Formal Caregivers Assisting Residents with Moderate and Severe Alzheimerâs Disease: Investigating the use of Communication Strategies during Activities of Daily Living
Bibliographic record
Abstract
The prevalence of Alzheimer’s disease (AD) in Canada is on the rise, creating the need for evidence-based care practices designed to support individuals with AD and their care providers. Declines in memory, language, visual-spatial, executive abilities, and functional capacity associated with AD create the need for caregiver assistance during the completion of activities of daily living (ADLs). Unfortunately, assisting individuals with more advanced stages of AD is further complicated by communication breakdowns that occur in the dyad (i.e., caregiver and the individual with AD) established to meet a common goal: to complete ADLs. Clinically recommended communication strategies are the current solution used to support caregivers interacting with individuals with AD. However, there are limitations to these recommendations, including that the majority are based on caregiver experience, few are supported by empirical research, and little is known about which strategies are effective when assisting individuals with moderate to severe AD specifically during the context of completing ADLs. \n\nThis dissertation presents novel research studies that systematically examined formal caregivers’ use of communication strategies while successfully assisting residents with moderate and severe AD during the completion of a representative ADL. Two observational studies and one focus group interview study were conducted to address our hypotheses and research objectives. Key findings from the studies comprising this dissertation were: (1) caregivers used a variety of verbal and nonverbal task-focused communication strategies when successfully assisting residents with AD during the completion of a representative ADL; (2) the task-focused communication strategies caregivers most frequently used were supported by empirical literature and included the use of one direction or idea (i.e., proposition) at a time, closed-ended questions, and paraphrased repetition; (3) when assisting residents with severe AD, caregivers used the resident’s name, one proposition, and paraphrased repetition significantly more than when assisting residents with moderate AD; and (4) the communication strategies that caregivers perceived to use in their care practice indicate that person-centered dementia care is a central aspect to facilitating the completion of ADLs. This research is an important step towards the development of evidence-based communication strategies for caregivers assisting individuals with AD during ADLs. \n
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".