PERSON-CENTERED LANGUAGE-BASED STRATEGIES USED BY HOME CARE WORKERS WHO CARE FOR PERSONS LIVING WITH DEMENTIA

Abstract

Abstract Several studies recommend language-based strategies for communication with persons living with dementia. Language-based strategies improve coherence, clarity, reciprocity, and continuity of interactions. Person-centered communication (PCC) strategies are the gold standard, including facilitation, recognition, validation, and negotiation. Only one study has examined the overlap between language-based strategies and PCC in long-term care. Little is known about which language-based strategies support PCC in home care. Accordingly, this study investigated the overlap between language-based strategies and PCC in home care interactions. Conversation analysis of 30 audio-recorded routine care interactions between home care workers and persons living with dementia was conducted. The overlap between communication-units coded for PCC and 33 language-based strategies was analyzed. Of 11,347 communication-units, 2,664 overlapped with PCC. For facilitation, 21% were yes/no questions and 15% were announcements of action/intent. For recognition, 25% were yes/no questions and 22% were affirmations. For validation, the majority (81%) of communication-units were affirmations and positive feedback. Finally, for negotiation, 60% of communication-units were yes/no questions. This is the first study examining naturalistic interactions between home care workers and persons living with dementia. The findings highlight the person-centeredness of language-based strategies. Yet only six of 33 language -based strategies occurred in the top 50% of overlapping communication-units. Home care workers in this study use a uniform set of person-centered language-based strategies, illustrated by the frequent use of yes/no questions overlapping with most PCC indicators. Our findings emphasize the need for training among home care workers in the use of diverse language-based strategies that are potentially person-centered.