Perceptions of older and younger adults who wear hearing aids.

OBJECTIVE: To investigate older and younger adults' perceptions of older and younger adults who wear hearing aids. DESIGN: Participants completed two Implicit Association Tests: One with images of older adults (OA-IAT) and one with images of younger adults (YA-IAT), either wearing or not wearing hearing aids. Participants also rated age, attractiveness, and intelligence of younger and older adults pictured with or without a hearing aid. STUDY SAMPLE: Thirty older adults (M age = 70 years, SD = 4.38) and 30 younger adults (M age = 23 years, SD = 3.01) who reported not having hearing aids or a diagnosed hearing impairment. RESULTS: For both IATs, older and younger participants responded faster and more accurately when images of individuals wearing hearing aids were paired with negative words in comparison to positive words. Photo ratings did not vary in relation to the presence or absence of hearing aids for either age group. CONCLUSION: Although the photo rating tasks indicate neutral explicit attitudes towards individuals who wear hearing aids, our interpretation of the IAT results indicates that younger and older adults may hold negative implicit attitudes towards both older and younger hearing aid users.

?It's all communication': Family members' perspectives on the communication needs for themselves and their relatives with primary progressive aphasia.

BACKGROUND: Communication disabilities, such as primary progressive aphasia (PPA), impact family members as well as the individuals with the condition. To provide adequate communication care to people with PPA (PwPPA) and their family members, it is crucial to understand the communication needs from the family members' perspectives. To date, research on the communication needs of people with primary progressive aphasia and their family members from the perspectives of family members has been limited. AIMS: The specific research objectives were to explore (a) the communication needs pertaining to PwPPA in the early, middle and late stages; and (b) the communication needs pertaining to family members of PwPPA in the early, middle and late stages, from the perspectives of family members. METHODS & PROCEDURES: This study employed a qualitative description approach, underpinned by the pragmatic paradigm. Data collection involved semi-structured qualitative interviews with eight family members (relatives of four individuals with the logopenic variant of PPA, of two individuals with the nonfluent variant of PPA, of one individual with the semantic variant of PPA and of one individual with mixed PPA). Qualitative content analysis was used to identify codes and categories in relation to the research objectives. OUTCOMES & RESULTS: Qualitative content analysis revealed eight categories of communication needs pertaining to the PwPPA: person-specific needs; diagnosis and disclosure; general communication difficulties; impact on communication in everyday life; impact on cognition; impact on psychosocial well-being; impact on person's dignity and autonomy; and future planning. Six categories were identified pertaining to the family members: information about and awareness of PPA; impact of communication difficulties on family/others; increased responsibilities for the family in everyday life; impact on psychosocial well-being; and future planning. CONCLUSIONS & IMPLICATIONS: This investigation has expanded our knowledge in the area by providing insights about communication needs which speech-language pathologists and other health professionals should be aware of and take into account when providing communication care to PwPPA and their families. WHAT THIS PAPER ADDS: What is already known on the subject Person- and family-centred communication care is optimally guided by the person's and family's needs and values. Research on communication care for people with primary progressive aphasia has underscored the inclusion of family members. Previous research has investigated the impact and experiences of living with primary progressive aphasia from the family member perspective. What this paper adds to existing knowledge To date, research focusing on identifying the communication needs of people with primary progressive aphasia and their family members from the perspective of family members is limited. This study adds the family members' perspectives on the communication needs pertaining to themselves and their relatives with primary progressive aphasia in the early, middle and late stages of primary progressive aphasia. What are the potential or clinical implications of this work? Several clinical implications have been raised. Family members experience communication needs for themselves and should be included as recipients of communication care. Clinicians supporting people with primary progressive aphasia should be cognizant of the impact of communication fatigue on everyday life and therapy tasks. Communication care for this population should include communication partner training, support for psychosocial well-being and support with communication around future planning.

VPR-254: an inhibitor of ROR-gamma T with potential utility for the treatment of inflammatory bowel disease.

