Experience of Dementia Patients in Communicating with Nurses: A Literature Review

This literature review explores the experience of dementia patients in communicating with nurses and the level of communication skills needed by nurses to provide social and intellectual stimulation to people living with dementia. The review compares different methodologies used in the studies and analyzes the research findings. The importance of considering dignity and autonomy during interaction with patients is also highlighted. The subject is related to nursing and healthcare, and the course code and college/university are not mentioned.

Running head: LITERATURE REVIEW
Literature review
Name of the student:
Name of the University:
Author’s note

1LITERATURE REVIEW
Introduction:
Older people living with dementia experience several challenges in their life and not
getting appropriate care or support in nursing homes often lead them to social isolation and
withdrawal (Joling et al. 2017, pp. 509-517). Nurses are the main staffs who provide care to
dementia patients. However, gap in communication between health care workers and the people
living with dementia is one issue that makes living in nursing homes as a burdensome task for
such patients. Dooley, Bailey and McCabe (2015, pp.1277-1300) reports that dementia patients
spend very little time in direct interaction with other and this increases the likelihood of not
meeting psychosocial needs of client. To understand their experience in detail, the main purpose
of the report conducts a review of literature to understand the experience of dementia patient in
communicating with nurses and to understand the level of communication skills needed by
nurses to provide social and intellectual stimulation to people living with dementia.
Literature review:
Comparison of methodologies:
The study by Söderlund et al. (2016, pp.37-47) gave an insight into the experience of
dementia patients living in nursing homes by comparing the action and reactions of dementia
people after one-to-one communication with nurses. The researcher used naturalistic design with
the use of videotapes to capture reactions of people living with dementia and a descriptive
approach was used to explain the participant’s experience of communication with nurses. The
advantage of using video taped conversation to evaluate experience was that it could give brief
idea about first impressions formed and also evaluate patient’s satisfaction with communication
process by observing non-verbal cues like eye contact, gestures, orientation and body posture.

2LITERATURE REVIEW
However, one disadvantage of using this approach is that raises concerns related to the
confidentiality of research participants and the overall cost for this type of research is high (Asan
and Montague 2014, p.161).
In contrast, Walker and Paliadelis (2016, pp. E6-E10) used phenomenological approach
to explore lived experiences of older persons in the setting. Phenomenological approach is used
in qualitative studies to explore the experience related to a phenomenon from a participant’s
perspective. (Smith 2015). Using this approach to explore lived experience can help to improve
services to a large extent. Another research literature use qualitative content analysis approach to
explore experience of nursing staff related to caring for people with dementia (Söderman and
Rosendahl 2016, pp.311-326). Use of qualitative approach favoured getting in-depth data
regarding personal experiences of nursing staff.
Analysis of research findings:
Few actions and more reactions by patients during interaction with nurse
Söderlund et al. (2016, pp.37-47) used video tapes conversation to collect response from
participants and the review of findings indicates several factors that limit effective
communication process. Nurses failed to get appropriate response from participants because
participants were uninterested to answer questions and they talked about more than one topic at a
time. However, one positive and unique findings was that nurses were attentive and participants
gave appropriate response when they were trying to talk about what was in their mind. They
seemed to be more comfortable with this type of conversation. The study also revealed the
important of gestures like eye contact and touching to enable patients to speak freely. This

