Characteristics of elderspeak communication in hospital dementia care: Findings from The Nurse Talk observational study

Shaw, Clarissa; Ward, Caitlin; Gordon, Jean; Williams, Kristine; Herr, Keela

doi:10.1016/j.ijnurstu.2022.104259

Cited by 9 publications

(11 citation statements)

References 54 publications

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“…The care encounters occurred primarily in the morning (64.8%) and were focused on ADL care (57.9%). See Supplementary Tables S1 and S2 for sample demographics and the parent study for additional details on study design and measures ( Shaw et al, 2022a , 2022b ).…”

Section: Resultsmentioning

confidence: 99%

“…This study is a secondary analysis of observational data from the Nurse Talk study. The purpose of the Nurse Talk study was to determine the impact of elderspeak communication (i.e., infantilization or speech that sounds like baby talk) on rejection of care by hospitalized patients with dementia ( Shaw et al, 2022a , 2022b ). A secondary analysis of the data was completed to explore the relationship between pain severity, delirium severity, and specific rejection of care behaviors.…”

Section: Methodsmentioning

confidence: 99%

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The Relationship Between Rejection of Care Behaviors and Pain and Delirium Severity in Hospital Dementia Care

Shaw

Ward

Williams

et al. 2023

Innovation in Aging

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Background and Objectives Rejection of care is common in hospitalized persons living with dementia. However, distinguishing between rejection of care behaviors related to care practices or other causes such as pain or delirium is challenging. The purpose of this study is to further understand the relationship between rejection of care and pain and delirium in hospitalized patients with dementia by identifying which rejection of care behaviors are associated with pain and delirium. Research Design and Methods Care encounters between hospitalized patients with dementia (n=16) and nursing staff (n=53) were observed on 88 separate occasions across 35 days. Rejection of care was measured using the 13 behaviors from the Resistiveness to Care Scale. Pain and delirium severity were measured using a variety of scales including the Pain Assessment in Advanced Dementia Scale (PAINAD), Checklist of Nonverbal Pain Indicators (CNPI), and numeric rating scale for pain severity and the Confusion Assessment Method—Severity (CAM-S) short form and Delirium Observation Screening Scale (DOS) for delirium severity. Linear-mixed-modeling was used to determine the relationship between rejection of care behaviors and pain and delirium severity for each measure. Results 48.9% of the observations included rejection of care, 49.9% included a patient in pain, and 12.5% included a patient with delirium. Cry, push away, scream/yell, and turn away indicated a higher pain severity across pain measures. No rejection of care behaviors were found to indicate delirium severity. Discussion and Implications Certain rejection of care behaviors may be helpful in identifying pain in hospitalized patients with dementia suggesting that caregivers should be cognizant of pain when these rejection of care behaviors are present. However, in this sample rejection of care behaviors were not found to be a useful for identifying delirium severity in hospital dementia care.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The Relationship Between Rejection of Care Behaviors and Pain and Delirium Severity in Hospital Dementia Care

Shaw

Ward

Williams

et al. 2023

Innovation in Aging

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“…Examples of elderspeak communication by nursing staff and RoC by PLWD are provided in Table 1. Additional information on elderspeak use by the nursing staff and the Nurse Talk study methods are reported elsewhere 35 …”

Section: Resultsmentioning

confidence: 99%

“…Additional information on elderspeak use by the nursing staff and the Nurse Talk study methods are reported elsewhere. 35 Hospitalized PLWD exhibited RoC in nearly half (48.9%) of the care encounters. The majority (75.0%) of PLWD exhibited RoC in at least one observation; however, four PLWD (25.0%) exhibited no RoC in any of the observations.…”

Section: Elderspeak and Rejection Of Carementioning

confidence: 98%

Elderspeak communication and pain severity as modifiable factors to rejection of care in hospital dementia care

