The effect of care worker communication style on the communicative behaviour of care home residents with dementia : a mixed methods study

• Main Author: Gray, Miriam
• Published: University of Nottingham 2014
• Subjects: 616.8; WM Psychiatry
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.635108

Previous research into communication between care workers and care home residents with dementia has not utilised the experience of healthcare professionals who work with people with dementia on a daily basis. Previous research mostly consists of observational studies and the assessment of care worker training programmes. No study has yet attempted to establish the efficacy of isolated communication strategies, recommended by healthcare professionals, and administered by care workers within a residential care setting. This thesis first presents the thematic analysis of 16 semi-structured interviews with healthcare professionals who have experience of working with people with dementia. The participants discuss the personal characteristics required in a healthcare professional to facilitate communication, the verbal and non-verbal strategies they use and the organisational factors which can impact the delivery of communication as desired. Two of the recommended strategies, alpha commands and pacing an interaction, were then analysed experimentally. Three care worker-resident dyads were videoed during morning care routines in an ABAC design. Resident communicative behaviour was measured using an amended version of the Positive Response Schedule (PRS) (Perrin, 1997), the Resistiveness to Care Scale (RTC-DAT) (Mahoney et al., 1999) and compliance. It was found that the conditions containing a significantly higher percentage of alpha commands produced significantly higher PRS scores. This was shown within each dyad and across the dyads (r=+0.65, p<0.05). The results for the pacing condition were inconclusive as the residents responded quickly after instructions were given. This exploratory study found a significant effect of alpha commands on the communicative behaviour of care home residents with dementia. The implications for future research and care worker training are discussed.