Nurse-patient communication in dementia: improving the odds

This study investigates the use of a range of conversational strategies in a nurse-led socialization group with long-term care residents who have dementia. Eight residents whose Mini-Mental State Examination (MMSE) scores ranged from 0 to 19 participated in weekly group sessions for 10 weeks. All sessions were tape recorded and transcribed verbatim. Analysis of transcribed sessions resulted in two taxonomies: a taxonomy of nurse conversational strategies (clarifying, exploring, moderating, validating, rescuing, and general discourse markers) and a taxonomy of patient responses (discourse markers, limited engagement, expanded responses, personalized response, self-initiated participation, and disconnected or fragmented participation). The effectiveness of the nurse conversational strategies was reflected in the encouraging level of resident participation rates. The findings of this study suggest that with effective support and prompting, patients with advanced dementia are able to engage in social conversations beyond what would be expected given their diagnosis and MMSE scores.