Elderspeak to Resident Dementia Patients Increases Resistiveness to Care in Health Care Profession

Abstract

Resistiveness to care is very common among patients of dementia as these patients do not take medicines, meals or bath very easily. Indeed, it is a very challenging task for health caregivers and there is a significant rise in time and cost involved in managing dementia patients. Amongst different factors, the type of communication between resident dementia patients and health caregivers is an important contributing factor in the development of resistiveness to care. Elderspeak (baby talk) is a type of communication in which health caregivers adjust their language and style while interacting with elderly and dependent patients. It involves the use of short sentences, simple grammar, slow and high pitch voice, repeating phrases to provide a comfortable and friendly environment to patients. Most of the time, caregivers tend to adapt elderspeak as they handle weak and fragile older patients for routine activities. Although elderspeak is meant to provide support, warmth and care to patients, yet patients perceive elderspeak as patronizing and it induces negative feelings about self-esteem. Scientists have found a correlation between the development of resistiveness to care and the extent of elderspeak in communication. Therefore, there have been strategies to develop alternative communication strategies by avoiding the use of elderspeak. Moreover, the beneficial effects of such communications have been documented as it improves the quality of life, reduces aggression, agitation and psychosocial symptoms. The present review discusses the scientific studies discussing the use of elderspeak in communication and development of resistiveness to care in resident patients of dementia.

The Association Between Engagement in Activities of Daily Living and Care Interactions for Residents Living With Dementia

“…Receiving neutral or negative care interaction is associated with increased resistiveness to care,14,15 anxiety,16,17 depression,16,17 lower psychological well-being,5 and apathy16 among RwD. Prior research has shown that RwD receive limited care interactions overall, and the interactions that do occur are neutral, task-oriented, and rushed 7,9,15.…”

“…In contrast, neutral interactions are brief and do not contain pleasant verbal and nonverbal communication, and negative care interactions are restrictive to residents' freedoms or inappropriately controlling due to resident safety concerns. 10 Receiving neutral or negative care interaction is associated with increased resistiveness to care, [14][15][16][17] , anxiety, 18,19 depression, 18,19 lower psychological well-being, 5 and apathy 18 among residents living with dementia. Prior research has shown that residents living with dementia receive limited care interactions overall, and the interactions that do occur are neutral, taskoriented, and rushed.…”

“…Cognition was measured using the BIMS, 27 which ranges from 0 to 15 points. The range goes from severe cognitive impairment (0-7), moderate cognitive impairment (8)(9)(10)(11)(12), and intact cognition (13)(14)(15). Previous psychometric testing of the BIMS has indicated evidence of reliability and validity.…”

A framework for rehabilitation for older adults living with dementia

“…Excessively slow speech by care providers does not facilitate communication, [39][40][41] and, in fact, "elderspeak" (also called "infantilizing," where caregiver speaks slowly, with elevated pitch, and terms of endearment) can lead to decreased self-esteem and resistiveness to care [42]. More important than slowing of speech is purposeful pacing, allowing time for processing and response formulation.…”

Information and Assistance Needs and Expectations of Senior Residents in a Nursing Home in Singapore: Semi-structured Interviews With Senior Residents and Staff

“…or "patronizing" (usually from individuals who are unfamiliar to the senior resident). It has been found that patients having positive perceptions about "elderspeak" (i.e., words conveyed with warmth from familiar persons) have reported higher levels of self-esteem, reduced agitation, and calmness (Zhang et al, 2020).…”