Communication Strategies Flashcards
List the 10 PROPOSED strategies for effective communication with someone with dementia
1) Eliminate Distractions
2) Approach the person slowly and from the front
3) Use short simple sentences
4) Speak slowly (no experimental evidence/ __)
5) “Elderspeak” (not effective)
6) Ask one question/ give one instruction at a time
7) Yes/no vs open-ended questions
8) Repeat and rephrase
9) Avoid interrupting (no evidence )
10) Encourage the person to describe the word he is searching for
Describe eliminating distractions:
- a non-verbal strategy of controlling the environment
- reduce distractions by simplifying the surroundings (ie. turn off the TV)
- Studies show this is associated with fewer breakdowns in communication
T or F: A study shows that approaching the person from the front and maintaining eye contact are strategies used rarely by the caregiver during activities.
False- They are used frequently although caregivers perceived that they use them less often
Using short simple sentences reduces demands on __________
working memory
Describe 4 study results that support using short simple sentences:
1) Associated with fewer breakdowns in communication with a caregiver (small et al. 2003)
2) Increased success on a description-picture matching task when using simple sentences (Kemper et al. 1994)
3) Better comprehension of simple sentences on the Revised Token Test (Tomoeda et al. 1990)
4) Fewer Errors with simple sentences than complex sentences during a sentence-picture matching task (Small et al. 1997)
Describe one possible disadvantage of using short simple sentences:
Using this strategy over time may lead to a decline in ability to understand complex sentences
T or F: You should simplify sentences if the client can still understand complex sentences
False - use sentences that are at the level the client understands not below that level
__________ compensates for slower information processing speeds by allowing additional processing time but could increase ______ demands
speaking slowly
working memory
T or F: There is experimental evidence supporting speaking slowly
False - no experimental evidence
- more breakdowns in communication with a caregiver though caregivers felt it helped
- no difference in sentence comprehension b/w slow and normal rates
________ is systematic speech accommodations directed towards older adults.
“Elderspeak”
Describe 4 strategies used by people using Elderspeak:
1) Simplistic vocabulary and grammar
2) Shortened sentences
3) Slowed speech
4) Also exaggerated prosody
T or F: Elderspeak is an effective way of speaking to older adults
False - older adults with and without dementia react negatively
Describe results of 3 studies showing ways the negative effects of elderspeak:
- decreased successful task performance
- negative assessments of their own and the speakers communicative competence
- resistance to care
T or F: People with Alzheimer’s disease have more difficulties with multi-propositional sentences due to greater demands on their working memory.
True - ask one question or give one instruction at a time
Several studies show that Yes/no questions are _______ for communication.
more effective
T or F: Open-ended questions have no place in communicating with someone with dementia
False
- positive relevant and meaningful responses to open ended questions too
- open-ended questions were proposed to be useful to encourage emotional responses.
- open-ended questions requiring semantic vs episodic memory were more effective
Tappen et al. proposed that closed ended questions may be better for ________ while open-ended questions may ecourage ________
everyday living tasks
emotional response
In a study 32 pairs of caregivers and individuals with dementia prepared a meal. Questions were coded for type (yes/no vs open ended) and for outcome (success vs failure). Communication success was: - highest with \_\_\_\_\_\_\_ ( \_\_\_%) - lower with \_\_\_\_\_\_\_ (\_\_\_%) - lowest with \_\_\_\_\_\_\_ (\_\_\_%)
- highest with yes/no questions (83%)
- lower with choice questions (67%)
- lowest with open-ended questions (39%)
Caregivers use yes/no questions more frequently (___% vs___%) and yes/no questions were associated with ______communication breakdowns.
66% vs 34%
fewer
In a study cargivers and spouses with AD were audiotape and transcribed. Conversations were coded according to occurance, type, memory type and outcome. Describe the results:
- yes/no questions were used the same as open-ended questions
- —– yes/no were more successful
- episodic memory questions were used twice as often as semantic memory questions
- —– semantic memory questions were more successful
T or F: Repeating and rephrasing questions is shown to increase comprehension
True
_______ is good if they haven’t heard what they heard. _______ is good when they heard but didn’t understand (ie. if they respond something similar to what you expect but not the right way)
repetition
rephrase
T or F: Small et al. found that caregivers that used the strategy of avoiding interrupting and allowing plenty of time to respond had fewer breakdowns in communication
False- no clear difference between caregivers that used and didn’t use this strategy
T or F: Caregivers consider it important to simplify their language and not interrupt their loved ones but instead encourage them to come up with their words and caregivers frequently employ this strategy.
True
Caregivers perceived themselves to use the strategy of ____________ but they virtually never used it. Because it only occurred once during the Small et al. (2003) study the use was not recorded and more research is required.
Encouraging the person to “talk around” or describe the word he or she is searching for.
Of the 10 proposed strategies list which work/ don’t work:
- **Effective: Experimental Evidence:
1) Eliminate distractions
2) Approach the person slowly and from the front
3) Using short simple sentences (as long as appropriate level)
6) Ask one question or give one instruction at a time
7) Use yes/no questions and semantic memory
8) Repeat and rephrase- **No Evidence either way:
9) Avoid interrupting; Allow plenty of time to respond
10) Encourage the person to “talk around” or describe the word he is searching for - **Detrimental: Experimental Evidence:
4) Speaking slowly (caregivers felt it helped)
5) Elderspeak
- **No Evidence either way:
A review article based on 13 studies found the most effective techniques for communication were ________ combined with ________
memory aids combined with specific caregiver training
List the 7 parts of the FOCUSED program:
1) Face to face
2) Orientation
3) Continuity
4) Unsticking
5) Structure
6) Exchange
7) Direct
Describe FOCUSED program: Face to face
- face the patient directly
- attract the patient’s attention
- maintain eye contact
Describe FOCUSED program: Orientation
- orient the patient by repeating key words several times
- repeat sentences exactly
- give the patient time to comprehend what you say
Describe FOCUSED program: Continuity
- continue the same topic of convo for as long as possible
- prepare the patient if a new topic must be introduced
Describe FOCUSED program: Unsticking
- help patients become unstuck when they use a word incorrectly by suggesting the word they want
- repeat the patients sentence using the correct word
- ask “Do you mean . . .”
Describe FOCUSED program: Structure
- Structure questions to give the patient a simple choice to respond with
- Provide only two options at a time
- Provide options that the patient would like
Describe FOCUSED program: Exchange
- keep the normal exchange of ideas in conversation
- begin conversation with pleasent normal topics
- ask easy questions the patient can answer
- give the patient clues as to how to answer
Describe FOCUSED program: Direct
- keep sentences short, simple and direct
- use specific, concrete nouns rather than pronouns
- Use hand signals, pictures and facial expressions
Describe the two benefits of the FOCUSED Program
- Increased Knowledge and improved communication satisfaction for nursing assistance caring for AD patients
- education in strategies altered attitudes towards patients and improved quality of life for patients with dementia