Shaw

Ward

Gordon

et al. 2022

J American Geriatrics Society

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Background Rejection of care (RoC) occurs when persons living with dementia (PLWD) withstand or oppose the efforts of their caregiver. Improvements in hospital dementia care are needed, and one way to address this need is by identifying factors that lead to RoC, particularly those that are modifiable. Elderspeak communication is an established antecedent to RoC among PLWD in nursing homes. The purpose of this study was to extend these results to acute care settings by determining the impact of elderspeak communication by nursing staff on RoC by hospitalized PLWD. Methods Care encounters between nursing staff and PLWD were audio‐recorded, transcribed verbatim, and coded for semantic, pragmatic, and prosodic features of elderspeak. RoC behaviors was scored in real‐time using the Resistiveness to Care Scale. A Bayesian repeated‐measures hurdle model was used to evaluate the association between elderspeak and both the presence and severity of RoC. Results Eighty‐eight care encounters between 16 PLWD and 53 nursing staff were audio‐recorded for elderspeak and scored for RoC. Nearly all (96.6%) of the encounters included some form of elderspeak. Almost half of the care encounters (48.9%) included RoC behaviors. A 10% decrease in elderspeak was associated with a 77% decrease in odds of RoC (OR = 0.23, 95% CI = 0.03, 0.68) and a 16% decrease (eβ= 0.84, CI = 0.73, 0.96) in the severity of RoC. A one‐unit decrease in pain severity was associated with 73% reduced odds of RoC (OR = 0.27, CI = 0.12, 0.45) and a 28% decrease (eβ= 0.72, CI = 0.64, 0.80) in the severity of RoC. Conclusions Both elderspeak by nursing staff and RoC by PLWD are present and pervasive in acute care. Pain and elderspeak are two modifiable factors of RoC in hospitalized PLWD. Person‐centered interventions are needed that address communication practices and pain management for hospitalized PLWD.

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“…It is not only adults with intellectual disability who experience infantilisation or use of terminology such as mental age. For example, infantilising speech, known as 'elderspeak' was observed to be in frequent use in acute care settings (Shaw et al, 2022) particularly involving elders living with cognitive impairment. Additional research may bear this in mind.…”

Section: Study Limitationsmentioning

confidence: 99%

Mental age and intellectual disability: Psychologists' perspectives on the use of the term ‘mental age’ as it relates to adults with an intellectual disability

Rogers,

McGuire

2024

Policy Practice Intel Disabi

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Despite the growing international move away from the term ‘mental age’, the term continues to be used in some settings with adults with an intellectual disability. Arguably, the construct of ‘mental age’ conflicts with current rights‐based approaches yet its continued use suggests that it may have certain utilities. This study aimed to explore the use of the construct of mental age in the context of supporting adults with an intellectual disability in Ireland, and its perceived value and limitations in clinical practice. Forty‐three psychologists in Ireland responded to a 10‐item online survey using a mix of closed and open‐ended questions. Descriptive statistics were used and analysis was informed by reflexive thematic analysis. Twenty of the 43 respondents reported that mental age continues to be used in clinical practice. Analysis was informed by reflexive thematic analysis and identified five main themes: (1) negative connotations, (2) inconsistent with best practice, (3) supporting the person with an intellectual disability, (4) communicating about the person with intellectual disability and (5) moving on from mental age. The findings suggest that this construct is considered problematic and limited in its meaning and while there is a desire for change, there are challenges in finding an alternative method of communicating information about ability in a brief and easily understood way.

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Characteristics of elderspeak communication in hospital dementia care: Findings from The Nurse Talk observational study

Cited by 9 publications

References 54 publications

The Relationship Between Rejection of Care Behaviors and Pain and Delirium Severity in Hospital Dementia Care

The Relationship Between Rejection of Care Behaviors and Pain and Delirium Severity in Hospital Dementia Care

Elderspeak communication and pain severity as modifiable factors to rejection of care in hospital dementia care

Mental age and intellectual disability: Psychologists' perspectives on the use of the term ‘mental age’ as it relates to adults with an intellectual disability

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