Resistiveness to care is common in older adults with dementia. Resistiveness to care disrupts nursing care, increasing costs of care by 30%. Elderspeak (infantilizing communication used by nursing staff) may trigger resistiveness to care in individuals with dementia. Videotaped care episodes (n = 80) of nursing home residents with dementia (n = 20) were coded for type of staff communication (normal talk and elderspeak) and subsequent resident behavior (cooperative or resistive to care). Bayesian statistical analysis tested relationships between staff communication and subsequent resident resistiveness to care. The probability of resistiveness to care varied significantly with communication (Bayes P = .0082). An increased probability of resistiveness to care occurred with elderspeak (.55, 95% CrI, .44-.66), compared with normal talk (.26, 95% CrI, .12-.44). Communication training has been shown to reduce elderspeak and may reduce resistiveness to care in future research.
Williams K., Kemper S., Hummert MLImproving nursing home communication: an intervention to reduce elderspeak . Gerontologist. 2003;43:242-247.
2.
Kemper S., Harden T.Experimentally disentagling what's beneficial about elderspeak from what's not. Psychol Aging. 1999;14:656-670.
3.
Ryan EB, Hummert ML, Boich LHCommunication predicaments of aging; patronizing behavior toward older adults . J Lang Soc Psychol. 1995;14:144-166.
4.
Orange JB, Colton-Hudson A.Enhancing communication in dementia of the Alzheimer's type. Top Geriatr Rehabil.1998;14:56-75.
5.
Small J., Geldart K., Gutman G.Communicaton between individuals with dementia and thier caregives during activities of daily living. Am J Alzheimers Dis Other Demen . 2000;18:291-316.
6.
O'Connor B., Rigby H.Perceptions of baby talk, frequency of receiving baby talk, and self-esteem among community and nursing home residents. Psychol Aging.1996;11: 147-154.
7.
Ryan EB, Meredith SD, Maclean MJ, Orange JBChanging the way we talk with elders: promoting health using the communication enhancement model. Int J Aging Hum Dev. 1995 ;41:89-107.
8.
Burgio L., Butler F., Roth D., Hardin J., Hsu C., Ung K.Agitation in nursing home residents: the role of gender and social context . Int Psychogeriatr. 2000;12:495-511.
9.
Talicero K., Evans L., Strumpf N.Mental health correlates of aggression in nursing home reisdents with dementia . Gerontologist. 2002;42:169-177.
10.
Beeri MS, Werner P., Davidson M., Noy S.The cost of behavioral and pshychological symptoms of dementia (BPSD) in community dwelling AD patients. Int J Geriatr Psychiatry . 2002;17:403-408.
11.
Davis L., Buckwalter K., Burgio L.Measuring problem behaviors in dementia: developing a methodological approach . ANS Adv Nurs Sci. 1997;20:45-55.
12.
Burgio LD, Allen-Burge R., Roth DL, et al. Come talk with me improving communication between nursing assistants and nursing home residents during care routines. Gerontologist.2001;41:449-460.
13.
McCallion P. , Toseland R., Lacey D., Banks S.Educating nursing assistants to communicate more effectively with nursing home residents. Gerontologist . 1999;39:546-558.
14.
Barrick AL, Rader J., Hoeffer B., Sloane P.Bathing Without a Battle: Personal Care of Individuals With Dementia . New York, NY: Springer; 2002.
15.
Williams K.Improving outcomes of nursing home interactions . Res Nurs Health. 2006;29:121-133.
16.
Mahoney EK, Hurley AC, Volicer L., et al. Development and testing of the resistiveness to care scale. Res Nurs Health. 1999;22:27-38.
17.
Balestri L. , GrossbergA,Grossberg G.Behavioral and psychological symptoms of dementia as a risk factor for nursing home placment. Int Psychogeriatr . 2000;12:59-62.
18.
Perkins L., Whitworth A., Lesser R.Conversing in dementia: a conversation analytic approach. J Neurolinguistics. 1998;11:33-53.
19.
Caporael L.The paralanguage of caregiving: baby talk to the institutionalized aged. J Pers Soc Psychol. 1981;40: 876-884.
Ryan EB, Giles H., Bartolucci RY, Henwood K.Psycholinguistic and social psychological components of communication by and with the elderly. Lang Commun. 1986 ;6:1-24.
22.
Kemper S., Ferrell P., Harden T., Finter-Urczyk A., Billington C.Use of elderspeak by young and older adults to impaired and unimpaired listeners . Aging Neuropsychol Cogn.1998;5:43-55.
23.
Kitwood T.The experience of dementia. Aging Ment Health. 1997;7:15-22.
24.
Kitwood T., Bredin K.Towards a theory of dementia care: personhood and wellbeing. Ageing Soc. 1992;12:269-287.
25.
