Modifying Repetitive Verbalizations of Community-Dwelling Patients with AD

Florida State University, Tallahassee 32306-2007, USA.
The Gerontologist (Impact Factor: 3.21). 03/1997; 37(1):30-9. DOI: 10.1093/geront/37.1.30
Source: PubMed


Seven caregivers of a home-dwelling spouse with Alzheimer's disease were trained during 12 weekly home visits to implement behavior management programs including written cuing procedures in response to repetitive verbalizations. Data from 7 trained caregivers and 7 matched control caregivers who only tracked repetitive behavior were compared. Results revealed that trained caregivers were successful at decreasing patient repetitions using written cues. Patients of control subjects showed no systematic changes in behavioral disturbances due to behavior tracking. In addition, intervention effects lasted for 16 weeks or longer and several caregivers reported applying the cuing intervention to other, nontargeted behaviors. Trained caregivers' perceptions of their efficacy in managing difficult patient behavior improved significantly at the 3-month follow-up assessment when program staff were no longer visiting them weekly.

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    • "Mostly individual setting. Bourgeois (1997), Chang (1999), Chien (2011), Dias (2008), Fortinsky (2009), Gerdner (2002), Gitlin (2010a), Gitlin (2010b), Gitlin (2001), Hebert (2003), Huang (2003), Joling (2012), Martin-Carrasco (2009), Nobili (2004) Multicomponent Various combinations of interventions (psychoeducational interventions, support, respite …) with equal relevance. "
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    ABSTRACT: Within the last years various interventions for cognitively impaired persons and their informal caregivers have been developed and evaluated. As different these interventions are, as different are the outcome dimensions and instruments used. There might be the potential to affect outcomes on both sides. Therefore, the aim of this review is to analyze the amount of studies that report on care recipient outcomes, to show what main outcome dimensions can be categorized, and which validated instruments are most frequently used. A systematic literature search of the electronic databases PubMed, Medline and PsycINFO was conducted. Overall 1547 studies were identified. After exclusion of duplicates and screening of titles and abstracts 162 records remained. Of those 105 would have met the inclusion criteria but 36 records (34.3%) didn’t assess any care recipient outcomes. Sixty nine studies (65.7%) reported on care recipient outcomes and were finally analyzed. The following assessments were used most in the main outcome dimensions: the Revised Memory and Behavior Problem Checklist and the Neuro-Psychiatric Inventory for problem behaviors, the Cornell Scale for Depression in Dementia for depressive symptoms, Quality of Life in Alzheimer's Disease for quality of life, the Mini Mental State Examination for cognition, and Lawton and Brody’s Instrumental Activities of Daily Living scale for activities of daily living. In dementia caregiver studies care recipient outcomes should more often be assessed. For a better comparability between interventions and target groups more homogeneity of the instruments is necessary. Instruments that are not specifically developed for cognitively impaired persons should only be used if they have been validated for persons with a comparable cognitive status.
    Full-text · Article · Mar 2015 · International journal of emergency mental health
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    • "i Accepting misunderstandings j Talk about person to another h,i Focusing on the present k,l,m Speaking slowly a,b Asking general questions k,l,m Parallel communication style r Accepting misunderstandings j Harsh tone of voice f Focusing on the present k,l,m Frustration, impatience t Asking general questions k,l,m Demanding communication f,s Sharing of self k,l,m Threats p,s Supportive touch e Sarcastic humor s Nonverbal gestures a,k,l,m Patronizing tone of voice s Verbal encouragers a,k,l,m Distancing, little eye contact s Closed-ended questions a Ignoring s Open-ended questions o,l Correcting, pointing out errors t Calm approach i Specific questions p Allowing time to respond i,o Speaking louder a,b Acknowledging autonomy i Demeaning s Note: The above listed communication strategies are supported by evidence from the following literature: a Small et al. (2003), b Small et al. (1997), c Bourgeois et al. (1997), d Bourgeois (1992), e Hendryx-Bedalov, P.M. (2000), f Small & Gutman (2002), g Hopper (2001), h Small & Perry (2005), i Williams (2008), j Bohling (1991), k Tappen et al. (2001), l Tappen et al. (1997), m Williams & Tappen (1999), o Acton et al. (2007), p Sabat (1991), q Small et al. (2005), r Roberto et al. (1998), s Ostuni & Santo Pietro (1991), t Blieszner & Shifflett (1990). "
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    ABSTRACT: There have been few reported studies of communication between spouses with Alzheimer's disease (AD) and related dementia. An observer rating scale for verbal and nonverbal behavior, Verbal-Nonverbal Interaction Scale for Caregivers (VNVIS-CG), was developed to study caregiver communication in couples affected by AD. Preliminary psychometric testing showed that the VNVIS-CG evidenced good reliability and validity. Researchers observed both common caregiver communication strategies and novel strategies that have not been reported in the literature. In future studies, researchers can examine the relationship between caregiver communication and indicators of mental health. Everyday conversations provide fertile ground for nurses to influence family relationships. Nurses can teach caregivers to use strategies that promote engagement and avoid those that discourage participation.
    Full-text · Article · Apr 2012 · Issues in Mental Health Nursing
    • "Second, future interventions could include the use of low-tech augmentative and alternative communication (AAC) strategies for residents with language disorders and cognitive impairments. For instance, as mentioned previously, Bourgeois et al. (1997) found that using reminder cards helped to diminish repetitive verbalisations in individuals with Alzheimer's disease, and Burgio et al. (2001) found that using memory books contributed to positive verbal interactions between certified nursing assistants and residents in nursing homes. Third, more long-term effects of such training need to be studied, and methods to ensure the clinical sustainability of the programme need to be developed. "
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    ABSTRACT: Background: Positive interactions between caregivers and residents in long-term care institutions have been documented to improve residents' quality of life, their psychological and social well-being as well as their life expectancy. Residents with language disorders pose a unique challenge due to their difficulties understanding conversation, speaking, reading, and writing. The success and efficiency of such residents' communication can be improved by enhancing partners' abilities to communicate with them. Individualised communication plans, education and training, and staff support have been documented to be important components in this type of intervention.Aims: This paper reports on the development and evaluation of a communication training programme for nurses working with persons with language impairments in a complex continuing care facility. The specific aims of this study were (a) to explore changes in staff knowledge about language impairment, (b) to determine their perception of the training workshop, and (c) to explore staff's perceptions of the Communication Plans' usefulness in practice.Methods & Procedures: Eighteen nursing staff and nine residents with communication impairments participated in this study with a descriptive design. The intervention consisted of three components: developing Communication Plans, holding a 1-day workshop, and offering support while implementing the plans into practice.Outcomes & Results: There was a statistically significant increase in staff's knowledge of language disorders after training. Staff perceived the Communication Plans to be very useful in their interactions with residents.Conclusions: Individualised Communication Plans, a 1-day workshop, and the follow-up and support of a speech-language pathologist can have a beneficial effect on staff outcomes. Nursing staff demonstrated an enhancement in their knowledge and perceived skills in caring for residents with communication impairments. Results have implications for the speech-language pathologist's role with residents with communication impairments in complex continuing care.
    No preview · Article · Nov 2010 · Aphasiology
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