Missed opportunities for person-centered communication: implications for staff-resident interactions in long-term care

BACKGROUND: Social interactions in long-term care settings between staff and residents with dementia have been characterized as task-oriented, patronizing, and/or overly directive. Long-term care settings can be contexts that emphasize dependency and threaten the personal identity of older residents. Yet, leaders in the long-term care sector have acknowledged recently that dementia care must move beyond the completion of caregiving tasks and adopt a person-centered approach. This approach involves caregivers incorporating a resident's life history and preferences during interactions. The objectives of this study were to examine the extent to which staff-resident communication is person-centered and the extent to which staff miss opportunities to communicate with residents in a person-centered manner. METHODS: Conversations (N = 46) of 13 staff-resident dyads were audio-recorded during routine care tasks over 12 weeks. Staff utterances within these conversations were coded for person-centered communication and missed opportunities where person-centered communication could have been used. RESULTS: Findings revealed a common communication sequence where utterances coded as person-centered were followed by utterances coded as missed opportunities. This sequence suggests that the positive impact of person-centered communication may be undermined when such communication is followed by missed opportunities. Data also revealed that missed opportunities highlight the need for staff training. CONCLUSION: The findings underscore the importance of sustaining person-centered communication while completing routine care tasks.