Improving outcomes of nursing home interactions

Abstract

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.

Elderspeak Communication: Impact on Dementia Care

“…Reducing nursing staff use of elderspeak may better meet the needs of individuals with dementia, reduce resistiveness behaviors, and thus improve nursing care. Future research will evaluate whether an intervention empirically proven to decrease nursing home staff elderspeak use, 1,15 will result in reductions in RTC behaviors of care recipients with dementia. Boxplots of the 95% probability distributions of subsequent resident resistiveness to care behavior when staff use elderspeak, normal talk, or are silent.…”

“…Each text transcript then was coded for diminutives and collective pronoun substitutions using established operational definitions. 1,15 Training and practice by research assistants using previously collected video recordings was used to establish reliability of transcription and coding at 90% or greater agreement for segmenting utterances and coding of diminutive and collective pronoun substitutions. During coding of the study sample, ten percent of the videos were separately transcribed and coded by two research team members, confirming 90% or greater agreement.…”

Communication skills training in dementia care: a systematic review of effectiveness, training content, and didactic methods in different care settings

“…Small group discussions on frustration and self-experience, brainstorming sessions on successful and failed communication, and roleplay were frequently chosen as means of learning. Problem-based learning techniques were used, such as case discussions of written or real-life Burgio et al (2001) 13-13.50 Burgio et al (2002) 6.59-6.69 Done and Thomas (2001) Not stated (no PWD included) Haberstroh et al (2006) Not stated (no PWD included) Haberstroh et al (2009) Not stated Kuske et al (2009) 8.7-10.4 McCallion et al (1999 4.9-6.3 Magai et al (2002) 3.2-4.2 Teri et al (2005) 13.0-14.2 Williams (2006) Not stated Allen-Burge (2001) 16-25 Ripich et al (1994) Not stated (no PWD included)…”

“…Another three studies used a gratification system either in the form of monetary compensation (Magai et al, 2002;Williams, 2006) or a certificate of completion as a means of recognizing the participants' efforts and accomplishments (McCallion et al, 1999). Written or oral feedback, ongoing support, selfmonitoring, and supervision were used to reach sustainability and maintenance of trained skills.…”

Individualized Care in Practice: Communication Strategies of Nursing Aides and Residents in Nursing Homes

“…Among residents, the data suggest a heightened sensitivity to being told what they could and could not do because of their vulnerabilities. Respect from CNAs communicating what they would be doing to or for the residents might help, especially if they avoid condescension (Williams, 2006).…”