A different story: exploring patterns of communication in residential dementia care

Abstract

This article reports findings from a three-year project on ‘Communication patterns and their consequences for effective care’ that explored communication in dementia-care settings. As the proportion of people with dementia living in British care-homes continues to grow, there is a need to understand better their care. Using a range of qualitative methods, the project set out to identify the constituent elements of dementia-care practice and the patterns that characterise day-to-day relations in care homes. The tightly prescribed and standardised nature of the interactions between staff and residents is described: it raises questions about the capacity for dementia care to be truly person-centred. The project found that people with dementia are both capable of communication, and invest much effort in seeking to engage those around them, but are excluded from the monitoring, planning and provision of care in ways that we argue are discriminatory. The case is made for promoting and supporting communication as key skills and competencies for care workers. The value of measuring the level and quality of communication as a means to evaluate care is demonstrated. The authors question the priorities that currently guide care practice and argue that we need to listen to people with dementia and rethink what lies at the heart of dementia care.

Sensor e-textiles: person centered co-design for people with late stage dementia

“…Previous research has revealed the importance of textiles and clothing in establishing and maintaining a sense of personhood (Ward et al, 2008;Ward and Campbell, 2013;Kontos and Martin, 2013). When people enter residential care they are often parted from personal possessions 'disrupting connections to memories, biography and identity' (Twigg and Buse, 2013, pp.…”

Missed opportunities for person-centered communication: implications for staff-resident interactions in long-term care

“…Previous studies demonstrated that there are considerably fewer interactions between staff and residents with dementia versus staff interactions with residents without dementia (Kitwood and Bredin, 1992;Ward et al, 1992;Acton et al, 2007;Ward et al, 2008). For example, residents with dementia were left alone for approximately 75% of the time; the more confused residents remained inactive for nearly 85% of the time (Hallberg et al, 1990).…”

“…Social interactions in long-term care settings between staff and residents with dementia have been characterized as task-oriented, patronizing, and/or overly directive (Ward et al, 2008;Williams et al, 2009;Vasse et al, 2010). Staff-resident interactions can be infrequent, short, and fragmented (Ekman et al, 1991;Kolanowski et al, 2006).…”

‘Can't cook, won't cook’: men's involvement in cooking when their wives develop dementia

“…Yet, it should be noted that 'assisted autonomy' is necessary to promote the agency of people with dementia (Boyle 2008). Although Sabat (2003, p. 85) had suggested that people with dementia are susceptible to 'malignant positioning' by others which can undermine their sense of social competency, it is important to note that, at times, this negative positioning may be explained more by gender inequality than by -what Ward et al (2008) referred to as -'cognitive disablism'.…”