Resistiveness to care (RTC) is common in older adults with dementia. RTC disrupts nursing care, increasing costs of care by 30%. Elderspeak (infantilizing communication used by nursing staff) may trigger RTC in individuals with dementia. Videotaped care episodes (N=80) of nursing home residents with dementia (N=20) were coded for type of staff communication (normal talk and elderspeak) and subsequent resident behavior (cooperative or RTC). Bayesian statistical analysis tested relationships between staff communication and subsequent resident RTC. The probability of RTC varied significantly with communication (Bayes p = .0082). An increased probability of RTC occurred with elderspeak (.55, CrI = .44 -.66), compared to normal talk (.26, CrI = .12-.44). Communication training has been shown to reduce elderspeak and may reduce RTC in future research.

Teaching CNAs to reduce elderspeak holds promise as an approach to improving the social environment in nursing homes.

As the population ages, risks for cognitive decline threaten independence and quality of life for older adults and present challenges to the health care system. Nurses are in a unique position to advise clients about cognitive health promotion and to develop interventions that optimize cognition in the growing aging population. A literature review was completed to provide nurses working in mental health and geriatric care with an overview of research related to the promotion of successful cognitive aging for older adults. Research evaluating cognitively stimulating lifestyles and the effects on cognitive function of older adults of interventions targeting cognitive training, physical activity, social engagement, and nutrition were reviewed. Overall research findings support positive effects of cognitive and physical activity, social engagement, and therapeutic nutrition in optimizing cognitive aging. However, the strength of the research evidence is limited by research designs. Conclusions include recommended applications for health promotion to optimize cognitive aging and future direction for research.

In this study, an intervention designed to improve staff-resident communication was evaluated in three nursing homes. Audio recordings of staff speech from baseline, and immediately and 2 months post-intervention, were compared on elderspeak (infantilizing speech) and rated for care, respect, and control. After the intervention, staff used less elderspeak (i.e., diminutives, collective pronoun substitutions, shortened statements, and simplistic vocabulary). Immediate post-intervention conversations were rated as less controlling, but more respectful and caring. After 2 months, communication was more controlling, less respectful, and less caring. Reduction in staff elderspeak use continued for psycholinguistic measures, but improvements in care, respect, and control decayed, suggesting the need for ongoing reinforcement of training.