INTRODUCTION: Retinoic Acid Related Orphan Nuclear Receptor gamma T (RORγT) is a lineage specifying transcription factor for IL-17 expressing cells, which may contribute to the pathogenesis of Inflammatory Bowel Disease (IBD). VPR-254 is a selective in vitro inhibitor of RORγT. AIMS: The main goals of our study were twofold: (1) To determine if ex vivo treatment with VPR-254 reduced relevant cytokine (IL-17 and IL-21) secretion from colonic strips of mice with colitis; (2) To determine if treatment of mice with VPR-254 attenuated parameters of colitis, using three murine IBD models. METHODS: VPR-254 was evaluated ex vivo in a colonic strip assay, using tissue from mice with Dextran sulfate sodium (DSS)-induced colitis. In vivo, VPR-254 was evaluated for efficacy in DSS, Trintirobenzenesulfonic acid (TNBS) and Anti-CD40 antibody-induced murine models of colitis. RESULTS: VPR-254 reduced the production of key pro-inflammatory cytokines (e.g., IL-17) in ex vivo and in vivo models of colitis. This small molecule inhibitor of RORγT also improved various morphometric and histological parameters associated with three diverse murine models of IBD. CONCLUSION: Our results support the concept that an inhibitor of ROR-gamma T may have potential utility for the treatment of IBD.

Polyfluorinated substances in abiotic standard reference materials.

The National Institute of Standards and Technology (NIST) has a wide range of Standard Reference Materials (SRMs) which have values assigned for legacy organic pollutants and toxic elements. Existing SRMs serve as homogenous materials that can be used for method development, method validation, and measurement for contaminants that are now of concern. NIST and multiple groups have been measuring the mass fraction of a group of emerging contaminants, polyfluorinated substances (PFASs), in a variety of SRMs. Here we report levels determined in an interlaboratory comparison of up to 23 PFASs determined in five SRMs: sediment (SRMs 1941b and 1944), house dust (SRM 2585), soil (SRM 2586), and sludge (SRM 2781). Measurements presented show an array of PFASs, with perfluorooctane sulfonate being the most frequently detected. SRMs 1941b, 1944, and 2586 had relatively low concentrations of most PFASs measured while 23 PFASs were at detectable levels in SRM 2585 and most of the PFASs measured were at detectable levels in SRM 2781. The measurements made in this study were used to add values to the Certificates of Analysis for SRMs 2585 and 2781.

Verbal and nonverbal indicators of quality of communication between care staff and residents in ethnoculturally and linguistically diverse long-term care settings.

Linguistic and ethnocultural diversity in long-term residential care is a growing trend in many urban settings. When long-term care staff and residents do not share the same language or ethnocultural background, the quality of their communication and care are jeopardized. There is very little research addressing how staff and residents communicate when they experience a mismatch in their language and ethnocultural backgrounds. Thus, the goals of the present study were to 1) document the verbal and nonverbal behaviours used by staff and residents in diverse interactions, and 2) identify and account for behaviours that either promoted or detracted from positive communication by drawing on principles from 'Communication Accommodation Theory'. Two long-term care facilities in British Columbia Canada were selected due to the diverse linguistic and ethnocultural backgrounds of their staff and residents. Twenty-seven staff and 27 residents consented to being video-recorded during routine activities (e.g., mealtimes, recreational activities). The recorded observations were transcribed, translated, and coded using qualitative descriptive and interpretive analyses. A number of verbal and nonverbal behaviours were identified and interpreted in relation to whether they promoted or detracted from positive communication. The findings point to considering a variety of proactive strategies that staff and administrators could employ to effectively accommodate to language and ethnocultural diversity in long-term care practice.

Perfluoroalkyl contaminants in Lake Ontario Lake Trout: detailed examination of current status and long-term trends.

Perfluoroalkyl contaminants (PFCs) were determined in Lake Ontario Lake Trout sampled annually between 1997 and 2008 in order to assess how current trends are responding to recent regulatory bans and voluntary phase-outs. We also combined our measurements with those of a previous study to provide an updated assessment of long-term trends. Concentrations of PFCs generally increased from the late 1970s until the mid-1980s to mid-1990s, after which concentrations either remained unchanged (perfluorooctane sulfonate (PFOS) and perfluorocarboxylates) or declined (perfluorodecanesulfonate (PFDS)). The temporal trends were assessed using three models, quadratic, exponential rise to maximum, and two-segment linear piecewise function, and then evaluated for best fit using Akaike Information Criteria. For PFOS and perfluorocarboxylates, the exponential rise to maximum function had the best fit. This is particularly interesting for PFOS as it suggests that although concentrations in Lake Ontario Lake Trout may have stopped increasing in response to voluntary phase-outs in 2000-2002, declines have yet to be observed. This may be due to continuing input of PFOS from products still in use and/or slow degradation of larger precursor molecules. A power analysis of PFOS suggested that 15 years of data with a within-year sample size of 10 is required to obtain sufficient power (80%) to detect a 5% decreasing trend. However, the length of the monitoring program had a greater influence on the ability to detect a trend compared to within-year sample size. This provides evidence that additional sampling years are required to detect a response to bans and phase-outs, given the variability in the fish data. The lack of observed declines of perfluorocarboxylate residues in fish may be expected as regulations for these compounds were only recently enacted. In contrast to the other compounds, the quadratic model had the best fit for PFDS. The results of this study emphasize the importance of long-term monitoring for assessing the effectiveness of bans and phase-outs on PFCs in the environment.

