J Korean Acad Psychiatr Ment Health Nurs.  2018 Sep;27(3):264-273. 10.12934/jkpmhn.2018.27.3.264.

Experience of Long-term Care Workers' Communication with Older Adults with Dementia Focused on Emotional Expression

• Lee S
• Lee KH

• KMID: 2422598
• DOI: http://doi.org/10.12934/jkpmhn.2018.27.3.264

Abstract

PURPOSE
The purposes of this study were to understand (1) emotional expression of older adults with dementia and (2) communication between long-term care workers and older adults with dementia.
METHODS
Ten long-term care workers who provided care services for older adults with dementia in long-term care were interviewed. Qualitative content analysis was conducted to reveal themes and subthemes.
RESULTS
Participants stated that they tried to learn emotional expressions in older adults with dementia, but it was difficult due to emotional fluctuation in older adults with dementia. Care workers attempted to interact with older adults with dementia using verbal and non-verbal communication skills. They stated difficulties in verbal communication with older adults with dementia. In addition, care workers improved their tailored communication skills with the accumulation of care experience and noticed their care service value.
CONCLUSION
It is meaningful to understand long-term care workers' perceptions of emotional expression and communication among older adults with dementia in long-term care. Well-organized communication protocols should be provided for long-term care workers to enhance emotion-oriented and person-centered care services based on the needs and preferences of older adults with dementia.

Keyword

Dementia; Emotions; Communication; Health personnel; Long-term care

MeSH Terms

Adult*
Dementia*
Health Personnel
Humans
Long-Term Care*

Reference

1. National Institute of Dementia. 2017 National institute of dementia annual report. Seongnam: National Institute of Dementia;2018.

2. Lee SB, Kwon OD. Factors affecting care worker's burden of patients with dementia. J Korean Neurol Assoc. 2015; 33(3):162–167. DOI: 10.17340/jkna.2015.3.4.

3. Lee KH, Algase DL, McConnell ES. Daytime observed emotional expressions of people with dementia. Nurs Res. 2013; 62(4):218–225. DOI: 10.1097/NNR.0b013e31829999d7.

4. Arai Y, Zarit SH. Exploring strategies to alleviate caregiver burden: effects of the national long-term care insurance scheme in Japan. Psychogeriatrics. 2011; 11(3):183–189. DOI: 10.1111/j.1479-8301.2011.00367.x.

5. Mayhew M. The growing challenge of Alzheimer disease part 2. J Nurse Pract. 2005; 1(3):149–156. DOI: 10.1016/j.nurpra.2005.09.014.

6. Talerico KA, Evans LK, Strumpf NE. Mental health correlates of aggression in nursing home residents with dementia. Gerontologist. 2002; 42(2):169–177. DOI: 10.1093/geront/42.2.169.

7. Beeri MS, Werner P, Davidson M, Noy S. The cost of behavioral and psychological symptoms of dementia (BPSD) in community dwelling Alzheimer's disease patients. Int J Geriatr Psychiatry. 2002; 17(5):403–408. DOI: 10.1002/gps.490.

8. Kleijer BC, Van Marum RJ, Egberts ACG, Jansen PAF, Frijters D, Heerdink ER, et al. The course of behavioral problems in elderly nursing home patients with dementia when treated with antipsychotics. Int Psychogeriatr. 2009; 21(5):931–940. DOI: 10.1017/S1041610209990524.

9. Suh HK, Choi HJ. An analysis of caregivers' recognition of communication problems in patients with dementia. J Speech Hear Disord. 2010; 19(3):1–18.

10. Chon YH. A study on relationships between the elderly with dementia and care workers under the long-term care insurance for the elderly in Korea. Stud Life Cult. 2017; 43:129–171.

11. Nam YH, Kim YS, Kim JC. A study on the phenomenological of caregivers about the work adaption process. J Welf Aged. 2014; 64:287–321.

