Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-10T21:10:26.222Z Has data issue: false hasContentIssue false
  • English
  • Français

A systematic review of communication strategies for people with dementia in residential and nursing homes

Published online by Cambridge University Press:  29 July 2009

Emmelyne Vasse ,
Myrra Vernooij-Dassen ,
Anouk Spijker ,
Marcel Olde Rikkert  and
Raymond Koopmans
Emmelyne Vasse*
Affiliation:
Scientific Institute for Quality of Healthcare (IQ healthcare) and Nijmegen Alzheimer Centre, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
Myrra Vernooij-Dassen
Affiliation:
Scientific Institute for Quality of Healthcare (IQ healthcare) and Nijmegen Alzheimer Centre, Radboud University Nijmegen Medical Centre, Nijmegen, Kalorama Foundation, The Netherlands
Anouk Spijker
Affiliation:
Scientific Institute for Quality of Healthcare (IQ healthcare) and Nijmegen Alzheimer Centre, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
Marcel Olde Rikkert
Affiliation:
Department of Geriatrics and Nijmegen Alzheimer Centre, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
Raymond Koopmans
Affiliation:
Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health and Nijmegen Alzheimer Centre, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
*
Correspondence should be addressed to: Emmelyne Vasse, MSc, Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 114 IQ healthcare, 6500 HB Nijmegen, The Netherlands. Phone: +31 243 666 265; Fax: +31 243 540 166. Email: E.Vasse@iq.umcn.nl.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: The impairment of verbal skills of people with dementia challenges communication. The aim of this review was to study the effects of nonpharmacological interventions in residential and nursing homes on (1) communication between residents with dementia and care staff, and (2) the neuropsychiatric symptoms of residents with dementia.

Method: Pubmed, PsychInfo, Web of Science, the Cochrane Library, and reference lists from relevant publications were systematically searched to find articles about controlled interventions with communication strategies. The data collected were pooled and subjected to a meta-analysis.

Results: Nineteen intervention studies were selected for this review. They included structured and communicative “sessions at set times” for residents (e.g. life review) and communication techniques in activities of “daily care” applied by care staff (e.g. sensitivity to nonverbal communication). A meta-analysis of five set-time interventions (communication) and another meta-analysis of four set-time interventions (neuropsychiatric outcomes) found no significant overall effects. Individual set-time intervention studies report positive effects on communication when interventions are single-task sessions, like life review or one-on-one conversation. Interventions around daily care activities had positive effects on communication outcomes. Effects of both types of interventions on neuropsychiatric symptoms were divergent.

Conclusion: This review indicates that care staff can improve their communication with residents with dementia when strategies are embedded in daily care activities or interventions are single-task sessions at set times. These results offer the possibility of improving the quality of care, but not of directly reducing neuropsychiatric symptoms. More research is needed to study the effect of communication interventions on neuropsychiatric symptoms.

Keywords

psychosocial interventionnonpharmacological interventionresidential facilities
Type
Review Article
Information
International Psychogeriatrics , Volume 22 , Issue 2 , March 2010 , pp. 189 - 200
Copyright
Copyright © International Psychogeriatric Association 2009

