A Communication Intervention to Reduce Resistiveness in Dementia Care: A Cluster Randomized Controlled Trial

Area of Science:

• Gerontology
• Communication Studies
• Nursing

Background:

• Dementia care in nursing homes often involves challenging behaviors like resistiveness to care (RTC).
• RTC increases staff burden, stress, and healthcare costs.
• RTC is associated with specific communication styles, including elderspeak.

Purpose of the Study:

• To evaluate the effectiveness of a communication training program called Changing Talk (CHAT) for nursing home staff.
• To determine if CHAT reduces staff use of elderspeak.
• To assess the impact of CHAT on reducing resistiveness to care in residents with dementia.

Main Methods:

• Randomized controlled trial involving 13 nursing homes (intervention and control groups).
• Videotaped observations of staff-resident interactions before and after the CHAT intervention.
• Behavioral coding of staff communication (normal, elderspeak, silence) and resident behaviors (cooperative, RTC).

Main Results:

• Elderspeak significantly decreased post-intervention and at 3-month follow-up.
• Resistiveness to care (RTC) also significantly declined after the intervention.
• The CHAT intervention was a significant predictor of reduced elderspeak, which in turn predicted reduced RTC.

Conclusions:

• A brief communication intervention (CHAT) can effectively improve staff-resident communication in dementia care.
• CHAT offers a viable nonpharmacological strategy to manage challenging behaviors like RTC.
• This approach has the potential to enhance the quality of care for nursing home residents with dementia.