12. Small J, Chan SM, Drance E, Globerman J, Hulko W, O'Connor D, et al. Verbal and nonverbal indicators of quality of communication between care staff and residents in ethnoculturally and linguistically diverse long-term care settings. J Cross Cult Gerontol. 2015; 30(3):285–304. DOI: 10.1007/s10823-015-9269-6.

13. Abbott KM, Sefcik JS, Van Haitsma K. Measuring social integration among residents in a dementia special care unit versus traditional nursing home: a pilot study. Dementia. 2017; 16(3):388–403. DOI: 10.1177/1471301215594950.

14. Wheeler NL, Oyebode JR. Dementia care 1: person centred approaches help to promote effective communication. Nurs Times. 2010; 106(24):18–21.

15. Christenson AM, Buchanan JA, Houlihan D, Wanzek M. Command use and compliance in staff communication with elderly residents of long-term care facilities. Behav Ther. 2011; 42(1):47–58. DOI: 10.1016/j.beth.2010.07.001.

16. Wilson R, Rochon E, Mihailidis A, Leonard C. Quantitative analysis of formal caregivers' use of communication strategies while assisting individuals with moderate and severe Alzheimer's disease during oral care. J Commun Disord. 2013; 46(3):249–263. DOI: 10.1016/j.jcomdis.2013.01.004.

17. Wilson R, Rochon E, Mihailidis A, Leonard C. Examining success of communication strategies used by formal caregivers assisting individuals with Alzheimer's disease during an activity of daily living. J Speech Lang Hear Res. 2012; 55(2):328–341. DOI: 10.1044/1092-4388(2011/10-0206).

18. Stanyon MR, Griffiths A, Thomas SA, Gordon AL. The facilitators of communication with people with dementia in a care setting: an interview study with healthcare workers. Age Ageing. 2016; 45(1):164–170. DOI: 10.1093/ageing/afv161.

19. D'Hondt A, Kaasalainen S, Prentice D, Schindel Martin L. Bathing residents with dementia in long-term care: critical incidents described by personal support workers. Int J Older People Nurs. 2012; 7(4):253–263. DOI: 10.1111/j.1748-3743.2011.00283.x.

20. Hart BD, Wells DL. The effects of language used by caregivers on agitation in residents with dementia. Clin Nurse Spec. 1997; 11(1):20–23. DOI: 10.1097/00002800-199701000-00015.

21. Belzil G, Vezina J. Impact of caregivers' behaviors on resistiveness to care and collaboration in persons with dementia in the context of hygienic care: an interactional perspective. Int Psychogeriatr. 2015; 27(11):1861–1873. DOI: 10.1017/s104161021500099x.

22. Park K, Moon SH, Youn JC, Son GRH. Frequency, competency, and difficulty of long-term care (LTC) services according to length of job experience among care-workers in long-term care facilities. J Korean Gerontol Nurs. 2017; 19(2):135–144. DOI: 10.17079/jkgn.2017.19.2.135.

23. Yih BS. The experiences of long term care workers who care for people with dementia at home. J Korea Acad Ind Coop Soc. 2016; 17(2):394–401. DOI: 10.5762/KAIS.2016.17.2.394.

24. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005; 15(9):1277–1288. DOI: 10.1177/1049732305276687.

25. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today. 2004; 24(2):105–112. DOI: 10.1016/j.nedt.2003.10.001.

26. Fritsch T, Kwak J, Grant S, Lang J, Montgomery RR, Basting AD. Impact of TimeSlips, a creative expression intervention program, on nursing home residents with dementia and their caregivers. Gerontologist. 2009; 49(1):117–127. DOI: 10.1093/geront/gnp008.

27. van Weert JC, van Dulmen AM, Spreeuwenberg PM, Ribbe MW, Bensing JM. Effects of snoezelen, integrated in 24 h dementia care, on nurse-patient communication during morning care. Patient Educ Couns. 2005; 58(3):312–326. DOI: 10.1016/j.pec.2004.07.013.

28. Lim DY. Coping with dementia related behavior problems of the elderly and care providers. J Korea Acad Ind Coop Soc. 2015; 16(7):4805–4815. DOI: 10.5762/KAIS.2015.16.7.4805.