Review Article

A systematic review of communication strategies for people with dementia in residential and nursing homes

Emmelyne Vasse^a1 c1, Myrra Vernooij-Dassen^a2, Anouk Spijker^a1, Marcel Olde Rikkert^a3 and Raymond Koopmans^a4

^a1 Scientific Institute for Quality of Healthcare (IQ healthcare) and Nijmegen Alzheimer Centre, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

^a2 Scientific Institute for Quality of Healthcare (IQ healthcare) and Nijmegen Alzheimer Centre, Radboud University Nijmegen Medical Centre, Nijmegen, Kalorama Foundation, The Netherlands

^a3 Department of Geriatrics and Nijmegen Alzheimer Centre, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

^a4 Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health and Nijmegen Alzheimer Centre, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

ABSTRACT

Background: The impairment of verbal skills of people with dementia challenges communication. The aim of this review was to study the effects of nonpharmacological interventions in residential and nursing homes on (1) communication between residents with dementia and care staff, and (2) the neuropsychiatric symptoms of residents with dementia.

Method: Pubmed, PsychInfo, Web of Science, the Cochrane Library, and reference lists from relevant publications were systematically searched to find articles about controlled interventions with communication strategies. The data collected were pooled and subjected to a meta-analysis.

Results: Nineteen intervention studies were selected for this review. They included structured and communicative “sessions at set times” for residents (e.g. life review) and communication techniques in activities of “daily care” applied by care staff (e.g. sensitivity to nonverbal communication). A meta-analysis of five set-time interventions (communication) and another meta-analysis of four set-time interventions (neuropsychiatric outcomes) found no significant overall effects. Individual set-time intervention studies report positive effects on communication when interventions are single-task sessions, like life review or one-on-one conversation. Interventions around daily care activities had positive effects on communication outcomes. Effects of both types of interventions on neuropsychiatric symptoms were divergent.

Conclusion: This review indicates that care staff can improve their communication with residents with dementia when strategies are embedded in daily care activities or interventions are single-task sessions at set times. These results offer the possibility of improving the quality of care, but not of directly reducing neuropsychiatric symptoms. More research is needed to study the effect of communication interventions on neuropsychiatric symptoms.

(Received January 12 2009)

(Revised March 13 2009)

(Revised June 11 2009)

(Accepted June 15 2009)

(Online publication July 29 2009)

Key words:

• psychosocial intervention;
• nonpharmacological intervention;
• residential facilities

Correspondence:

^c1 Correspondence should be addressed to: Emmelyne Vasse, MSc, Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 114 IQ healthcare, 6500 HB Nijmegen, The Netherlands. Phone: +31 243 666 265; Fax: +31 243 540 166. Email: E.Vasse@iq.umcn.nl.