Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Science

Program

Health and Rehabilitation Sciences

Supervisor

Savundranayagam, Marie Y.

Abstract

Many persons living with dementia experience difficulties comprehending language and benefit from nonverbal communication (NVC). This research aimed to identify potential strategies for nonverbal behaviour adaptation to enhance communication with persons living with dementia, based on the Communication Enhancement Model. Studies included a scoping review of NVC strategies for caregivers with persons living with dementia and an analysis of whether NVC strategies used by personal support workers (PSW) co-occurred with verbal communication demonstrating person-centered indicators (recognition, negotiation, validation and facilitation). Video-recorded interactions (n=40) between PSW and simulated persons living with dementia were analysed using a codebook of NVC strategies (facial expression, gaze, gestures, touch) developed from review findings. Co-occurrence with person-centered verbal communication was examined. Of 1848 person-centered communication-units, 69% co-occurred. Gaze co-occurred with all person-centered indicators frequently (40-49%). Gestures using objects predominantly co-occurred with facilitation (17%) and negotiation (21%), suggesting distinct NVC strategies may align with selected person-centered indicators.

Summary for Lay Audience

The Communication Enhancement Model explains that when care partners adapt their communication using strategies matched to the needs and abilities of older adults, this can lead to enhanced communication with those they care for, among other benefits. Many persons living with dementia experience difficulties comprehending language and may benefit from nonverbal communication. Therefore, this research aimed to identify potential strategies for care partners to adapt their nonverbal behaviour in order to enhance communication with persons living with dementia.

A scoping review examined the current literature for nonverbal communication strategies for care partners which have been observed to support communication with persons living with dementia. Findings revealed six supportive strategies: gaze, gestures, facial expression, touch, close proximity, and frontal orientation. These results contributed to the development of a novel codebook of nonverbal communication strategies. The second study used the codebook to analyse forty video-recorded interactions between personal support workers and actors portraying persons living with dementia. The study aimed to determine whether nonverbal strategies identified to support communication with persons living with dementia in the extant literature, co-occurred with verbal communication demonstrating person-centered interaction. Indicators of person-centered communication included ‘Recognition’, ‘Negotiation’, ‘Validation’ and ‘Facilitation’. Written transcripts were segmented into communication-units. Out of 1848 person-centered communication-units, 69% co-occurred with nonverbal communication strategies. This finding shows that personal support workers frequently accompany verbal communication with nonverbal communication strategies in demonstrations of person-centered communication with persons living with dementia. Gestures with an object frequently co-occurred with facilitation and negotiation, and not recognition and validation. Conversely, positive facial expressions co- occurred with recognition and validation frequently but infrequently co-occurred with facilitation and negotiation. These results suggest that distinct nonverbal communication strategies may align with specific person-centered indicators. Findings make a significant contribution to the current literature by identifying potentially beneficial strategies which, if applied in practice, could equip care partners to create the communication enhancement model in their interactions with persons living with dementia.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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