Small J., Geldart K., Gutman G., Scott MAThe discourse of self in dementia. Ageing Soc. 1998;18:291-316.
26.
Brown P., Levinson SCPoliteness: Some Universals in Language Useage. Cambridge , UK: Cambridge University Press; 1987.
27.
Sloane P., Honn VJ, Dwyer SAR, Weiselquist J., Cain C., Meyers S.Bathing the Alzheirmer's patient in long-term care: results and recommendatons from three studies. Am J Alzheimers Dis Other Demen. 1995;10:3-11.
28.
Beck C., Heacock P., Mercer S., Walls R., Rapp C., Vogelpohl T.Improving dressing behavior in cognitively impaired nursing home residents . Nurs Res. 1997;46: 126-132.
29.
Hoeffer B., Rader J., McKenzie D., Lavelle M., Stewart B.Reducing aggression during bathing cognitively impaired nursing home residents . J Gerontol Nurs. 1997;23:16-23.
30.
Algase DL, Beck C., Kolanowski A., Berrent S., Richards K., Beattie E.Need-driven dementia-compromised behavior: an alternative view of dirsruptive behavior. Am J Alzheimers Dis Other Demen. 1996;11:10-19.
31.
Kolanowshi A., Hurwitz S., Taylor L., Evans L., Strumpf N.Contextual factors associated with disturbing behaviors in institutionalized elders. Nurs Res. 1994;43:73-79.
Ripich D.Functional communication with AD patients: a caregiver training program . Alzheimer Dis Assoc Disord. 1994;8(suppl 3):95-109.
34.
Ryden MB, Bossenmaier M., McLachlan C.Agressive behavior in cognitivly impaired nursing home residents. Res Nurs Health. 1991;14:87-95.
35.
Williams K. , Ilten T., Bower H.Meeting communication needs: topics of talk in the nursing home. J Psychosoc Nurs Ment Health Serv. 2005;43:38-45.
36.
Cohen-Mansfield J., Taylor L., McConnell D., Horton D.Estimating the cognitive ability of nursing home residents from the minimum data set. Outcomes Manag Nurs Pract. 1999;3:43-36.
37.
Hartmaier SL , Sloane PD, Guess HA, Koch GCThe MDS Cognition Scale: a valid instrument for identifying and staging nursing home residents with dementia using the minimum data set. J Am Geriatr Soc . 1994;42:1173-1179.
38.
Caris-Verhallen W., Kerkstra A., van der Heijden P., Bensing J.Nurse-elderly patient communication in home care and institutional care; an explorative study. Int J Nurs Stud. 1998;35:95-108.
39.
Beck C., Vogelpohl T., Rasin J., et al. Effects of behavioral interventions on disruptive behavior and affect in demented nursing home residents. Nurs Res. 2002;51:219-228.
40.
Edberg AK, Sandgrean AN, Hallberb IRInitiating and terminating verbal interaction between nurses and severely demented patients regarded as vocally disruptive. J Psychiatr Ment Health Nurs. 1995;2:3-12.
41.
Miller JF, Chapman RSSALT: Systematic Analysis of Language Transcripts. Madison, WI: University of Wisconsin; 1984 .
42.
Hummert ML, Garstka TA, Shaner JL, Strahm S.Judgments about stereotypes of the elderly; attitudes, age associations, and typicality ratings of young, middle-aged, and elderly adults. Res Aging. 1995;17:168-189.
43.
Gibson M.Differentiating aggressive and resistive behaviors in long-term care . J Gerontol Nurs. 1997;32:21-28.
44.
Hurley A., Volicer L., Hanrahan P., Houde S., Volicer L.Assessment of discomfort in advanced Alzheimer's patients. Res Nurs Health. 1992;15:369-377.
45.
Roth DL, Stevens AB, Burgio LD, Burgio KLTimed-event sequential analysis of agitation in nursing home residents during personal care interactions with nursing assistants. J Gerontol B Psychol Sci Soc Sci. 2002;57B: P461-P468.
46.
Hardin JW, Hilbe JMGeneralized Estimating Equations. New York, NY : Chapman and Hall/CRC; 2003.
47.
Somboontanont W., Sloane PD, Floyd FI, Holditch-Davis D., Hogue CC, Murphy MMAssaultive behavior in Alzheimer's disease: identifying immediate antecedents during bathing. J Gerontol Nurs.2004;30:22-29.
48.
Lunn DJ, Thomas A., Best N., Spiegelhalter D.WinBUGS- a Bayesian modeling framework: concepts, sturcture, and extensibility . Stat Comput. 2000;10: 325-337.
49.
Carpenter J. , Gajewski B., Teel C., Aaronson L.Data analysis: estimating the efficiency of Tai Chi as a case study. Nurs Res. In press.
50.
Gajewski B. , Simon S.A one-hour training seminar on Bayesian statistics for nursing graduate students. Am Stat. In press.
