title: Missed opportunities for person-centered communication: implications for staff-resident interactions in long-term care.
abstract: BACKGROUND
  Social interactions in long-term care settings between staff and residents with dementia have been characterized as task-oriented, patronizing, and/or overly directive. Long-term care settings can be contexts that emphasize dependency and threaten the personal identity of older residents. Yet, leaders in the long-term care sector have acknowledged recently that dementia care must move beyond the completion of caregiving tasks and adopt a person-centered approach. This approach involves caregivers incorporating a resident's life history and preferences during interactions. The objectives of this study were to examine the extent to which staff-resident communication is person-centered and the extent to which staff miss opportunities to communicate with residents in a person-centered manner.
  
  
  METHODS
  Conversations (N = 46) of 13 staff-resident dyads were audio-recorded during routine care tasks over 12 weeks. Staff utterances within these conversations were coded for person-centered communication and missed opportunities where person-centered communication could have been used.
  
  
  RESULTS
  Findings revealed a common communication sequence where utterances coded as person-centered were followed by utterances coded as missed opportunities. This sequence suggests that the positive impact of person-centered communication may be undermined when such communication is followed by missed opportunities. Data also revealed that missed opportunities highlight the need for staff training.
  
  
  CONCLUSIONS
  The findings underscore the importance of sustaining person-centered communication while completing routine care tasks.
authors.affiliation: School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada.
authors.forename: Marie Y
authors.initials: MY
authors.lastname: Savundranayagam
mesh_terms: D017028:Caregivers; D003142:Communication; D003463:Cues; D003704:Dementia / Q000451:nursing; D006707:Homes for the Aged / Q000458:organization & administration*; D009735:Nursing Homes / Q000458:organization & administration*; D018802:Patient-Centered Care / Q000458:organization & administration*; D011369:Professional-Patient Relations; D013637:Tape Recording; D014481:United States; D014505:Urban Population