A massive research effort headed by a University of Kansas investigator deepens our understanding of how Alzheimer's disease affects our ability to think, especially in its earliest stages. David K. Johnson, KU professor of psychology, and colleagues from Washington University School of Medicine in St. Louis have shown that testing a person's aptitude with spatial relationships between objects - the skills needed to complete a jigsaw puzzle, for instance - could give an earlier indication of Alzheimer's disease than conventional methods involving verbal memory. Read the rest of the press release here.
The first graduate of KU’s interdisciplinary Ph.D. program in Gerontology has received national attention for her research on the effects of “elderspeak” with Alzheimer’s patients.
KU Medical Center News Release
Jul 28, 2008
Adults with Alzheimer's in nursing homes who are talked to like children are more likely to be resistive to care, according to research reported by Kristine Williams, RN, PhD, associate professor at the University of Kansas School of Nursing.
Kristine Williams, RN, PhD
Williams, along with many other researchers, are presenting at the 2008 Alzheimer's Association International Conference on Alzheimer's Disease (ICAD 2008) in Chicago.
As effective pharmaceutical treatments and prevention for Alzheimer's remain elusive, researchers, including Williams, are focusing their efforts on improving quality of life and care – including communication.
"The style of communication that we use with people with Alzheimer's influences how they feel about themselves and how well they respond to those providing care," said Sam Fazio, PhD, Director, Medical and Scientific Relations at the Alzheimer's Association. "With the growing prevalence of Alzheimer's, it will be increasingly important for healthcare providers, caregivers and families to understand the effect Alzheimer's has on communication and, perhaps more importantly, the impact their communication may have on the individual's quality of life."
The growing population of adults with Alzheimer's presents complex challenges to care providers. Williams and colleagues at the KU School of Nursing explored the relationship between how nursing home staff communicates with those with dementia and subsequent behaviors that disrupt care, or resistiveness to care (RTC). Specifically, the study examined whether nursing staff "elderspeak" affected RTC behaviors.
The researchers defined elderspeak as overly caring, controlling and infantilizing communication, similar to "baby talk." Common features are simplified grammar and vocabulary, substitution of collective pronouns and overly intimate endearments.
RTC increases nursing staff stress, time needed to provide care and costs of care. At the same time, RTC may actually indicate unmet needs that the person with Alzheimer's is unable to communicate in a conventional way.
Twenty (20) nursing home residents with dementia were filmed during bathing, dressing, oral care and other care activities (2005-2006) and the sequences subsequently analyzed (2006-2008, and ongoing) for nursing staff communication (normal talk, elderspeak, or silence) and resident behavior (cooperative, resistive to care, or neutral). Residents and staff in Special Dementia Care Units in three skilled nursing facilities in Kansas were used for the study. The mean age of residents in the sample was 82.9 years, with a range of 69 to 97. Cognitive test scores indicated a relatively homogeneous sample in the moderate stage of dementia. Staff participants were primarily (78%) certified nursing assistants. The remaining staff participants included nurses, therapists, and social workers who were involved in direct care.
The probability of RTC behavior varied significantly with the type of nursing staff communication. Residents with dementia were more likely to resist care when nursing staff used elderspeak communication; they were more likely to cooperate with care when normal adult communication was used.
The Resistiveness to Care Scale (RTCS) is a measure of the occurrence of and intensity of behaviors of persons with dementia including those that disrupt care. It assesses 13 behaviors including grabbing objects, saying no, adduction [holding the arms or legs tight against the body], grabbing a person, pulling away, clenching teeth, crying, screaming, turning away, pushing away, hitting/kicking, threatening and moving the body in the opposite direction from staff. Each occurrence of the 13 RTC behaviors was scored by duration and intensity. The total RTC score was the sum of multiplying the duration of each incident by its observed intensity providing a weighted score within a possible range of 0 (no resistiveness) to 156 (maximum resistiveness).
When elderspeak communication was used, the probability of RTC was .55 (CrI = .44 - .66). In contrast, the probability of RTC was .26 (CrI = .12 - .44) when staff used normal adult communication. Silence resulted in a probability of .36 (CrI = .21-.55) for RTC.
"This study suggests that there is an association between communication style and resident behaviors," Williams said. "This may significantly impact nursing care and how nursing home staff should best be trained to communicate with residents with Alzheimer's. Future research is needed to test whether interventions that reduce nursing staff elderspeak communication will contribute to greater cooperation with care for persons with dementia.”
