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Effect of care assistant communication style on communicative behaviours of residents with dementia: a systematic multiple case-study

Stanyon, Miriam; Griffiths, Amanda; Gordon, Adam; Thomas, Shirley


Miriam Stanyon

Amanda Griffiths

Professor of The Care of Older People


Objectives: To determine whether varying the communication style of care assistants, encouraging them to use direct instructions and allowing more time for residents’ responses, influenced the communicative behaviour of care home residents living with dementia.

Design: This study used a multiple systematic case-study design. Participants were videorecorded during morning care routines in three communication conditions: usual communication, direct instructions and pacing (allowing more time for resident responses).
Each dyad acted as its own control.

Setting: The study took place in a residential care home in the East Midlands, UK.

Participants: Three dyads (person with dementia/care worker)

Measures: The level of compliance with instructions was measured. Validated measures were used to rate positive communicative behaviour (engagement with care tasks, eye contact, initiation of interaction) and negative communicative behaviour (e.g. shouting, kicking).

Results: Care assistants were able to employ direct instructions after brief training. The use of direct instructions was positively correlated with positive communicative behaviour from residents (p [less than] 0.05). The pacing condition was not employed adequately to evaluate effectiveness. Negative communicative behaviour (resistiveness to care) was rare.

Conclusion: The use of direct instructions by care assistants holds promise for effective communication with people with dementia and warrants further investigation in larger samples and in varied contexts.


Stanyon, M., Griffiths, A., Gordon, A., & Thomas, S. (2019). Effect of care assistant communication style on communicative behaviours of residents with dementia: a systematic multiple case-study. Scandinavian Journal of Caring Sciences, 33(1), 207-214.

Journal Article Type Article
Acceptance Date Sep 11, 2018
Online Publication Date Oct 17, 2018
Publication Date 2019-03
Deposit Date Sep 27, 2018
Publicly Available Date Oct 18, 2019
Journal Scandinavian Journal of Caring Sciences
Print ISSN 0283-9318
Electronic ISSN 1471-6712
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 33
Issue 1
Pages 207-214
Keywords Dementia; Residential care; Communication
Public URL
Publisher URL


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