By Geralyn Magan
LTSS Center researchers are helping the University of Kansas School of Nursing pilot test an online training program to enhance communication in nursing homes.
Can an in-person training program to reduce elderspeak among nursing home staff be adapted successfully to an online format?
The LeadingAge LTSS Center @UMass Boston will be helping researchers at the University of Kansas (KU) School of Nursing answer that question over the next few months.
LTSS Center researchers will be consultants on the new project, which is designed to pilot test an online version of Changing Talk (CHAT), an in-person training program designed to help nursing home team members avoid elderspeak, the baby talk commonly used by younger nursing home staff in conversation with older nursing residents.
Preliminary findings show that the online version of the training—called CHATO—is as effective as the original CHAT in-person training. However, researchers want to validate those findings with a larger sample size. The new study will test the effectiveness of the CHATO online modules, and the program’s accompanying implementation guide, in 120 nursing homes. The research is funded by the National Institute of Nursing Research and the National Institute on Aging.
COMBATTING ELDERSPEAK
The design of both CHAT and CHATO are based on evidence regarding the powerful stereotypes that paint older adults as being incompetent. Those stereotypes prompt younger individuals, including nursing home team members, to alter their communication with older adults without considering the communication and cognitive abilities of the individual. The resulting elderspeak, or babytalk, is perceived as demeaning, and contributes to isolation, depression, assumption of dependency, and behavioral symptoms.
The CHAT and CHATO sessions use actual nursing home video recordings to reinforce the negative effects of elderspeak. The sessions encourage participants to consider the older adult’s perspective during communication, and guide team members in evaluating their own communication.
The in-person CHAT training has been shown to successfully improve nursing home staff communication by reducing elderspeak. That improved communication has been demonstrated to improve resident outcomes, including reducing behavioral symptoms of dementia and resistance to care, according to a 2017 article in The Journal of Continuing Education in Nursing. The program also has been found to reduce antipsychotic medication usage.
CHATO ONLINE MODULES
Eager to present the CHAT training to larger numbers of team members at more nursing homes, researchers at the University of Kansas decided to transfer CHAT’s content to the interactive CHATO online format. Nursing home team members can complete the CHATO training in 3 weekly, 1-hour sessions covering:
- The importance, benefits, and components of effective communication in care of older adults.
- Communication barriers and challenges, and effective and ineffective communication strategies. Elderspeak communication and its negative effects are discussed during this session, and alternatives are identified.
- Effective communication strategies and person-centered communication. The learning and practice activities in this session are designed to provide participants with opportunities to apply the knowledge and skills presented in the course. A virtual discussion forum is available to help participants reflect on and share their experiences with others.
ROLE OF THE LTSS CENTER
As consultants to the CHATO project, LTSS Center researchers will help University of Kansas researchers:
- Create an implementation guide and training manual for the 120 nursing homes participating in the CHATO pilot test;
- Develop a plan to evaluate outcomes from the CHATO pilot test;
- Pilot test the implementation guide and training manual with nursing home leadership teams; and
- Design a larger research study to evaluate the impact of CHATO.