Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-31T17:05:23.927Z Has data issue: false hasContentIssue false
  • English
  • Français

Missed opportunities for person-centered communication: implications for staff-resident interactions in long-term care

Published online by Cambridge University Press:  28 November 2013

Marie Y. Savundranayagam
Marie Y. Savundranayagam*
Affiliation:
School of Health Studies, Faculty of Health Sciences, 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, CanadaN6A 5B9. Phone: +1-519-661-2111 x82215. Email: [email protected].
Get access

Abstract

Background:

Social interactions in long-term care settings between staff and residents with dementia have been characterized as task-oriented, patronizing, and/or overly directive. Long-term care settings can be contexts that emphasize dependency and threaten the personal identity of older residents. Yet, leaders in the long-term care sector have acknowledged recently that dementia care must move beyond the completion of caregiving tasks and adopt a person-centered approach. This approach involves caregivers incorporating a resident's life history and preferences during interactions. The objectives of this study were to examine the extent to which staff–resident communication is person-centered and the extent to which staff miss opportunities to communicate with residents in a person-centered manner.

Methods:

Conversations (N = 46) of 13 staff–resident dyads were audio-recorded during routine care tasks over 12 weeks. Staff utterances within these conversations were coded for person-centered communication and missed opportunities where person-centered communication could have been used.

Results:

Findings revealed a common communication sequence where utterances coded as person-centered were followed by utterances coded as missed opportunities. This sequence suggests that the positive impact of person-centered communication may be undermined when such communication is followed by missed opportunities. Data also revealed that missed opportunities highlight the need for staff training.

Conclusion:

The findings underscore the importance of sustaining person-centered communication while completing routine care tasks.

Keywords

person-centered communicationstaff caregiversdementialong-term care
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Issue 4 , April 2014 , pp. 645 - 655
Copyright
Copyright © International Psychogeriatric Association 2013 

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

Acton, G. J., Yauk, S., Hopkins, B. A. and Mayhew, P. A. (2007). Increasing social communication in persons with dementia. Research & Theory for Nursing Practice, 21, 32–44.Google Scholar
Ashburner, C., Meyer, J., Johnson, B. and Smith, C. (2004). Using action research to address loss of personhood in a continuing care setting. Illness, Crisis & Loss, 12, 23–37. doi:10.1177/1054137303259739.Google Scholar
Carpiac-Claver, M. L. and Levy-Storms, L. (2007). In a manner of speaking: communication between nurse aides and older adults in long-term care settings. Health Communication, 22, 59–67.Google Scholar
Ekman, S. L., Norberg, A., Viitanen, M. and Winblad, B. (1991). Care of demented patients with severe communication problems. Scandinavian Journal of Caring Sciences, 5, 163–170.Google 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.Google Scholar
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.Google Scholar
Hamilton, H. E. (1994). Conversations with an Alzheimer's Patient: An Interactional Sociolinguistic Study. New York: Cambridge University Press.Google Scholar
Herman, R. and Williams, K. N. (2009). Elderspeak's influence on resistiveness to care: focus on behavioral events. American Journal of Alzheimer's Disease & Other Dementias, 24, 417–423. doi:10.1177/1533317509341949.CrossRefGoogle ScholarPubMed
Kitwood, T. (1997). Dementia Reconsidered: The Person Comes First. Bristol, PA: Open University Press.Google Scholar
Kitwood, T. and Bredin, K. (1992). A new approach to the evaluation of dementia care. Journal of Advances in Health and Nursing Care, 1, 41–60.Google Scholar
Kolanowski, A., Buettner, L., Litaker, M. and Yu, F. (2006). Factors that relate to activity engagement in nursing home residents. American Journal of Alzheimer's Disease & Other Dementias, 21, 15–22. doi:10.1177/153331750602100109.Google Scholar
Langdon, S. A., Eagle, A. and Warner, J. (2007). Making sense of dementia in the social world: a qualitative study. Social Science & Medicine, 64, 989–1000.Google Scholar
Passalacqua, S. A. and Harwood, J. (2012). VIPS communication skills training for paraprofessional dementia caregivers: an intervention to increase person-centered dementia care. Clinical Gerontologist, 35, 425–445. doi:10.1080/07317115.2012.702655.Google Scholar
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.Google Scholar
Ryan, E. B., Meredith, S. D., MacLean, M. J. and Orange, J. B. (1995). Changing the way we talk with elders: promoting health using the communication enhancement model. International Journal of Aging and Human Development, 41, 89–107.Google 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., Ryan, E. B., Anas, A. P. and Orange, J. B. (2007). Communication and dementia: staff perceptions of conversational strategies. Clinical Gerontologist, 31, 47–63. doi:10.1300/J018v31n02_04.Google Scholar
Shakespeare, P. (1998). Aspects of Confused Speech: A Study of Verbal Interaction between Confused and Normal Speakers. Mahwah, NJ: Lawrence Erlbaum.Google Scholar
Stein-Parbury, J., Chenoweth, L., Jeon, Y. H., Brodaty, H., Haas, M. and Norman, R. (2012). Implementing person-centered care in residential dementia care. Clinical gerontologist, 35, 404–424. doi:10.1080/07317115.2012.702654.Google Scholar
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, T., Murphy, B., Procter, A. and Weinman, J. (1992). An observational study of two long-stay psychogeriatric wards. International Journal of Geriatric Psychiatry, 7, 211–217.Google Scholar
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.Google Scholar
Williams, K. N., Kemper, S. and Hummert, M. L. (2003). Improving nursing home communication: an intervention to reduce elderspeak. Gerontologist, 43, 242–247.Google Scholar
Williams, K. N., Ilten, T. and Bower, H. (2005). Meeting communication needs: topics of talk in the nursing home. Journal of Psychosocial Nursing & Mental Health Services, 43, 38–47.CrossRefGoogle ScholarPubMed
Williams, K. N., Herman, R., Gajewski, B. and Wilson, K. (2009). Elderspeak communication: impact on dementia care. American Journal of Alzheimer's Disease & Other Dementias, 24, 11–20.Google Scholar