Determination of perfluorinated alkyl acid concentrations in biological standard reference materials.

Standard reference materials (SRMs) are homogeneous, well-characterized materials used to validate measurements and improve the quality of analytical data. The National Institute of Standards and Technology (NIST) has a wide range of SRMs that have mass fraction values assigned for legacy pollutants. These SRMs can also serve as test materials for method development, method validation, and measurement for contaminants of emerging concern. Because inter-laboratory comparison studies have revealed substantial variability of measurements of perfluoroalkyl acids (PFAAs), future analytical measurements will benefit from determination of consensus values for PFAAs in SRMs to provide a means to demonstrate method-specific performance. To that end, NIST, in collaboration with other groups, has been measuring concentrations of PFAAs in a variety of SRMs. Here we report levels of PFAAs and perfluorooctane sulfonamide (PFOSA) determined in four biological SRMs: fish tissue (SRM 1946 Lake Superior Fish Tissue, SRM 1947 Lake Michigan Fish Tissue), bovine liver (SRM 1577c), and mussel tissue (SRM 2974a). We also report concentrations for three in-house quality-control materials: beluga whale liver, pygmy sperm whale liver, and white-sided dolphin liver. Measurements in SRMs show an array of PFAAs, with perfluorooctane sulfonate (PFOS) being the most frequently detected. Reference and information values are reported for PFAAs measured in these biological SRMs.

A new frontier in spaced retrieval memory training for persons with Alzheimer's disease.

The objective of this pilot study was to investigate how a memory training technique called "Spaced Retrieval" (SR) might be effectively applied in helping persons with Alzheimer's disease improve their recall of recent events. Capitalising on the interdependence among spared and impaired memory systems, it was hypothesised that SR training with support at encoding and retrieval would facilitate the retention and recall of meaningful recent events. Eight participants with a diagnosis of Alzheimer's disease or related disorder were recruited for this study. The study employed a quasi-experimental multiple baseline treatment design across participants, items, and behaviours. SR training was provided in three domains: Semantic, Prospective, and Episodic recent memory. The results show important training gains made by all participants across conditions at post-training follow-up. In the Episodic condition, participants were able to recall specific details about recent events following training. This study provides preliminary evidence that individuals with mild to severe cognitive impairment can learn and recall new episodic information through Spaced Retrieval training. If replicated, these findings would support the use of Spaced Retrieval as an intervention tool to help individuals maintain their functioning in the area of episodic recent memory.

Biomagnification of perfluorinated compounds in a remote terrestrial food chain: Lichen-Caribou-wolf.

The biomagnification behavior of perfluorinated carboxylates (PFCAs) and perfluorinated sulfonates (PFSAs) was studied in terrestrial food webs consisting of lichen and plants, caribou, and wolves from two remote northern areas in Canada. Six PFCAs with eight to thirteen carbons and perfluorooctane sulfonate (PFOS) were regularly detected in all species. Lowest concentrations were found for vegetation (0.02-0.26 ng/g wet weight (ww) sum (Σ) PFCAs and 0.002-0.038 ng/g ww PFOS). Wolf liver showed highest concentrations (10-18 ng/g ww ΣPFCAs and 1.4-1.7 ng/g ww PFOS) followed by caribou liver (6-10 ng/g ww ΣPFCAs and 0.7-2.2 ng/g ww PFOS). Biomagnification factors were highly tissue and substance specific. Therefore, individual whole body concentrations were calculated and used for biomagnification and trophic magnification assessment. Trophic magnification factors (TMF) were highest for PFCAs with nine to eleven carbons (TMF = 2.2-2.9) as well as PFOS (TMF = 2.3-2.6) and all but perfluorooctanoate were significantly biomagnified. The relationship of PFCA and PFSA TMFs with the chain length in the terrestrial food chain was similar to previous studies for Arctic marine mammal food web, but the absolute values of TMFs were around two times lower for this study than in the marine environment. This study demonstrates that challenges remain for applying the TMF approach to studies of biomagnification of PFCAs and PFSAs, especially for terrestrial animals.

Bisphenol A in the Canadian environment: A multimedia analysis.

