Electronic Thesis and Dissertation Repository

Thesis Format



Master of Science


Health and Rehabilitation Sciences


Holmes, Jeffrey D.


Communication deficits are common in Parkinson’s disease and can compromise the ability for informal care partners to communicate effectively with their partner. This may result in the avoidance of critically important conversations, thus placing strain on the relationship, and can harm the well-being of both parties. The aim of this thesis is to explore evidence-informed communication strategies that can be utilized to assist care partners of individuals with Parkinson’s Disease (IWPD) in conducting difficult conversations. Utilizing a scoping review methodology, seven themes emerged from peer-reviewed literature on communication: selecting an appropriate physical environment; conversation preparation; verbal communication skills; non-verbal communication skills; post-conversation actions; care partner character attributes; and communication frameworks tailored for navigating difficult conversations. The results obtained offer practical recommendations that we anticipate will enhance communication skills and the efficacy of care partners in navigating difficult conversations. This review also identifies research gaps and suggests potential next steps forward.

Summary for Lay Audience

Care partners play an important role in the lives of individuals with Parkinson’s disease (IWPD). Throughout the course of disease progression, a care partner must continue to adapt to the demand and dependence for their care. It is a role that can be very rewarding but challenging to hold. One area of the relationship that may cause challenges for the care partner and care recipient is participating in difficult conversations. In this thesis, one study was conducted to explore the literature for communication strategies that could be used by care partners when they are having difficult conversations.

A scoping review of 4 databases yielded 85 articles that met our inclusion criteria and were included in the review. The results from the literature provided many helpful communication strategies that fall into seven identified themes: i) selecting an appropriate physical environment; ii) conversation preparation; iii) verbal communication skills; iv) non-verbal communication skills; v) post-conversation actions; vi) care partner character attributes; and vii) existing communication frameworks tailored for navigating difficult conversations.

The findings highlight areas of focus and nuances of communication that care partners should be attentive to if they would like to create a suitable opportunity for effective communication with their partner. Additionally, this review of the literature has identified gaps in the current research and suggest potential next steps forward that would better align the communication research to the experience of informal care partners of IWPD to ultimately improve the efficacy of communication for care partners.