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Cited by 105Dementia and Cognitive Impairment ResearchGeriatric Care and Nursing HomesPatient-Provider Communication in Healthcare

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A Communication Intervention to Reduce Resistiveness in Dementia Care: A Cluster Randomized Controlled Trial

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Williams, Kristine N., Perkhounkova, Yelena, Herman, Ruth, Bossen, Ann·2017·The Gerontologist
DOI 10.1093/geront/gnw047PMC PMC5881770
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Abstract

Purpose of the Study: Nursing home (NH) residents with dementia exhibit challenging behaviors or resistiveness to care (RTC) that increase staff time, stress, and NH costs. RTC is linked to elderspeak communication. Communication training (Changing Talk [CHAT]) was provided to staff to reduce their use of elderspeak. We hypothesized that CHAT would improve staff communication and subsequently reduce RTC. Methods: Thirteen NHs were randomized to intervention and control groups. Dyads (n = 42) including 29 staff and 27 persons with dementia were videorecorded during care before and/or after the intervention and at a 3-month follow-up. Videos were behaviorally coded for (a) staff communication (normal, elderspeak, or silence) and (b) resident behaviors (cooperative or RTC). Linear mixed modeling was used to evaluate training effects. Results: On average, elderspeak declined from 34.6% (SD = 18.7) at baseline by 13.6% points (SD = 20.00) post intervention and 12.2% points (SD = 22.0) at 3-month follow-up. RTC declined from 35.7% (SD = 23.2) by 15.3% points (SD = 32.4) post intervention and 13.4% points (SD = 33.7) at 3 months. Linear mixed modeling determined that change in elderspeak was predicted by the intervention (b = −12.20,p = .028) and baseline elderspeak (b = −0.65,p < .001), whereas RTC change was predicted by elderspeak change (b = 0.43,p < .001); baseline RTC (b = −0.58,p < .001); and covariates. Implications: A brief intervention can improve communication and reduce RTC, providing an effective nonpharmacological intervention to manage behavior and improve the quality of dementia care. No adverse events occurred.

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Metadata

Authors
Williams, K. N., Perkhounkova, Y., Herman, R., & Bossen, A.
Affiliations
  • University of Iowa (US)
  • University of Kansas (US)
Corresponding author
Williams, Kristine N.
ORCID
Venue
The Gerontologist
Publisher
Oxford University Press (OUP)
Published
2016-04-05
Volume
57
Issue
4
Pages
707-718
ISSN
  • 0016-9013 (ISSN-L)
  • 1758-5341
DOI
10.1093/geront/gnw047
PMC
PMC5881770
OpenAlex
W2332207343
Cited by
105
References
6
Citations by year
2026: 9 · 2025: 11 · 2024: 7 · 2023: 10 · 2022: 14 · 2021: 13 · 2020: 15 · 2019: 10 · 2018: 3 · 2017: 12 · 2016: 1
FWCI
6.62
Type
journal article
Language
en
Open access
Licence
academic.oup.com/pages/standard-publication-reuse-rights (vor)
Locations
  • The Gerontologist (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (R01NR011455, NCT01324219)
  • National Institute of Nursing Research
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Geriatrics and Gerontology › Geriatric Care and Nursing Homes
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Keywords
dementia care, elderspeak, nursing home residents, behavioral problems, non-pharmacological treatment, staff-patient communication, quality of care
MeSH terms
Adult, Aged, Aged, 80 and over, Communication, Dementia, Female, Humans, Male, Middle Aged, Nurse-Patient Relations, Nursing Homes, Speech, Videotape Recording, Young Adult

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