Bisphenol A (BPA) is an industrial chemical that has been identified by some jurisdictions as an environmental concern. In 2010, Canada concluded that this substance posed a risk to the environment and human health, and implemented actions to reduce its concentrations in the environment. To support these activities, a multimedia analysis of BPA in the Canadian environment was conducted to evaluate spatial and temporal trends, and to infer mechanisms influencing the patterns. BPA was consistently detected in wastewater and biosolids across Canadian wastewater treatment plants (WWTPs) and in landfill leachate. In addition, BPA concentrations were significantly higher in surface water downstream compared to upstream of WWTPs in three of five urban areas evaluated. However, application of biosolids to Canadian agricultural fields did not contribute to elevated BPA concentrations in soil, earthworms, and European Starling (Sturnus vulgaris) plasma one and two years post-treatment. Spatial trends of BPA concentrations in surface water and sediment are influenced by human activity, with higher concentrations typically found downstream of industrial sources and WWTPs in urban areas. BPA was detected in bird plasma at locations impacted by WWTPs and landfills. However, spatial trends in birds were less clear and may have been confounded by metabolic biotransformation. In terms of temporal trends, BPA concentrations in surface water decreased significantly at 10 of 16 monitoring sites evaluated between 2008 and 2018. In contrast, recent temporal trends of BPA in six sediment cores were variable, which may be a result of biotransformation of the flame retardant tetrabromobisphenol A to BPA. Overall, our study provides evidence that Government of Canada actions have been generally successful in reducing BPA concentrations in the Canadian environment. Our results indicate that long-term monitoring programs using surface water are more effective than other media for tracking and understanding future environmental trends of BPA.

Determination of perfluorinated alkyl acid concentrations in human serum and milk standard reference materials.

Standard Reference Materials (SRMs) are certified reference materials produced by the National Institute of Standards and Technology that are homogeneous materials well characterized with values for specified properties, such as environmental contaminant concentrations. They can be used to validate measurement methods and are critical in improving data quality. Disagreements in perfluorinated alkyl acid (PFAA) concentrations measured in environmental matrices during past interlaboratory comparisons emphasized the need for SRMs with values assigned for PFAAs. We performed a new interlaboratory comparison among six laboratories and provided, for the first time, value assignment of PFAAs in SRMs. Concentrations for perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA), and other PFAAs in two human serum and two human milk SRMs are reported. PFAA concentration measurements agreed for serum SRM 1957 using different analytical methods in six laboratories and for milk SRM 1954 in three laboratories. The interlaboratory relative standard deviation for PFOS in SRM 1957 was 7%, which is an improvement over past interlaboratory studies. Matrix interferences are discussed, as well as temporal trends and the percentage of branched vs. linear isomers. The concentrations in these SRMs are similar to the present-day average concentrations measured in human serum and milk, resulting in representative and useful control materials for PFAA human monitoring studies.

Care Staff Perspectives on Using Mobile Technology to Support Communication in Long-Term Care: Mixed Methods Study.

BACKGROUND: Long-term care (LTC) homes provide 24-hour care for people living with complex care needs. LTC staff assist older adults living with chronic conditions such as Alzheimer disease, related dementias, and stroke, which can cause communication disorders. In addition to the complex cognitive challenges that can impact communication, further difficulties can arise from cultural-language differences between care staff and residents. Breakdowns in caregiver-resident communication can negatively impact the delivery of person-centered care. Recent advances in mobile technology, specifically mobile devices (tablets and smartphones) and their software apps, offer innovative solutions for supporting everyday communication between care staff and residents. To date, little is known about the care staff's perspectives on the different ways that mobile technology could be used to support communication with residents. OBJECTIVE: This study aims to identify care staff's perspectives on the different ways of using devices and apps to support everyday communication with adults living in LTC homes and the priority care areas for using mobile technology to support communication with residents. METHODS: This descriptive study employed concept mapping methods to explore care staff's perspectives about ways of using mobile technology with residents and to identify the usefulness, practicality, and probable uses of mobile technology to support communication in priority care areas. Concept mapping is an integrated mixed methods approach (qualitative and quantitative) that uses a structured process to identify priority areas for planning and evaluation. In total, 13 care staff from a single LTC home participated in this study. Concept mapping includes 2 main data collection phases: (1) statement generations through brainstorming and (2) statement structuring through sorting and rating. Brainstorming took place in person in a group session, whereas sorting and rating occurred individually after the brainstorming session. Concept mapping data were analyzed using multidimensional scaling and cluster analysis to generate numerous interpretable data maps and displays. RESULTS: Participants generated 67 unique statements during the brainstorming session. Following the sorting and rating of the statements, a concept map analysis was performed. In total, 5 clusters were identified: (1) connect, (2) care management, (3) facilitate, (4) caregiving, and (5) overcoming barriers. Although all 5 clusters were rated as useful, with a mean score of 4.1 to 4.5 (Likert: 1-5), the care staff rated cluster 2 (care management) as highest on usefulness, practicality, and probable use of mobile technology to support communication in LTC. CONCLUSIONS: This study provided insight into the viewpoints of care staff regarding the different ways mobile technology could be used to support caregiver-resident communication in LTC. Our findings suggest that care management, facilitating communication, and overcoming barriers are 3 priority target areas for implementing mobile health interventions to promote person-centered care and resident-centered care.