Williams is currently funded by the National Institutes of Nursing Research and Aging. She has a bachelor of science degree in nursing from Kent State University, a master of science degree in nursing from the University of Connecticut and was the first student to complete the Interdisciplinary PhD program in Gerontology from the University of Kansas, Lawrence.
More stories:
- Good Morning America
- CBS News
- New York Times
- Lawrence Journal World
- Kansas Public Radio
Legislators get close look at Life Span research
By Mary-Margaret Simpson
A key group of Kansas legislators toured the Life Span Institute Jan. 22 to see first-hand how groundbreaking research is tackling critical issues related to child development, disability and aging.
Senior scientists in gerontology, communication disorders and assistive technology were among those who presented their research to 16 members of the House and Senate at the Dole Center for Human Development on the KU campus. The tour was organized by the Life Span Institute and the Provost's office to show how research in the neurosciences and related areas at KU directly benefits the lives of Kansans.
Specific research projects presented included a demonstration of a non-invasive method of measuring brain activity when an individual hears a spoken sentence; a demonstration of the Actifier and NTrainer, developed at KU, which diagnoses and trains premature infants with no or poor sucking ability to suck normally; a test to determine how aging affects the ability to do two things at once; a presentation on accelerated weight loss as a marker of Alzheimer's disease and a presentation of a model statewide system in Kansas to deliver assistive technology throughout the state, including remote areas.
Steven Warren, director of the Life Span Institute and vice chancellor for Research and Graduate Studies, presented an overview of several research projects underway that address serious health issues in Kansas, including autism, obesity and Alzheimer's disease.
Scientists affiliated with Life Span who demonstrated their research included Steven M. Barlow, professor and director, Communication Neuroscience Laboratories; David K. Johnson, assistant professor of psychology and gerontology; Susan Kemper, Roberts Distinguished Professor of Psychology; Mabel Rice, Distinguished Professor and Director, Merrill Center for Advanced Studies and Sara Sack, senior scientist and director of Assistive Technology for Kansans.
Legislators who attended were Rep. Bob Bethell, Alden; Rep. Tom Burroughs, Kansas City; Rep. David Crum, Augusta; Sen. Marci Francisco, Lawrence; Rep. Tom Hawk, Manhattan; Rep. Jerry Henry, Cummings; Rep. Peggy Mast, Emporia; Rep. Jo Ann Pottorff, Wichita; Rep. Marc Rhoades, Newton; Sen. Vicki Schmidt, Topeka; Sen. Dwayne Umbarger, Thayer; Rep. Kay Wolf, Prairie Village, and Rep. Kevin Yoder, Olathe. Also attending was Nikki Feuerborn, chief of staff to the chairman of the House Appropriations Committee.
University officials included Chancellor Robert Hemenway and Provost and Executive Vice Chancellor Richard Lariviere.
The Life Span Institute is one of the largest research and development programs in the nation for the prevention and treatment of developmental disabilities. The Institute includes 12 centers and more than 120 programs and projects located on the Lawrence and Medical Center campuses and in Kansas City, Kansas and Parsons.
Skye Leedahl, who recently earned her M.A. in Gerontology, was the recipient of two awards at the annual meeting of the Gerontological Society of America in San Francisco. Skye’s paper, based on her Master’s thesis was titled, “Social Organizations and Aging: The Benefits of VFW Membership.” This work was recognized with the 2007 Paper Award by the Emerging Scholar and Professional Organization of GSA. It was also given the 2007 Master’s level paper award from the Social Research, Policy & Practice Section of GSA.
Chiung-Ju Liu, who completed her doctorate in gerontology from KU in 2006, has been honored with the 2007 Retirement Research Foundation Award for Doctoral Dissertation Research from Division 20 (Adult Development and Aging) of the American Psychological Association. She received a cash prize and was recognized at the APA annual meeting held in September in San Francisco. Liu is currently a postdoctoral fellow in the School of Medicine at Boston University.
Dr. Susan Kemper has been awarded a grant for a new project on aging & language production. Read more...
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The University of Kansas Gerontology Center Dole Human Development Center 1000 Sunnyside Ave. Room 3090 Lawrence, KS 66045-7555 gerontology@ku.edu 785/864-4130 |
Photos © The University of Kansas Office of University Relations. This file was modified 10/21/09 11:13:44 AM |
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