title: Exploratory investigation of communication management in residential-aged care: a comparison of staff knowledge, documentation and observed resident-staff communication.
abstract: BACKGROUND
  There is a high prevalence of communication difficulty among older people living in residential-aged care. Such functional deficits can have a negative impact on resident quality of life, staff workplace satisfaction and the provision of quality care. Systematic research investigating the nature of communication management in residential-aged care and factors impacting optimal communication management is lacking.
  
  
  OBJECTIVE
  To use data triangulation across multiple sources to describe resident-staff communication and communication management in residential-aged care.
  
  
  METHODS
  Participants included a sample of 14 residents and 29 staff directly involved in communication interactions with residents. Data were obtained from: (1) resident file review (n = 14), (2) observation of resident-staff communication (n = 14), (3) resident surveys (n = 14) and (4) staff surveys (n = 29). Data from each source were examined separately then triangulated.
  
  
  RESULTS
  All residents had limited opportunity for meaningful communication with staff. Documentation of residents' communication needs and strategies to facilitate resident-staff communication was insufficient to provide individualized recommendations. Although staff were observed to use various strategies to facilitate communication with residents, staff agreement about the applicability of these strategies to individual residents was inconsistent. Differences in resident-staff communication for residents who experience nil/mild versus moderate/severe communication difficulty were also found.
  
  
  CONCLUSIONS
  Resident-staff communication and communication management in residential-aged care is limited in scope and challenged in meeting residents' individual communication needs. Improvements in both documentation and staff knowledge of residents' communication needs are necessary. Strategies to facilitate communication with individual residents must be tailored, evidence based, documented in care plans and delivered to staff through ongoing education. Increased involvement of specialist providers such as speech pathologists to support better communication management in residential-aged care may provide one way of facilitating such change.
authors.affiliation: The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, QLD, Australia.
authors.forename: Michelle K
authors.initials: MK
authors.lastname: Bennett
authors.affiliation: The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, QLD, Australia.|Centre for Functioning and Health Research (CFAHR), Queensland Health, Brisbane, QLD, Australia.
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Ward
authors.affiliation: The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, QLD, Australia.
authors.forename: Nerina A
authors.initials: NA
authors.lastname: Scarinci
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003142:Communication; D003147:Communication Disorders / Q000175:diagnosis* / Q000209:etiology / Q000451:nursing / Q000628:therapy*; D003145:Communication Methods, Total; D032882:Comprehension; D004282:Documentation; D005260:Female; D006707:Homes for the Aged / Q000458:organization & administration; D006801:Humans; D008297:Male; D009723:Nurse-Patient Relations; D009735:Nursing Homes / Q000458:organization & administration; D010347:Patient Care Planning / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration; D011369:Professional-Patient Relations; D058996:Quality Improvement / Q000458:organization & administration; D011793:Queensland
keywords: language; long term-care; quality of life; speech-language pathology