About the Project
Background
Dementia is characterised by a range of cognitive difficulties such as memory loss and difficulties with thinking, problem-solving or language, which in turn affect interpersonal communication (Anon, 2016; Jost, Neumann, Himmelmann, 2010). These communication difficulties can contribute to or challenge the existing relation between the person with dementia and their informal carer, i.e. the spouse or another family member. Furthermore, a changing relation can in turn disturb and significantly alter the pre-existing communication styles between the person with dementia and their informal carers (McGilton, 2004). Accurate and informed interpretation of and response to the verbal and non-verbal communication signals by the cares can reduce problematic behaviours exhibited by the person with dementia and enhance the quality of care provision (Acton, Mayhew, Hopkins, and Yauk, 1999). To equip cares to best do this, we need to understand how the exchange of messages between the person with dementia and the carer shapes the interaction. This is because a supportive relational dynamics between the person with dementia and the carer can mediate and enhance the quality of care provision (Bowers, Esmond and Jacobson, 2000). Additionally, the carers may benefit from a knowledge of their communicative strengths and how these can be best utilised to bring in changes in their communicative strategies. A detailed analysis of the communicative exchanges between the person with dementia and their informal carer will allow development of new knowledge about the elements that support and sustain effective interpersonal communication and relational dynamics (Harahan, 2001; Williams, and Coupland, 1998). The first step in this direction is the development of a valid and sensitive observational measure to capture the intricacies of reciprocal interaction. Such a measure will aid in taking a systemic approach to develop and assess strategic and tailored relational interventions to enhance capacity and nurture independence and autonomy for people with dementia and their informal carers.
Aim
Broad aim of this project is to understand the elements of interpersonal communication that support care provision between people with dementia and their informal carers. The main specific objective includes development and validation of an observation based measure.
This study will use a mixed methods approach (quantitative and qualitative methods) and will include the people with dementia and their informal carers in all stages of the study development and execution.
The three-year plan of investigation will involve:
1. Research proposal development
2. A systematic review of the research literature on the interactional communication styles/approaches and measures currently used in dementia care and its impact on care provision by the informal carers
3. Quantitative research using video recordings and in-depth analysis of interaction between the person with dementia and their informal carer
4. Qualitative research with people with dementia and their informal carers to seek their point of view about the enablers and barriers to effective interpersonal communication and how this affects care
5. Using data from #3 and #4 to develop and pilot an observation based measure to assess the reciprocal interaction between the person with dementia and their informal carer
Training
To include evidence synthesis, observational coding, quantitative and qualitative research methods, writing for publication, Thesis preparation, dissemination, and personal and career development.
Impact
Evidence and experience to develop further research into communication and dementia care and methodological development.
Specific output
Thesis, publications and conference presentations.
Criteria
This project is suitable for a student with a good first degree (at least 2:1) and preferably also a Masters in a related topic area (e.g., psychology, communication, neuropsychology, health sciences, or research methods) or equivalent research experience. The prospective student will have an interest in communication, dementia care and will be a motivated and independent learner.
To find out more about undertaking a PhD in the School of Health Sciences at UEA, visit https://www.uea.ac.uk/medicine-health-sciences/graduate-school .
References
Acton, G., Mayhew, P., Hopkins, B., Yauk, S. (1999). Communicating with individuals with dementia-The impaired person's perspective. Journal of Gerontological Nursing, 25 (2): 6-9.
Anon, (2016). [online] Available at: http://Alzheimer’s Society [Accessed 25 May 2016].
Bowers, B.J., Esmond, S., Jacobson, N. (2000). The relationship between staffing and quality in long-term care facilities: exploring the views of nurse aides. Journal of Nursing Care Quality, 14(4):55-64.
Harahan, M.F. (2001). New paradigms for guiding research, interventions and policies for family caregivers. Aging & Mental Health, 5 (1): S52-S55.
Jost, A., Neumann, E., Himmelmann, K.H. (2010). Synchronized communication between people with dementia and their volunteer caregivers. A video-based explorative study on temporal aspects of interaction and the transfer to education. Current Alzheimer Research, 7(5): 439-44.
McGilton, K. (2004). Relating well to persons with dementia: A variable influencing staffing and quality of care outcomes. Alzheimer's Care Quarterly, 5 (1):71-80.
Williams, A., and Coupland, N. (1998) Epilogue: The socio- political framing of aging and communication research. Journal of Applied Communication Research, 26 (1):139-154