Conversations between persons with dementia disease living in nursing homes and nurses – qualitative evaluation of an intervention with the validation method

Abstract

Living with dementia disease (DD) can include difficulties describing experiences of everyday lives, which can lead to withdrawal, social isolation or existential homelessness. Persons with DD living in nursing homes are mainly dependent on the nurses for establishing and maintaining relationships with those around them. It can be challenging for nurses to understand what a person with DD is trying to express and to make themselves understood in turn. The validation method is intended to facilitate communication with persons with DD, but to our knowledge, there have been no qualitative studies of how this influences persons' communication. This study aimed to illuminate the actions and reactions of persons with DD living in nursing homes in one-to-one conversations with nurses during 1 year of validation method training, as observed in videotapes. Four persons with DD were involved in videotaped conversations with four nurses who were participating in a validation method training programme. Videotapes with at least 5 months between the first and last recording were analysed and compared qualitatively. The findings are presented in four categories that were identified to various degrees in conversations at the beginning and at the end of the programme: being uninterested in or unable to answer questions, talking about more than one topic of conversation at the same time, trying to talk about what is on one's mind and speaking more freely about what is on one's mind. In the videotaped conversations at the end of the programme, the persons had the opportunity to use their remaining communication abilities. This may have been related to the development of the nurses' communication skills during the training programme, and so it is possible that persons with DD could benefit from communicating with nurses trained in the validation method.

Communication training interventions for family and professional carers of people living with dementia: a systematic review of effectiveness, acceptability and conceptual basis

“…Eight detailed qualitative studies of training-interventions were available (Chenoweth et al, 2015;Figueiredo, Barbosa, Cruz, Marques, & Sousa, 2013;Hammar et al, 2011;Lykkeslet et al, 2014;Soderlund et al, 2013;Soderlund et al, 2016;Soderlund, Cronqvist, Norberg, Ternestedt, & Hansebo, 2016;Soderlund, Norberg, & Hansebo, 2012, 2014. As previously discussed the methodology and focus of these studies was diverse, and the quality was variable.…”

Sense of Self among Persons with Advanced Dementia

“…As their cognitive abilities decrease, persons with advanced dementia increasingly need to be in communion with carers to preserve their vulnerable self. Söderlund et al (71) reported positive results from using the Feil' s validation method during one-to-one conversations with persons with advanced dementia. The focus was not the facts about what was expressed but rather the feelings behind what the persons tried to talk about and the aim was to treat them as adults and increase their feelings of self-worth and well-being.…”

Factors contributing to serious adverse events in nursing homes

“…Today, nursing home residents tend to be older and more disabled than before (S€ oderlund, Cronqvist, Norberg, Ternestedt, & Hansebo, 2016;Young, Barhydt, Broderick, Colello, & Hannan, 2010). The majority may also have cognitive impairment, which makes it difficult to interpret the older person's needs, wishes and symptoms (Condelius, Edberg, Jakobsson, & Hallberg, 2008;Dwyer, Gabbe, Stoelwinder, & Lowthian, 2014).…”