3LITERATURE REVIEW
finding can be used to improve communication skills of nurses and respond to unique needs of
dementia patient (Brooker and Latham 2015).
Role of non-verbal language and the language abilities
Similar to the study by Söderlund et al. (2016, pp.37-47), Söderman and Rosendahl
(2016, pp.311-326) also highlighted about the role of non-verbal language and the language
abilities in limiting conversation between older people and nursing staffs. The study revealed that
participants were sensitive to the non-verbal signals of nursing staff. Hence, findings from two
research articles suggest that communicating using appropriate body language can work for
dementia patient living in residential care facilities. Ellis and Astell (2017, p.e0180395) explain
that loss of verbal language often makes dementia patients struggle in their life and they are
excluded from the social world. However, use of alternative methods of communication in the
care environment has the potential to improve the quality of life of dementia patient.
Importance of considering dignity and autonomy during interaction with patient:
In contrast to the two studies, Walker and Paliadelis (2016, pp. E6-E10) mainly gave
outcome related to independence, dignity and autonomy of patients. Many participants gave the
opinion that they lost control over their life choices and losing independence was a major shock
for these patients. In relation to communicating with staffs, it was found that continuity of staffs
was an issue many participants preferred to be cared by permanent residents. Due to lack of
partnership approach, reduced sense of identity, feelings of apprehension and loss of control was
common in patients. The study also indicated that the Australian aged care system is dominated
by regulations that reduce sense of identity and impairs patient experience. Bentwich, Dickman
and Oberman (2018) argues that improving public and professional attitude to dementia is

4LITERATURE REVIEW
important to promote autonomy and human dignity of patients with dementia. Hence, this result
gave the implications to promote policy changes in the delivery of health care services for older
people and enhance their satisfaction with care.
Conclusion:
The review of all three literatures related to experience of elderly patients in residential
care facility gave useful ideas regarding the factors that lead to challenges and dissatisfaction
with care. However, several limitations in research methodology were also found which
demanded need for future research. For example, the study by Walker and Paliadelis (2016, pp.
E6-E10) did not included patients with dementia as participants or those coming from diverse
cultural background. Recruiting participants from diverse cultural background would have given
more idea about the influence of social factors on patient’s experience in residential care facility.
In addition, Söderman and Rosendahl (2016, pp.311-326) recruited a sample group who were
relatively more healthy. Taking diverse group would have enabled getting reliable data that could
be applied in local settings too.

5LITERATURE REVIEW
Reference:
Asan, O. and Montague, E., 2014. Using video-based observation research methods in primary
care health encounters to evaluate complex interactions. Informatics in primary care, 21(4),
p.161.
Bentwich, M. E., Dickman, N., and Oberman, A. 2018. Autonomy and dignity of patients with
dementia: Perceptions of multicultural caretakers. Nursing ethics, 25(1), 37-53.
Brooker, D. and Latham, I., 2015. Person-centred dementia care: Making services better with
the VIPS framework. Jessica Kingsley Publishers.
Dooley, J., Bailey, C. and McCabe, R., 2015. Communication in healthcare interactions in
dementia: a systematic review of observational studies. International psychogeriatrics, 27(8),
pp.1277-1300.
Ellis, M. and Astell, A., 2017. Communicating with people living with dementia who are
nonverbal: The creation of Adaptive Interaction. PloS one, 12(8), p.e0180395.
Joling, K.J., Windle, G., Dröes, R.M., Huisman, M., Hertogh, C.M.M. and Woods, R.T., 2017.
What are the essential features of resilience for informal caregivers of people living with
dementia? A Delphi consensus examination. Aging & mental health, 21(5), pp.509-517.
Smith, J.A. ed., 2015. Qualitative psychology: A practical guide to research methods. Sage.
Söderlund, M., Cronqvist, A., Norberg, A., Ternestedt, B.M. and Hansebo, G., 2016.
Conversations between persons with dementia disease living in nursing homes and nurses–

6LITERATURE REVIEW
qualitative evaluation of an intervention with the validation method. Scandinavian journal of
caring sciences, 30(1), pp.37-47.
Söderman, M. and Rosendahl, S.P., 2016. Caring for Ethnic Older People Living with
Dementia–Experiences of Nursing Staff. Journal of cross-cultural gerontology, 31(3), pp.311-
326.
Walker, H. and Paliadelis, P., 2016. Older peoples’ experiences of living in a residential aged
care facility in Australia. Australasian journal on ageing, 35(3), E6-E10