Improving Communication Between Nursing Assistants and Nursing Home Residents During Care Routines

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Louis D. Burgioa,b, Rebecca Allen-Burgea,b, David L. Rothc, Michelle S. Bourgeoisd, Katinka Dijkstrad, John Gerstlea, Erik Jacksona and Leanna Bankestera
a Applied Gerontology Program, The University of Alabama, Tuscaloosa
b Department of Psychology, The University of Alabama, Tuscaloosa
c Department of Psychology, University of Alabama at Birmingham
d Department of Communication Disorders, Florida State University, Tallahassee

Correspondence: Louis D. Burgio, The University of Alabama, Department of Psychology and The Applied Gerontology Program, Box 870315, Tuscaloosa, AL 35487-0315. E-mail: lburgio@sw.ua.edu.

Decision Editor: Laurence G. Branch, PhD

Purpose: We examined the effects of communication skills training and the use of memory books by certified nursing assistants (CNAs) on verbal interactions between CNAs (n = 64) and nursing home residents (n = 67) during care routines. Design and Methods: CNAs were taught to use communication skills and memory books during their interactions with residents with moderate cognitive impairments and intact communication abilities. A staff motivational system was used to encourage performance and maintenance of these skills. Formal measures of treatment implementation were included. Results:Results were compared with those for participants on no-treatment control units. Trained CNAs talked more, used positive statements more frequently, and tended to increase the number of specific instructions given to residents. Changes in staff behavior did not result in an increase in total time giving care to residents. Maintenance of CNA behavior change was found 2 months after research staff exited the facility. Although an increase was found in positive verbal interactions between CNAs and residents on intervention units, other changes in resident communication were absent. Implications: Nursing staff can be trained to improve and maintain communication skills during care without increasing the amount of time delivering care. The methodological advantages of including measures to assess treatment implementation are discussed