The Effects of Language Used by Caregivers on Agitation in Residents with Dementia

Abstract

In this study, We addressed the problem of whether residents with a diagnosis of dementia would become agitated if given verbal commands at a level of language complexity above their comprehension ability. The study used an A-B-A research design. The convenience sample of 15 subjects was comprised of 11 men and 4 women who resided in a long-term care institution. Their mean age was 86.6 years, and their average length of stay in the institution was 317.3 days. The results lent support to the hypothesis that exposing residents with dementia to language beyond their comprehension ability could result in agitated behavior. The predominant manifestations of agitation were general restlessness, strange noises, and negativism. An important implication for nursing practice is that the language used by caregivers should match the comprehension ability of residents. Caregiving can thereby facilitate communication and, potentially, prevent agitation.

Relationship between speaking English as a second language and agitation in people with dementia living in care homes: Results from the MARQUE (Managing Agitation and Raising Quality of life) English national care home survey

“…In people with dementia, language impairment can impede functioning and effective communication, resulting in disruptive behaviour, due to unmet needs or frustration . Residents with dementia may become agitated if people use language beyond their comprehension or they are not understood when communicating . Language impairment may be especially challenging for people whose first language is not the local language, in whom cognitive decline can cause regression to the primary language, and loss of second language abilities…”

The Efficacy of Psychosocial Approaches to Behaviour Disorders in Dementia: A Systematic Literature Review

“…The articles have been grouped into the following intervention types for further discussion (some studies included more than one type): changes to the physical environment [13–19]; activity programs [20–26]; exposure to music, voice and language [20,27–35]; behaviour therapy [6,36–39]; massage and aromatherapy [40–42]; light therapy [43–46], multidisciplinary teams [47,48] and carer education [25,49–54]. Most attention will be given to papers rated as having moderate or strong validity.…”

“…In a study of communication style per se , Hart and Wells [34] sought to determine the contribution to agitation and other disturbed behaviours of the failure by patients to understand caregivers’ language. All of the 15 persons concerned could understand a simple one‐phase command, for example, ‘Touch your nose’ but none could follow a three‐stage command such as, ‘Point to my face, raise your arms and then clap your hands’.…”

Practice parameter: Management of dementia (an evidence-based review) [RETIRED]

“…150 Commands given above the patient's comprehension level increased agitated behaviors in a small study. 151 Several psychosocial interventions, including sensory intervention 152 and other specific individual care plans, 153 have proven ineffective for treatment of problem behaviors. Alzheimer's special care units.…”