Changing Talk to Reduce Resistiveness to Care

Staff:Inclusion criteria for CNAs are:

• age 18 years old or greater (age of legal consent in Kansas and Missouri), signed informed consent,
• permanent employment in the NH,
• primary assignment to a specified unit,
• and English speaking
• Staff must have been assigned to care for the resident at least twice weekly in the past month (documented in NH staffing records). This will assure that staff-resident dyads have established relationships and will control effects of variability in contact between dyads during days when data are not being collected.

Resident inclusion criteria are:

• a diagnosis of Alzheimer's disease or related dementia documented in their medical records,
• documentation of daily RTC over the past week,
• and ability to hear staff communication (from the most recent MDS).

Exclusion criteria

for CNAs include:

• non-English speaking,
• temporary employment, -and age under 18 years.
• If more than one CNA volunteers as a partner for a participating resident, a random selection will be made to determine which CNA will participate. Small variations in contact between staff and residents in dyads are anticipated due to PMMA policies for consistent CNA assignment to neighborhoods. Therefore dyads will have repeated contacts.

Exclusion criteria

for residents include:

• diagnosis with Huntington's disease,
• alcohol-related dementias,
• schizophrenia,
• manic-depressive disorder,
• deafness,
• and mental retardation.