Improving Outcomes of Nursing Home Communication Protocol Summary May 1, 2003

This research study investigates the effectiveness of a communication-training program in achieving an enhanced communication environment and improved resident and staff outcomes in nursing homes. It will also determine whether participants continue learned communication skills after a two-month interval.

The goal of the study is to determine whether a limited educational program can reduce the use of elderspeak, a type of patronizing or “baby talk” to older adults that is frequently used in intergenerational encounters, specifically those involving nursing home staff and residents. Research has demonstrated that older adults perceive elderspeak as patronizing, potentially resulting in lowered self-esteem, depression, isolation, and assumption of behaviors consistent with stereotypes of frail elders. These outcomes fail to promote independence or empower older adult care recipients.

This study expands on the investigator’s dissertation that determined that a three- hour training program was effective in alerting nursing home staff to potential negative messages they may communicate as caregivers that may impact negatively on older adult care recipients. After training, participants significantly reduced their use of elderspeak and their messages were rated as less controlling, more respectful, and equally caring.
The investigator will provide the communication-training program to the staff on a selected unit(s) in area nursing homes as a staff development activity. Volunteer staff will be solicited to participate in a research investigation to determine the effectiveness of this training. Participating staff will record their interactions with residents for a two-hour period before, after, and at a two-month follow-up point and will complete a 21-item job satisfaction survey after each recording session. Residents or the person responsible for decisions regarding nursing home care for legally incompetent residents residing on the participating unit(s) will be contacted to solicit signed informed consent for that resident’s inclusion in recordings of staff-resident interactions.

Portable recording devices will be used to collect samples of each staff person’s communication with residents before, after, and following a two-month interval from the training program. These recordings will be transcribed and rated on a number of communication measures and rated by listeners on affective characteristics of emotional tone. Participating staff will complete job satisfaction questionnaires and resident functional, cognitive, and engagement levels will be assessed. These measures will be compared in repeated measures analyses of variance to determine whether training results in improved staff communication, increased social engagement and other outcomes for residents, whether staff job satisfaction improves after training, and whether benefits continue over time. The ultimate goal is to evaluate the training as an effective means to improve the quality of life for older adults residing in long-term care facilities.