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

Beck, C. K. et al. (2002). Effects of behavioral interventions on disruptive behavior and affect in demented nursing home residents. Nursing Research, 51, 219–228.CrossRefGoogle ScholarPubMed
Brodaty, H., Draper, B. and Low, L. F. (2003a). Nursing home staff attitudes towards residents with dementia: strain and satisfaction with work. Journal of Advanced Nursing, 44, 583–590.CrossRefGoogle ScholarPubMed
Brodaty, H., Green, A. and Koschera, A. (2003b). Meta-analysis of psychosocial interventions for caregivers of people with dementia. Journal of the American Geriatrics Society, 51, 657–664.CrossRefGoogle ScholarPubMed
Buhr, G. T., Kuchibhatla, M. and Clipp, E. C. (2006). Caregivers’ reasons for nursing home placement: clues for improving discussions with families prior to the transition. Gerontologist, 46, 52–61.CrossRefGoogle ScholarPubMed
Burgio, L. D., Stevens, A., Burgio, K. L., Roth, D. L., Paul, P. and Gerstle, J. (2002). Teaching and maintaining behavior management skills in the nursing home. Gerontologist, 42, 487–496.CrossRefGoogle ScholarPubMed
Cott, C. A., Dawson, P., Sidani, S. and Wells, D. (2002). The effects of a walking/talking program on communication, ambulation, and functional status in residents with Alzheimer disease. Alzheimer Disease and Associated Disorders, 16, 81–87.CrossRefGoogle ScholarPubMed
de Klerk, M. M. Y. (2001). Report on the Elderly 2001. The Hague: The Netherlands Institute for Social Research.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, 143–157.Google Scholar
Edberg, A. K. and Hallberg, I. R. (1996). Effects of clinical supervision on nurse-patient cooperation quality: a controlled study in dementia care. Clinical Nursing Research, 5, 1271–46.CrossRefGoogle ScholarPubMed
Edberg, A. K. and Hallberg, I. R. (2001). Actions seen as demanding in patients with severe dementia during one year of intervention: comparison with controls. International Journal of Nursing Studies, 38, 271–285.CrossRefGoogle ScholarPubMed
Egger, M., Smith, G. D. and Phillips, A. N. (1997). Meta-analysis: principles and procedures. BMJ, 315, 1533–1537.CrossRefGoogle ScholarPubMed
Eggermont, L., Swaab, D., Luiten, P. and Scherder, E. (2006). Exercise, cognition and Alzheimer's disease: more is not necessarily better. Neuroscience and Biobehavioral Reviews, 30, 562–575.CrossRefGoogle Scholar
Engelborghs, S. et al. (2005). Neuropsychiatric symptoms of dementia: cross-sectional analysis from a prospective, longitudinal Belgian study. International Journal of Geriatric Psychiatry, 20, 1028–1037.CrossRefGoogle ScholarPubMed
Finnema, E. et al. (2005). The effect of integrated emotion-oriented care versus usual care on elderly persons with dementia in the nursing home and on nursing assistants: a randomized clinical trial. International Journal of Geriatric Psychiatry, 20, 330–343.CrossRefGoogle ScholarPubMed
Friedman, R. and Tappen, R. M. (1991). The effect of planned walking on communication in Alzheimer's disease. Journal of the American Geriatrics Society, 39, 650–654.CrossRefGoogle ScholarPubMed
Fromholt, P. and Larsen, S. F. (1991). Autobiographical memory in normal aging and primary degenerative dementia (dementia of Alzheimer type). Journal of Gerontology, 46, 85–91.CrossRefGoogle ScholarPubMed
Grol, R. and Wensing, M. (2006). Implementatie. Effectieve verbetering van de patiëntenzorg [Implementation. Effective Improvement of Patient Care]. Maarssen: Elsevier Gezondheidszorg.Google Scholar
Haight, B. K., Gibson, F. and Michel, Y. (2006). The Northern Ireland life review/life storybook project for people with dementia. Alzheimer's and Dementia, 2, 56–58.CrossRefGoogle ScholarPubMed
Hancock, G. A., Woods, B., Challis, D. and Orrell, M. (2006). The needs of older people with dementia in residential care. International Journal of Geriatric Psychiatry, 21, 43–49.CrossRefGoogle ScholarPubMed
Higgins, J. P. T., and Green, S. (eds.). (2008). Cochrane Handbook for Systematic Reviews of Interventions, Version 5.0.1 (updated September 2008). The Cochrane Collaboration. Available at www.cochrane-handbook.org.Google Scholar
Hope, T., Keene, J., Gedling, K., Fairburn, C. G. and Jacoby, R. (1998). Predictors of institutionalization for people with dementia living at home with a carer. International Journal of Geriatric Psychiatry, 13, 682–690.3.0.CO;2-Y>CrossRefGoogle ScholarPubMed
Livingston, G., Johnston, K., Katona, C., Paton, J. and Lyketsos, C. G. (2005). Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia. American Journal of Psychiatry, 162, 1996–2021.CrossRefGoogle Scholar
Lyketsos, C. G., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J. and DeKosky, S. (2002). Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the cardiovascular health study. JAMA, 288, 1475–1483.CrossRefGoogle ScholarPubMed
Magai, C., Cohen, C. I. and Gomberg, D. (2002). Impact of training dementia caregivers in sensitivity to nonverbal emotion signals. International Psychogeriatrics, 14, 25–38.CrossRefGoogle ScholarPubMed
