Effects of care assistant communication style on communicative behaviours of residents with dementia: a systematic multiple case study

Abstract

Objectives To determine whether varying the communication style of care assistants, encouraging them to use direct instructions and allowing more time for residents’ responses influenced the communicative behaviour of care home residents living with dementia. Design This study used a multiple systematic case study design. Participants were video‐recorded during morning care routines in three communication conditions: usual communication, direct instructions and pacing (allowing more time for resident responses). Each dyad acted as its own control. Setting The study took place in a residential care home in the East Midlands, UK. Participants Three dyads (person with dementia/care worker) Measures The level of compliance with instructions was measured. Validated measures were used to rate positive communicative behaviour (engagement with care tasks, eye contact and initiation of interaction) and negative communicative behaviour (e.g. shouting and kicking). Results Care assistants were able to employ direct instructions after brief training. The use of direct instructions was positively correlated with positive communicative behaviour from residents (p < 0.05). The pacing condition was not employed adequately to evaluate effectiveness. Negative communicative behaviour (resistiveness to care) was rare. Conclusion The use of direct instructions by care assistants holds promise for effective communication with people with dementia and warrants further investigation in larger samples and in varied contexts.

Testing the Impact of FFC‐AL‐EIT on Psychosocial and Behavioral Outcomes in Assisted Living

“…The implementation of Function Focused Care also resulted in a significant decline in resistiveness to care among participants. The decline in resistiveness to care adds to prior findings that providing direct and simple statements and optimizing resident participation in functional activities can decrease resistiveness to care 37‐40 . These techniques are major components of function focused care.…”

“…The decline in resistiveness to care adds to prior findings that providing direct and simple statements and optimizing resident participation in functional activities can decrease resistiveness to care. [37][38][39][40] These techniques are major components of function focused care. Even the small decrease in resistiveness to care noted in this study is important for older individuals and their caregivers as resistiveness to care can impact the quality of life of residents and caregiver burnout, turnover, and risk of abuse.…”

One Step at a Time: Evaluation of a Step-By-Step Recipe Tool Designed for People with Dementia

“…1). Each step only mentions a single task, as direct and short instructions are found to be most effective [28,29]. Furthermore, as some people with dementia find it difficult to remember the details of the step they are working on [19], each step mentions the number of ingredients and where they should be added.…”

“…Although many people with dementia often stop doing activities they are still capable of to avoid challenging situations [28], all participants of this study were excited to start cooking. Stanyon et al and Fitzsimmons et al suggest giving direct short instructions [29] and introducing collaborative cooking activities [18] can increase the involvement and initiative of people with dementia. Thus, we recommend using intuitive and inviting tools such as Happje to counter the apathy [35] often seen in people with dementia.…”

Nurturing Attentiveness: A Naturalistic Observation Study of Personal Care Interactions Between People With Advanced Dementia and Their Caregivers

“…Personal care interactions with a person with advanced dementia remain a key source of human contact, communication, and company ( Savundranayagam et al, 2016 ). Skilled caregiver communication, such as being attuned with the person ( Alsawy et al, 2017 ) or providing direct instructions ( Stanyon et al, 2019 ), can be received positively and is pertinent during the advanced stages of dementia where the person’s communication is likely to be impaired ( Banovic et al, 2018 ). However, elderspeak, a form of overaccommodating communication involving inappropriate spoken words and/or intonations for older people, including the use of collective pronouns, the overinclusive “we” or “us” when it should be “you” or “I,” can be perceived negatively by many older people and lead to behaviors that challenge people with dementia ( Shaw & Gordon, 2021 ).…”