Hostname: page-component-8448b6f56d-42gr6 Total loading time: 0 Render date: 2024-04-18T00:32:31.227Z Has data issue: false hasContentIssue false

Optimizing communication between medical professionals and people living with dementia

Published online by Cambridge University Press:  14 April 2011

Tony Johnstone Young*
Affiliation:
School of Education, Communication and Language Sciences, Newcastle University, Newcastle-upon-Tyne, UK
Chris Manthorp
Affiliation:
Barchester Healthcare, London, UK
David Howells
Affiliation:
Cardiff and Vale National Health Service Trust, Cardiff, UK
Ellen Tullo
Affiliation:
Institute of Ageing and Health, Newcastle University, Newcastle-upon-Tyne, UK
*
Correspondence should be addressed to: Dr. Tony Young, School of Education, Communication and Language Sciences, King George VI Building, Newcastle University, Queen Victoria Road, Newcastle-Upon-Tyne, NE1 7RU, UK. Phone: +44 (0)191 222 7515. Email: tony.young@ncl.ac.uk.

Abstract

Background: A growing body of research evidence indicates that improving communication with people living with dementia (PLWD) has a positive effect on their quality of life. Policy initiatives internationally highlight the prevalence of poor communication practices in care environments in general and medical contexts in particular as priority areas for improvement. Currently available communication interventions exhibit shortcomings, and their application remains unusual.

Methods: A spectrum of multidisciplinary professional and lay stakeholders, including PLWD, took part in an iterative consultation process in the UK. This aimed to develop a communications advice package which would meet their needs, and involved observation of practice in a variety of care contexts and semi-structured focus group and individual interviews.

Results: Lay participants reported dissatisfaction with current communicative practices, particularly during contact with medical professionals. Both lay and professional participants reported general dissatisfaction with currently available communication advice. An agreed version of a dementia toolkit for effective communication (DEMTEC) was produced. This consists of three “levels”. The foundation Level 1 details beliefs about the psychosocial effects of dementia on communication, as well as empowering approaches to communication involving PLWD. Level 2 consists of practical considerations and advice in eight key areas. Level 3 uses case studies to show how the principles and advice in preceding levels are applicable to individuals in different care contexts and at different stages of dementia.

