Communicative Behaviors Elicited by Leisure Activities in Memory Care Units

Abstract

Communication difficulties that result in social isolation and lower quality of life are well known to occur in individuals with dementia. Kempler and Goral note that, in most cases, dementia impacts multiple areas of cognitive function, leading to impairment in language functioning secondary to deficits in memory, attention, and executive functioning, all of which in turn are linked to communication impairments such as anomia and sentence processing problems [1]. Families, friends, spouses and caregivers report the impact that reduced communication has on personal relationships. In their review on dementia's impact on communication, Byrne and Orange [2] stated that communication is one of the first losses reported in dementia, with 24% of spouses listing breakdown of communication abilities as the most difficult part of the disease, ranking its effects above memory loss, aggression, and uncooperative behavior. Caregivers also report that the loss of communication and relationship is stressful and pain-Purpose: In this exploratory study, patterns of vocal communication elicited by different activities facilitated in a unit were examined. Research questions included: Do different activity types elicit more or less vocal communication? How do participants vary in terms of rate, type, and activity contexts for their vocal communication attempts? What patterns of interaction among residents and staff were observable during group activities?Methods: Data were collected using a live data collection tool, divided by vocalization type, and qualitative notes were taken for each activity and participant. Four participants with varying stages of dementia were included in analysis. Coding reliability was conducted on 43% of samples, with utterance function codes at 99% and vocalization types at 75% agreement.Results: Overall, the activity that elicited the most vocalizations for 3 participants was physical games, while the two activities that were consistently in the bottom range of total number of vocalizations were trivia/fill-in and exercises. Participants with substantial impairments in cognition appear to initiate communication more often during physically-based activities with clear turn-taking roles.Conclusions: Results suggested that diversity of ability among residents must be skillfully handled by staff to promote residents' equal participation. Suggestions for improving activity facilitation based on activity types and facilitation strategies are offered.