Enhancing Communication Skills in Dementia Care: Practical Interventions

1. Communication Intervention for Direct-Care Workers with Dementia Patients Language, Aging, and Health Patrick J. Payne Dr. Davis University of North Carolina at Charlotte May 6, 2006

2. Rationale • Semantic Memory: The vast network of associations and concepts that underlies our general knowledge of the world (Arkin 2001) • Semantic memory is compromised early and severely in people with Alzheimer’s Disease: Comprehending linguistic information is difficult due to deteriorated inferential capabilities and difficulty accessing and making connection between the contents of semantic memory (Arkin 2001)

3. Conversation Deficits • Reduced relevant units of information and informational content • Difficulty in word finding • Use of more pronouns without antecedants • Ideational preservation • Reduced cohesion and coherence • Poor topic maintenance and frequent shifting • Excessive use of verbs • Difficulty in comprehension of abstract language

4. Intervention 1: Memory Wall Direct-Care Workers can help residents/patients decorate a wall in their room: • Pictures of family and famous people from their past that they admire • Newspaper clippings of interesting topics • Other important articles from their past During this activity, the Direct-Care worker can initiate discussion about these articles to exercise semantic memory

5. Intervention 2: Cooking Activities Direct-Care workers can help resident/patient in minor cooking activities During this activity, the Direct-Care worker can initiate discussion about favorite recipies and other opinions about food. It is validating for a person with dementia to have their opinion or advice sought, particularly by a younger adult (Arkin 2001)

6. Intervention 3: Scripted Discourse Direct-Care workers can use specific conversation starters to initiate conversation • Limits word finding difficulty • Increases verbal activity • Decreases verbal repetitiveness

7. Intervention 4: Music Therapy Direct-Care workers can play music from the patient/resident’s past • Initiates discourse about favorites songs and how they make the resident/patient feel • Helps patients remember times when they were healthy and young

8. Intervention 5: Verbal Exercises Direct-Care workers can initiate discourse in the following ways: • Free and prompted descriptions of pictures • Associations to evocative words • Proverb completion and interpretation These interventions help patients/residents exercise semantic memory and build new neural pathways (Arkin 2001)

9. Intervention 6: Daily Routine Direct-Care workers can develop a daily schedule for the resident/patient • Decreases agitation • Decreases meaningless wandering • Helps Direct-Care workers keep track of resident/patient

10. Conclusion These interventions are useful in developing a stronger relationship between the Direct-Care worker and the resident/patient with dementia. Improvements will be seen in the quality and quantity of discourse in Alzheimer’s Patients Arkin, S., Mahendra, N.(2001).Discourse Analysis of Alzheimer’s Patients Before and After Intervention: Methodology and Outcomes. Aphasiology, 15(6), 533-569.