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


METHODS
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.


CONCLUSIONS
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.
Vasse
Emmelyne
E
Scientific Institute for Quality of Healthcare (IQ healthcare) and Nijmegen Alzheimer Centre, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. E.Vasse@iq.umcn.nl
Vernooij-Dassen
Myrra
M
Spijker
Anouk
A
Rikkert
Marcel Olde
MO
Koopmans
Raymond
R
D000368:Aged; D003142:Communication; D003704:Dementia / Q000523:psychology*; D006801:Humans; D009633:Nonverbal Communication / Q000523:psychology; D009735:Nursing Homes; D011787:Quality of Health Care; D012112:Residential Facilities / Q000379:methods; D014705:Verbal Behavior; D000078329:Workforce