Formal caregivers' perceptions of everyday interaction with Deaf people with dementia.

OBJECTIVES: Deteriorating interactive ability of people with dementia challenges formal caregivers. In Finland, Deaf people with advanced dementia may live in a nursing home designed for their care where the staff use Finnish Sign Language (FiSL). This study describes the perceptions of formal caregivers, focusing on the challenges, how they solve the challenges, and what support they need to improve interaction with Deaf residents. METHODS: Semi-structured interviews with 13 formal caregivers who work with Deaf people with dementia were conducted and analyzed using qualitative content analysis. A purposive sampling was used. RESULTS: Three key themes were challenges in interaction, strategies in supporting interaction, and support for coping. Caregivers perceived challenges in interaction caused by linguistic changes, deteriorating physical mobility and memory, and Deaf residents' behavioral challenges. Caregivers supported Deaf residents by learning to know them and using personal and linguistic strategies. Support for coping comprised supporting family members and other caregivers. CONCLUSIONS: Efficient skills in sign language (SL) and knowledge of dementia are essential in interacting with Deaf residents and to build interpersonal relationships for care. CLINICAL IMPLICATIONS: Supporting Deaf residents requires learning the way they interact which can be achieved over time.

Changes in communication of Deaf people with dementia: A thematic interview with a close family member.

BACKGROUND AND AIM: Learning about changes in communication of Deaf with dementia (DWD) is important in order to improve services and support DWD and their families. We explored family members' views on the changes in communication DWD have and the ways communication was adapted due to progression of dementia. METHODS: A qualitative content analysis of thematic interviews that were conducted with eight close family members of DWD. RESULTS: With decreasing vocabulary and increasing sign-finding difficulties, conversations became poorer, and DWD tended to diverge from the topic. Nonverbal communication became more important as the verbal communication abilities of DWD deteriorated, and the adult children took a more active role by taking initiative and guiding conversations. CONCLUSION: DWD seem to go through similar changes in communication as hearing people with dementia. Adult children of DWD need to get used to interpreting and assisting their parent's communication through different phases of dementia.

Lexical retrieval in discourse: an early indicator of Alzheimer's dementia.

We examined the progression of lexical-retrieval deficits in individuals with neuropathologically determined Alzheimer's disease (AD; n = 23) and a comparison group without criteria for AD (n = 24) to determine whether linguistic changes were a significant marker of the disease. Our participants underwent multiple administrations of a neuropsychological battery, with initial administration occurring on average 16 years prior to death. The battery included the Boston Naming Test (BNT), a letter fluency task (FAS) and written description of the Cookie Theft Picture (CTP). Repeated measures analysis revealed that the AD-group showed progressively greater decline in FAS and CTP lexical performance than the comparison group. Cross-sectional time-specific group comparisons indicated that the CTP differentiated performance between the two groups at 7-9 years prior to death and FAS and BNT only at 2-4 years. These results suggest that lexical-retrieval deficits in written discourse serve as an early indicator of AD.

Semantic verbal fluency in two contrasting languages.

This cross-linguistic study investigated Semantic Verbal Fluency (SVF) performance in 30 American English-speaking and 30 Finnish-speaking healthy elderly adults with different cultural and linguistic backgrounds. Despite the different backgrounds of the participant groups, remarkable similarities were found between the groups in the overall SVF performance in two semantic categories (animals and clothes), in the proportions of words produced within the first half (30 seconds) of the SVF tasks, and in the variety of words produced for the categories. These similarities emerged despite the difference in the mean length of words produced in the two languages (with Finnish words being significantly longer than English words). The few differences found between the groups concerned the types and frequencies of the 10 most common words generated for the categories. It was concluded that culture and language differences do not contribute significantly to variability in SVF performance in healthy elderly people.