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Visualising conversations between care home staff and residents with dementia

Published online by Cambridge University Press:  23 September 2013

ROSEMARY BAKER
Affiliation:
UQ Centre for Clinical Research, Royal Brisbane and Women's Hospital, The University of Queensland, Australia.
DANIEL ANGUS*
Affiliation:
School of Information Technology and Electrical Engineering, The University of Queensland, Australia. School of Journalism and Communication, The University of Queensland, Australia.
ERIN R. SMITH-CONWAY
Affiliation:
UQ Centre for Clinical Research, Royal Brisbane and Women's Hospital, The University of Queensland, Australia.
KATHARINE S. BAKER
Affiliation:
Department of Anesthesia, School of Medicine, Stanford University, Palo Alto, California, USA.
CINDY GALLOIS
Affiliation:
Faculty of Social and Behavioural Sciences, The University of Queensland, Australia.
ANDREW SMITH
Affiliation:
Institute for Social Science Research, The University of Queensland, Australia.
JANET WILES
Affiliation:
School of Information Technology and Electrical Engineering, The University of Queensland, Australia.
HELEN J. CHENERY
Affiliation:
UQ Centre for Clinical Research, Royal Brisbane and Women's Hospital, The University of Queensland, Australia. Asia-Pacific Centre for Neuromodulation, The University of Queensland, Australia.
*
Address for correspondence: Daniel Angus, School of Information Technology and Electrical Engineering, The University of Queensland, Queensland 4072, Australia. E-mail: d.angus@uq.edu.au

Abstract

People with dementia living in residential care often face the dual disadvantage of increasing difficulty with communication and reduced opportunities for conversation. Social interaction is central to wellbeing of residents with dementia, so it is important that care staff have the skills to engage in conversation with them. We studied conversations in 20 care staff–resident dyads, to examine conversation structure and content, patterns of engagement within conversations, including the topics around which engagement occurred, and communication behaviours by care staff that appeared to facilitate (or impede) participation by residents. The transcripts were analysed using Discursis, a computational information visualisation tool that allows interactive visual inspection, in context, of the contributions by each speaker, the turn-taking dynamics, and the content recurring within and between speakers. We present case examples (a) where care staff did most of the talking, initiated topics and were responsible for most recurrence of content; (b) where talk was more evenly shared between partners, with some topics initiated and/or elaborated by participants with dementia; and (c) where participants with dementia talked most, with care staff supporting the conversation. We identified accommodative strategies used by care staff, such as reflecting back the other person's responses to sustain engagement. We also noted care staff behaviours that impeded communication, such as not listening attentively and not allowing sufficient time for responses. The results from this study highlight aspects of social communication within the aged care context and suggest ways in which rewarding interactions between staff and residents with dementia might be encouraged.

