Long-term Home Care Communication With Dementia Elders in Taiwan: A Focus on Nonverbal Communication Strategies

Abstract

The population of older people living with dementia in Taiwan is growing dramatically. If seniors with dementia are to remain in their own homes, higher-quality long-term home care services are vital. One way to achieve this quality goal is to promote better communication between seniors and providers. Accordingly, this study addresses an aspect of communication behaviour that tends to be overlooked in studies on dementia-care communication: nonverbal communication accommodations. Specifically, it presents a typology of nonverbal communication strategies used in long-term home-care service in Taiwan, based on in-depth interviews with 30 long-term home-care workers with at least one year of dementia-care experience. Prominent among these strategies are constant smiling; using one’s fingers to draw patients’ attention to one’s eyes to maintain eye contact; gentle touching to express concern or care; and firm holding of hands, as a means of gauging acceptance or refusal of instructions. However, nonverbal signs of patients’ understanding also emerged as crucial to care workers’ decision-making. In particular, eye movement, turning the face to the side, looking downward, and maintaining steady eye contact all were reported to have different meanings, knowledge of which was essential to successful care communication. These findings not only extend our understanding of social-care practices, but also have the potential to enhance the wellbeing of dementia patients.