fairchild (2011) elderspeak
DESCRIPTION
An aging presentation at the 37th Annual Association for Behavior Analysis International Conference in Denver, CO.TRANSCRIPT
Elderspeak: An Investigation of OlderViews
Kathleen Fairchild, Jonathan C. Baker, & Jeffrey Buchanan
Elderspeak
TopographySlower Rate & frequent RepetitionExaggerated IntonationElevated Pitch & VolumeVocabulary RestrictionsDiminutives & Inappropriate ReferencesTag QuestionsCollective Pronoun Substitutions
Why study Elderspeak?
Used frequently in caregiving settingsPrevious research with a variety of different populations (e.g., caregivers, community-‐dwelling older adults, nursing home residents) has found mixed results regarding Elderspeak.
Implications of Elderspeak
Potential trigger for resistiveness to careMay be aversive and lead to escape maintained behaviorMay hinder communication between older
adults and caregiversMay cause older recipients to view themselves
as less competent May cause speaker to be viewed as less
competent
Current Study
PurposeAdd to existing literature regarding the perceptions of community dwelling older adults toward ES
If community dwelling older adults find elderspeakaversive it is likely that nursing home dwelling older adults will as well.
Current Study46 participants over the age of 55 living in Mankato and St. James
RecruitmentGender
35 female11 male
Age55-‐95; mean age was 71
Ethnicity97.8% Caucasian2.2% Puerto Rican
Participants were randomly assigned.Scenarios (ES vs. No ES)
23 in each groupES: 19 females, 4 malesNo ES: 16 females, 7 males
Example of Non ES scenario (control)
Nursing Assistant: Mrs. Jones, it is time to get ready for bed! Resident: Oh is it that time alreadyNursing Assistant: Yes it is. Can I help you help you change out of your clothes and put your nightclothes on? Resident: I have to use the restroom first. Nursing Assistant: All right, I will lay out your clothes while you use the restroom.
Example of Elderspeak Scenario
Nursing Assistant: Time for us to get ready for bed! Resident: Oh is it that time already? Nursing Assistant: It sure is honey. Now let me help you get your clothes off and get you into
jamiesResident: I have to use the restroom first.Nursing Assistant: All right, Sweety, I will lay out your clothes while you use the potty.
Measures
The Positive and Negative Affect Schedule (PANAS) (Watson, Clark, & Tellegen, 1988)
Measures how the participant feels at a given moment
5 point Likert scale 20 items Subscales
Positive Affect Negative Affect
Measures
Emotional Tone Rating Scale (Hummert, Shaner, Garstka & Henry, 1998)
nursing assistant5 point scale
12 itemsSubscales
CaringRespect Control
Qualitative Data
Qualitative DataEveryone
GenderAgeEthnicityFamily member in a long term care facility
Qualitative DataThe participants that listened to the ES scenario were asked additional questions to further assess their opinions of ESAttempted to assess:
Is this type of communication appropriateIf they had previously experienced this type of communicationUnder what circumstances might this type of communication be appropriate or inappropriateIf this type of communication affected their perception of the resident or nursing assistant.
Hypothesis
PANASES scenarios will have higher NA scores and lower PA scoresNon ES scenarios will have neutral PA and NA scores.
Emotional Tone Rating ScaleES will be viewed as less respectful, more controlling, and less warm Non ES will be viewed as neutral in respect, control, and warmth subscales.
Results
A series of one-‐way between subjects ANOVAs were conducted to test hypotheses.Bonferroni Correction indicated that the minimum alpha level should be p=.0451
Emotional Tone Rating Scale
* statistically significant at p < .01
0
10
20
30
40
50
60
70
80
90
100
Respect * Caring Control
Mean
Score
Series1
Series2
ES
No ES
Qualitative Data
All Participants37% participants have had a family member placed in a nursing home56% of participants were retired
Elderspeak Scenario Participants 83% of participants found Elderspeak inappropriate56% of participants in the ES condition had personally experienced being addressed with Elderspeak.
Under What Circumstances might ES be appropriate?
Working with individuals with dementia or low cognitive/physical abilitiesCertain Cultures
Individuals from the South
Never75% of males84% of females
Understandable but inappropriate
Does this type of communication affect your
competenceYes / Negatively
100% of males ; 73% of females
No 11% of females
Somewhat negatively 16% of females
Does this type of communication affect your perception of the nursing home
residentYes
75% of males26% of females
No answer21% of females
Summary
Elderspeak was found to be less respectful.Was not found to be less caring or more controlling. Participants that heard ES found it inappropriate
Found similar results to Ryan, et al (1991)CNA was viewed negatively when using ESAffected perception of resident
Adds to literatureSuggests that ES is viewed as less respectfulMay result in negative reactions or consequences
LimitationsShould have asked both groups if they found the nurses communication appropriate to compare the two groups.Small sample size
More men would have been helpful to evaluate gender differencesCultural Differences
PANASMay have been helpful to have participants fill out survey before and after the recording to see if the recording affected their initial mood.
ScenarioCaregiving scenario may have affected how controlling the aid sounded regardless of ES.
Recommendations for Future Research
behaviorDetermine what the function is for staff that engage in this kind of verbal behaviorEvaluate gender and cultural differences regarding ESUse different scenarios and compare perceptions.
CaregivingEveryday conversation
Qualitative interview about ESWhenWhere
Thank you!
Contact information:Kathleen Fairchild
Thank you Dr. Buchanan, the members of my committee, and the behavioral research team for their invaluable
participation.