pilot study of its implementation in a psychogeriatric service. International Journal of Geriatric Psychiatry, 8 (12), 1027–1029.CrossRefGoogle Scholar
Wilson, R., Rochon, E., Mihailidis, A. and Leonard, C. (2012). Examining success of communication strategies used by formal caregivers assisting individuals with Alzheimer's disease during an activity of daily living. Journal of Speech, Language, and Hearing Research, 55 (2), 328–341.CrossRefGoogle ScholarPubMed