Type
Articles
Copyright
Copyright © Cambridge University Press 2013 

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References

Access Economics 2009. Making Choices – Future Dementia Care: Projections, Problems and Preferences. Access Economics, Canberra. Available online at http://www.fightdementia.org.au/access-economics-reports.aspx [Accessed 6 October 2012].Google Scholar
Access Economics 2010. Caring Places: Planning for Aged Care and Dementia 2010–2050. Volume 1, Access Economics, Canberra. Available online at http://www.fightdementia.org.au/access-economics-reports.aspx [Accessed 6 October 2012].Google Scholar
Alzheimer's Society 2007. Dementia UK: A Report to the Alzheimer's Society by King's College London and London School of Economics. Alzheimer's Society, London.Google Scholar
Angus, D., Smith, A. E. and Wiles, J. 2012 a. Conceptual recurrence plots: revealing patterns in human discourse. IEEE Transactions on Visualization and Computer Graphics, 18, 6, 988–97.Google Scholar
Angus, D., Smith, A. and Wiles, J. 2012 b. Human communication as coupled time series: quantifying multi-participant recurrence. IEEE Transactions on Audio, Speech, and Language Processing, 20, 6, 1795–807.Google Scholar
Angus, D., Watson, B., Smith, A., Gallois, C. and Wiles, J. 2012. Visualising conversation structure across time: insights into effective doctor–patient consultations. PLoS ONE, 7, 6, e38014.Google Scholar
Atkinson, J. M. and Heritage, J. (eds) 1984. Structures of Social Action: Studies in Conversation Analysis. Cambridge University Press, Cambridge.Google Scholar
Australian Institute of Health and Welfare 2007. Dementia in Australia – National Data Analysis and Development. Australian Institute of Health and Welfare, Canberra. Available online at http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442454183 [Accessed 1 May 2013].Google Scholar
Boller, F., Verny, M., Hugonot-Diener, L. and Saxton, J. 2002. Clinical features and assessment of severe dementia. A review. European Journal of Neurology, 9, 2, 125–36.Google Scholar
Brooker, D. 2004. What is person-centred care in dementia? Reviews in Clinical Gerontology, 13, 3, 215–22.Google Scholar
Broughton, M. L., Smith, E. R., Baker, R., Angwin, A. J., Pachana, N. A., Copland, D. J., Humphreys, M. S., Gallois, C., Byrne, G. J. and Chenery, H. J. 2011. Evaluation of a caregiver education program to support memory and communication in dementia: a controlled pretest–posttest study with nursing home staff. International Journal of Nursing Studies, 48, 11, 1436–44.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, 1, 5967.Google Scholar
Dijkstra, K., Bourgeois, M., Burgio, L. and Allen, R. 2002. Effects of a communication intervention on the discourse of nursing home residents with dementia and their nursing assistants. Journal of Medical Speech – Language Pathology, 10, 2, 143–57.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. 1975. Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 3, 189–98.Google Scholar
Graham, K. S. and Hodges, J. R. 1997. Differentiating the roles of the hippocampal complex and the neocortex in long-term memory storage: evidence from the study of Semantic Dementia and Alzheimer's Disease. Neuropsychology, 11, 1, 7789.Google Scholar
Hamilton, H. E. 1991. Accommodation and mental disability. In Giles, H., Coupland, J. and Coupland, N. (eds), Contexts of Accommodation. Cambridge University Press, Cambridge, 157–86.CrossRefGoogle Scholar
Hamilton, H. E. 1994. Conversations with an Alzheimer's Patient: An Interactional Sociolinguistic Study. Cambridge University Press, Cambridge.CrossRefGoogle Scholar
Kitzinger, C. and Jones, D. 2007. When May calls home: the opening moments of family telephone conversations with an Alzheimer's patient. Feminism & Psychology, 17, 2, 184202.CrossRefGoogle Scholar
Kopelman, M. D. 1989. Remote and autobiographical memory, temporal context memory and frontal atrophy in Korsakoff and Alzheimer patients. Neuropsychologia, 27, 4, 437–60.Google Scholar
Liddle, J., Smith-Conway, E. R., Baker, R., Angwin, A. J., Gallois, C., Copland, D. A., Pachana, N. A., Humphreys, M. S., Byrne, G. J. and Chenery, H. J. 2012. Memory and communication support strategies in dementia: effect of a training program for informal caregivers. International Psychogeriatrics, 24, 12, 1927–42.Google Scholar
Mentis, M., Briggs-Whittaker, J. and Gramigna, G. D. 1995. Discourse topic management in senile dementia of the Alzheimer's type. Journal of Speech and Hearing Research, 38, 1054–66.Google Scholar
Miller, J. and Iglesias, A. 2010. Systematic Analysis of Language Transcripts (SALT), Research Version. SALT Software, Madison, WI.Google Scholar
Morris, R. G. 1994. Recent developments in the neuropsychology of dementia. International Review of Psychiatry, 6, 1, 85107.Google Scholar
Muller, N. and Guendouzi, J. A. 2005. Order and disorder in conversation: encounters with dementia of the Alzheimer's type. Clinical Linguistics and Phonetics, 19, 5, 393404.Google Scholar
Mungas, D. 1991. In-office mental status testing: a practical guide. Geriatrics, 46, 7, 54–8, 63, 66.Google Scholar
Ramanathan, V. 1997. Alzheimer Discourse: Some Sociolinguistic Dimensions. Lawrence Erlbaum, Hillsdale, New Jersey.Google Scholar
Ripich, D. N. and Terrell, B. Y. 1988. Patterns of discourse cohesion and coherence in Alzheimer's Disease. Journal of Speech and Hearing Disorders, 53, 815.CrossRefGoogle ScholarPubMed
Ripich, D. N., Vertes, D., Whitehouse, P., Fulton, S. and Ekelman, B. 1991. Turn-taking and speech act patterns in the discourse of Senile Dementia of the Alzheimer's Type patients. Brain and Language, 40, 3, 330–43.Google Scholar
Rousseaux, M., Seve, A., Vallet, M., Pasquier, F. and Mackowiak-Cordoliaani, M. A. 2010. An analysis of communication in conversation in patients with dementia. Neuropsychologia, 48, 13, 3884–90.Google Scholar
Sabat, S. R. 1991. Turn-taking, turn-giving, and Alzheimer's disease: a case study of conversation. The Georgetown Journal of Languages & Linguistics, 2, 2, 161–75.Google Scholar
Sagar, H. J., Cohen, N. J., Sullivan, E. V., Corkin, S. and Growdon, J. H. 1988. Remote memory function in Alzheimer's disease and Parkinson's disease. Brain, 111, 1, 185206.Google Scholar
Small, J. and Perry, J. 2005. Do you remember? How caregivers question their spouses who have Alzheimer's disease and the impact on communication. Journal of Speech, Language, and Hearing Research, 48, 1, 125–36.Google Scholar
Tappen, R., Williams-Burgess, C., Edelstein, J., Touhy, T. and Fishman, S. 1997. Communicating with individuals with Alzheimer's disease: examination of recommended strategies. Archives of Psychiatric Nursing, XI, 5, 249–56.Google Scholar
Ward, R., Vass, A. A., Aggarwal, N., Garfield, C. and Cybyk, B. 2008. A different story: exploring patterns of communication in residential care. Ageing & Society, 28, 629–51.Google Scholar
Williams, K. N., Kemper, S. and Hummert, M. L. 2003. Improving nursing home communication: an intervention to reduce elderspeak. The Gerontologist, 43, 2, 242–7.Google Scholar
Wray, A. 2011. Formulaic language as a barrier to effective communication with people with Alzheimer's disease. The Canadian Modern Language Review, 67, 4, 429–58.Google Scholar
Young, T. J., Manthorp, C., Howells, D. and Tullos, E. 2011. Developing a carer communication intervention to support personhood and quality of life in dementia. Ageing & Society, 31, 1003–25.Google Scholar