Conclusion: The project has produced a free-to-users instrument that is empirically supported and adaptable to individual PLWD and to a range of health, care and sociocultural environments.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alonso, T., Krishnamoorthy, E. S. and Gomez, K. (2010). Caregiving for dementia: global perspectives and transcultural issues. In Krishnamoorthy, E. S., Prince, M. J. and Cummings, J. L. (eds.), Dementia: A Global Approach (pp. 99106). Cambridge: Cambridge University Press.Google Scholar
Alzheimer's Society (2009). Counting the Cost: Caring for People with Dementia on Hospital Wards. Available at: www.alzheimers.org.uk/site/scripts/download_info.php?fileID=787; last accessed 15 September 2010.Google Scholar
Alzheimer's Society (2010). A to Z of Dementia. Communicating. Available at: www.alzheimers.org.uk/site/scripts/services_info.php?serviceID=26; last accessed 17 July 2010.Google Scholar
Beer, C. et al. (2010). Development and evaluation of an educational intervention for general practitioners and staff caring for people with dementia living in residential facilities. International Psychogeriatrics, 23, 221229.Google Scholar
Commission for Social Care Inspection (CSCI) (2008). See Me, Not Just the Dementia: Understanding People's Experiences of Living in a Care Home. Available at: www.cqc.org.uk/_db/_documents/Dementia%20Report-web.pdf; last accessed 16 July 2010.Google Scholar
Department of Health (DoH) (2009). Living Well with Dementia: A National Dementia Strategy. Available at: www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_094058; last accessed 21 October 2010.Google Scholar
Department of Health and Medical Research Council (2009). Report from the Ministerial Summit on Dementia Research. Available at: www.mrc.ac.uk/consumption/idcplg?IdcService=GET_FILE&dID=24618&dDocName=MRC006472&allowInterrupt=1; last accessed 18 July 2010.Google Scholar
Dodd, B., Worral, L. and Hickson, L. (1990). Communication: A Guide for Residential Care Staff. Canberra: Australian Government Publishing Service.Google Scholar
Goldsmith, M. (1996). Hearing the Voice of People with Dementia: Opportunities and Obstacles. London: Jessica Kingsley Publishers.Google Scholar
Goldstein, M. Z., MaLossi, R. A., Kye, K. and Young, B. (1999). A course in dementia for third-year medical students. Academic Psychiatry, 23, 142150.Google Scholar
Kuske, B. et al. (2007). Nursing home staff training in dementia care: a systematic review of evaluated programs. International Psychogeriatrics, 19, 818841. doi:10.1017/S1041610206004352.Google Scholar
Mace, N. L. and Rabins, P. V. (1999). The 36-Hour Day: A Family Guide to Caring for Persons With Alzheimer Disease, Related Dementing Illnesses, and Memory Loss in Later Life. Baltimore: John Hopkins University Press.Google Scholar
National Audit Office (2007). Improving Services and Support for People with Dementia. Available at: www.nao.org.uk/idoc.ashx?docId=64F3FFB3–16CE-4191-8556-926F58ADAA7B&version=-1; last accessed 16 October 2010.Google Scholar
National Audit Office (2010a). Improving Dementia Services in England – an Interim Report: Consultant Old Age Psychiatrist Survey Results. Available at: www.nao.org.uk/idoc.ashx?docId=2454AFBB-B40A-412A-80D7-B1832C9E9ACE&version=-1; last accessed 16 October 2010.Google Scholar
National Audit Office (2010b). Improving Dementia Services in England – An Interim Report. Available at: www.nao.org.uk/idoc.ashx?docId=82ECA9EE-C8DB-4CE5-B331-D5F482407F2F&version=-1; last accessed 16 October 2010.Google Scholar
National Institute for Health and Clinical Excellence (NICE) and Social Care Institute for Excellence (SCIE) (2006). Dementia: Supporting People With Dementia and Their Carers in Health and Social Care. Available at: www.nice.org.uk/guidance/cg42; last accessed 17 July 2010.Google Scholar
Peterson, D., Berg-Weger, M., McGillick, J. and Schwartz, J. (2002). Basic care. I: The effect of dementia-specific training on certified nursing assistants and other staff. American Journal of Alzheimer's Disease and Other Dementias, 17, 154164.Google Scholar
Pinner, G. and Bouman, W. P. (2003). What should we tell people about dementia? Advances in Psychiatric Treatment, 9, 335341.Google Scholar
Robinson, L., Bamford, C., Briel, R., Spencer, J. and Whitty, P. (2010). Improving patient-centered care for people with dementia in medical encounters: an educational intervention for old age psychiatrists. International Psychogeriatrics, 22, 129138.Google Scholar
Santo Pietro, M. J. and Ostuni, E. (2003). Successful Communication with Persons with Alzheimer's Disease: An In-Service Manual. St. Louis: Butterworth Heinemann.Google Scholar
Savundranayagam, M. Y., Ryan, E. B., Anas, A. P. and Orange, J. B. (2007a). Communication and dementia: staff perceptions of conversational strategies. Clinical Gerontologist, 31, 4763. doi: 10.1300/J018v31n02_04.CrossRefGoogle Scholar
Savundranayagam, M. Y., Ryan, E. B. and Hummert, M. L. (2007b). Communication, health and ageing: promoting empowerment. In Weatherall, A., Watson, B. M. and Gallois, C. (eds.), Language, Discourse and Social Psychology (pp. 81107). Basingstoke: Palgrave Macmillan.Google Scholar
Smith, S. C. et al. (2007). Development of a new measure of health-related quality of life for people with dementia: DEMQOL. Psychological Medicine, 37, 737746. doi: 10.1017/S0033291706009469.Google Scholar
Tullo, E., Gordon, A. L., Blundell, A. G., Masud, T. and Gladman, J. (2010). Putting in the hours? Dementia teaching for medical undergraduates around the UK. Presentation to British Geriatrics Society Conference, Autumn Meeting, Brighton, UK.Google Scholar
Vasse, E., Vernooij-Dassen, M., Spijker, A., Rikkert, M. O. and Koopman, R. (2010). A systematic review of communication strategies for people with dementia in residential and nursing homes. International Psychogeriatrics, 22, 189200. doi:10.1017/S1041610209990615.Google Scholar
Williams, C. L., Hyer, K., Kelly, A., Leger-Krall, S. and Trappen, R. M. (2005). Development of nurse competencies to improve dementia care. Geriatric Nursing, 26, 98105. doi:10.1016/j.gerinurse.2005.01.005.Google Scholar
Young, T. J. and Manthorp, C. (2009). Towards a code of practice for effective communication with people with dementing illnesses. Journal of Language and Social Psychology, 28, 174189.Google Scholar
Young, T. J., Manthorp, C. and Howells, D. (2010). Communication and Dementia: New Perspectives, New Approaches. Barcelona: Editorial Aresta. [Available in Spanish as Comunicación y Demencia: Nuevas Perspectivas, Nuevos Enfoques, and in Catalan as Comunicació i Demència: Noves Perspectives, Nous Enfocaments.]Google Scholar
Young, T. J., Manthorp, C., Howells, D. and Tullo, E. (2011). Developing a carer communication intervention to support personhood and quality of life in dementia. Ageing and Society, 31. Epublished ahead of print. doi:10.1017/S0144686×10001182.Google Scholar
Zimmerman, S. et al. (2005). Attitudes, stress, and satisfaction of staff who care for residents with dementia. The Gerontologist, 45 (Suppl. 1), 96105.Google Scholar