McCallion, P., Toseland, R. W., Lacey, D. and Banks, S. (1999). Educating nursing assistants to communicate more effectively with nursing home residents with dementia. Gerontologist, 39, 546–558.CrossRefGoogle ScholarPubMed
Novak, M. and Chappell, N. L. (1996). The impact of cognitively impaired patients and shift on nursing assistant stress. International Journal of Aging and Human Development, 43, 235–248.CrossRefGoogle ScholarPubMed
Orrell, M., Spector, A., Thorgrimsen, L. and Woods, B. (2005). A pilot study examining the effectiveness of maintenance Cognitive Stimulation Therapy (MCST) for people with dementia. International Journal of Geriatric Psychiatry, 20, 446–451.CrossRefGoogle ScholarPubMed
Petterson, A. F., Olsson, E. and Wahlund, L. O. (2007). Effect of divided attention on gait in subjects with and without cognitive impairment. Journal of Geriatric Psychiatry and Neurology, 20, 58–62.CrossRefGoogle Scholar
Politis, A. M., Vozzella, S., Mayer, L. S., Onyike, C. U., Baker, A. S. and Lyketsos, C. G. (2004). A randomized, controlled, clinical trial of activity therapy for apathy in patients with dementia residing in long-term care. International Journal of Geriatric Psychiatry, 19, 1087–1094.CrossRefGoogle ScholarPubMed
Potkins, D. et al. (2003). Language impairment in dementia: impact on symptoms and care needs in residential homes. International Journal of Geriatric Psychiatry, 18, 1002–1006.CrossRefGoogle ScholarPubMed
Schneider, L. S., Dagerman, K. S. and Insel, P. (2005). Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials. JAMA, 294, 1934–1943.CrossRefGoogle ScholarPubMed
Snowdon, J., Day, S. and Baker, W. (2006). Current use of psychotropic medication in nursing homes. International Psychogeriatrics, 18, 241–250.CrossRefGoogle ScholarPubMed
Spector, A. et al. (2003). Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia: randomised controlled trial. British Journal of Psychiatry, 183, 248–254.CrossRefGoogle ScholarPubMed
Spijker, A. et al. (2008). Effectiveness of nonpharmacological interventions in delaying the institutionalization of patients with dementia: a meta-analysis. Journal of the American Geriatrics Society, 56, 1116–1128.CrossRefGoogle ScholarPubMed
Tabourne, C. E. (1995). The effects of a life review program on disorientation, social interaction and self-esteem of nursing home residents. International Journal of Aging and Human Development, 41, 251–266.CrossRefGoogle ScholarPubMed
Tappen, R. M., Williams, C. L., Barry, C. and DiSesa, D. (2002). Conversation intervention with Alzheimer's patients: Increasing the relevance of communication. Clinical Gerontologist, 24, 63–75.CrossRefGoogle ScholarPubMed
Tondi, L., Ribani, L., Bottazzi, M., Viscomi, G. and Vulcano, V. (2007). Validation therapy (VT) in nursing home: a case-control study. Archives of Gerontology and Geriatrics, 44, S407–S411.CrossRefGoogle ScholarPubMed
Toseland, R. W., Diehl, M., Freeman, K., Manzanares, T., Naleppa, M. and McCallion, P. (1997). The impact of validation group therapy on nursing home residents with dementia. Journal of Applied Gerontology, 16, 31–50.CrossRefGoogle Scholar
van Weert, J. C., van Dulmen, A. M., Spreeuwenberg, P. M., Ribbe, M. W. and Bensing, J. M. (2005). Effects of snoezelen, integrated in 24 h dementia care, on nurse-patient communication during morning care. Patient Education and Counseling, 58, 312–326.CrossRefGoogle ScholarPubMed
van Weert, J. C., Janssen, B. M., van Dulmen, A. M., Spreeuwenberg, P. M., Bensing, J. M. and Ribbe, M. W. (2006). Nursing assistants’ behaviour during morning care: effects of the implementation of snoezelen, integrated in 24-hour dementia care. Journal of Advanced Nursing, 53, 656–668.CrossRefGoogle ScholarPubMed
Verkaik, R., van Weert, J. C. M. and Francke, A. L. (2005). The effects of psychosocial methods on depressed, aggressive and apathetic behaviors of people with dementia: a systematic review. International Journal of Geriatric Psychiatry, 20, 301–314.CrossRefGoogle ScholarPubMed
Wancata, J., Musalek, M., Alexandrowicz, R. and Krautgartner, M. (2003). Number of dementia sufferers in Europe between the years 2000 and 2050. European Psychiatry, 18, 306–313.CrossRefGoogle ScholarPubMed
Wells, D. L., Dawson, P., Sidani, S., Craig, D. and Pringle, D. (2000). Effects of an abilities-focused program of morning care on residents who have dementia and on caregivers. Journal of the American Geriatrics Society, 48, 442–449.Google ScholarPubMed
Woods, B., Spector, A., Jones, C., Orrell, M. and Davies, S. (2005). Reminiscence therapy for dementia. Cochrane Database of Systematic Reviews, 2, CD001120.Google Scholar
Zuidema, S. U., Derksen, E., Verhey, F. R. J. and Koopmans, R. T. (2007). Prevalence of neuropsychiatric symptoms in a large sample of Dutch nursing home patients with dementia. International Journal of Geriatric Psychiatry, 22, 632–638.CrossRefGoogle Scholar