The purpose of this study is to explore how long term care residents with dementia respond when nursing staff use elderspeak, a type of speech similar to babytalk, which has known negative effects on cognitively intact older adults. Elderspeak features simplistic vocabulary, short sentences, slow speech, elevated pitch and volume, and inappropriately intimate references and is extensively used by nursing staff in long-term care settings. Research has shown that cognitively intact older adults perceive elderspeak as patronizing and that elderspeak can precipitate communication breakdown in staff-resident interactions and contribute to problem behaviors such as resistiveness to nursing care. Resistiveness to care (e.g. withdrawal, aggression, wandering) disrupts care activities and increases the time and stress of providing nursing care. The Need-Based Dementia-Compromised Behavior Model that guides this study identifies communication as a factor in problem behaviors in dementia care. However, no research has been found that determines how elderspeak communication, specifically, affects older adults with dementia.
The specific aims of the proposed study are to determine the impact of nursing staff use of elderspeak on resident behavior during activities of daily care. This study proposes an exploratory design that uses psycholinguistic analysis to examine relationships between nursing staff use of elderspeak and resistive behaviors of care recipients with dementia. Experimental methods include the collection and analysis of video recordings of nursing staff and resident interactions during activities of daily living in long term care settings. Interactions between nursing staff-care recipient dyads lasting from 1-10 minutes (N=60) will be coded for resistiveness to care and elderspeak markers using valid and reliable measures. Resistiveness to care scores will be regresses on frequencies of elderspeak. Coding of the sequence of staff elderspeak and subsequent resident resistive behaviors will be reported to describe temporal relationships.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Small Research Grants (R03)
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Nursing Science: Adults and Older Adults Study Section (NSAA)
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Wasserman, Joan
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University of Kansas
Schools of Nursing
Kansas City
United States
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Williams, Kristine; Shaw, Clarissa; Lee, Alexandria et al. (2017) Voicing Ageism in Nursing Home Dementia Care. J Gerontol Nurs 43:16-20
Williams, Kristine; Herman, Ruth; Bontempo, Daniel (2013) Comparing audio and video data for rating communication. West J Nurs Res 35:1060-73
Williams, Kristine N; Boyle, Diane K; Herman, Ruth E et al. (2012) Psychometric Analysis of the Emotional Tone Rating Scale: A Measure of Person-Centered Communication. Clin Gerontol 35:376-389
Lann-Wolcott, Hannah; Medvene, Louis J; Williams, Kristine (2011) Measuring the person-centeredness of caregivers working with nursing home residents with dementia. Behav Ther 42:89-99
Williams, Kristine N; Herman, Ruth E (2011) Linking resident behavior to dementia care communication: effects of emotional tone. Behav Ther 42:42-6
Williams, Kristine N; Herman, Ruth; Gajewski, Byron et al. (2009) Elderspeak communication: impact on dementia care. Am J Alzheimers Dis Other Demen 24:11-20
Herman, Ruth E; Williams, Kristine N (2009) Elderspeak's influence on resistiveness to care: focus on behavioral events. Am J Alzheimers Dis Other Demen 24:417-23