Abstract
Persons living with dementia (PLWD) are twice as likely to be hospitalized compared to cognitively intact older adults and while hospitalized PWD often exhibit behavioral symptoms of dementia such as aggression. Challenging behaviors that disrupt nursing care are termed resistiveness to care (RTC) and leave patients at risk for neglect and nurses at risk for strain. Effective communication by nursing staff is critically important in preventing RTC. The purpose of this cross-sectional study was to identify and characterize elderspeak communication by hospital nursing staff to PLWD and determine the association between elderspeak communication and RTC by PLWD. Nursing staff were audio-recorded and observed during care encounters with hospitalized PLWD. Behavioral observations were performed to evaluate RTC by PLWD using the valid and reliable RTC Scale. Recordings were coded for elderspeak using an evidence-based elderspeak coding scheme. A mixed-effects model was used to evaluate the relationship between elderspeak and RTC. Eighty-eight observations between 16 PLWD and 53 nursing staff were collected. Twenty-eight percent of communication by hospital nursing staff to PLWD contained elderspeak. A 15% in reduction in elderspeak by nursing staff decreased the odds of RTC by 62% in PLWD (p=.002) while controlling for pain, length of stay, and PLWD gender. Elderspeak is a pervasive problem in acute care and leads to negative outcomes for hospitalized PLWD. Future research is needed on interventions to reduce elderspeak in the hospital setting.
Sigma Membership
Gamma
Lead Author Affiliation
The University of Iowa, Iowa City, Iowa, USA
Type
Report
Format Type
Text-based Document
Study Design/Type
Observational
Research Approach
Quantitative Research
Keywords:
Dementia, Elderspeak, Acute Care, Resistiveness to Care, Communication
Recommended Citation
Shaw, Clarissa, "Resistiveness in dementia: Nurse communication in acute care" (2021). Sigma Foundation for Nursing Research Grant Reports. 114.
https://www.sigmarepository.org/grant_reports/114
Rights Holder
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Review Type
None: Sigma Grant Recipient Report
Acquisition
Self-submission
Date of Issue
2021-05-18
Full Text of Presentation
wf_yes
Description
Dr. Shaw was a 2018-2019 recipient of a Sigma Small Grant.