Spaced Retrieval and Episodic Memory Training in Alzheimer's Disease.

INTRODUCTION: This study replicated and extended the findings from the author's previous pilot study to further explore how a spaced retrieval (SR) memory training program might be effectively applied to help persons with Alzheimer's disease (AD)  improve both short- and long-term recall of recent episodic events. METHODS: A quasi-experimental within-subject group study was conducted with 15 participants with a diagnosis of AD. RESULTS: Compared to a control condition, all participants were able to spontaneously recall significantly more specific details about trained events, and their recall was significantly enhanced when they were provided with cues. Although the findings indicated that people with AD were able to encode information during training, recall gains diminished by the end of the maintenance period. DISCUSSION: This study provides evidence that individuals with mild to moderate AD can learn and recall new episodic information through SR training. These findings support the use of SR as an intervention tool to help individuals maintain their functioning in episodic recent memory. However, more research into maintaining the long-term recall of recent episodic events is warranted.

Mobile Apps to Support Caregiver-Resident Communication in Long-Term Care: Systematic Search and Content Analysis.

BACKGROUND: In long-term residential care (LTRC), caregivers' attempts to provide person-centered care can be challenging when assisting residents living with a communication disorder (eg, aphasia) and/or a language-cultural barrier. Mobile communication technology, which includes smartphones and tablets and their software apps, offers an innovative solution for preventing and overcoming communication breakdowns during activities of daily living. There is a need to better understand the availability, relevance, and stability of commercially available communication apps (cApps) that could support person-centered care in the LTRC setting. OBJECTIVE: This study aimed to (1) systematically identify and evaluate commercially available cApps that could support person-centered communication (PCC) in LTRC and (2) examine the stability of cApps over 2 years. METHODS: We conducted systematic searches of the Canadian App Store (iPhone Operating System platform) in 2015 and 2017 using predefined search terms. cApps that met the study's inclusion criteria underwent content review and quality assessment. RESULTS: Although the 2015 searches identified 519 unique apps, only 27 cApps were eligible for evaluation. The 2015 review identified 2 augmentative and alternative cApps and 2 translation apps as most appropriate for LTRC. Despite a 205% increase (from 199 to 607) in the number of augmentative and alternative communication and translation apps assessed for eligibility in the 2017 review, the top recommended cApps showed suitability for LTRC and marketplace stability. CONCLUSIONS: The recommended existing cApps included some PCC features and demonstrated marketplace longevity. However, cApps that focus on the inclusion of more PCC features may be better suited for use in LTRC, which warrants future development. Furthermore, cApp content and quality would improve by including research evidence and experiential knowledge (eg, nurses and health care aides) to inform app development. cApps offer care staff a tool that could promote social participation and person-centered care. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/10.2196/17136.

Episodic and semantic memory influences on picture naming in Alzheimer's disease.

This study investigated the relationship between semantic and episodic memory as they support lexical access by healthy younger and older adults and individuals with Alzheimer's disease (AD). In particular, we were interested in examining the pattern of semantic and episodic memory declines in AD (i.e., word-finding difficulty and impaired recent memory) vis-à-vis more preserved remote memories. We administered a picture naming task in which the episodic period of the pictures and whether the pictured items were unique to one period or commonly used across periods were varied. Groups of younger adults (N=40), healthy older adults (N=20) and older adults with AD (N=18) were asked to name drawings of objects in four conditions: dated unique, contemporary unique, dated common, and contemporary common. The results indicated that all participants named items that were common to both episodic periods more successfully than items unique to one period. An interaction was observed such that the healthy older and AD groups were more successful in retrieving names of objects presented in the dated compared to contemporary unique conditions, whereas the younger adults showed the reverse pattern. These results indicate that naming ability is affected both by the cumulative frequency of using an item over a lifetime and by when an item was first acquired. The findings support a theoretical stance which proposes an enduring reciprocal link between semantic and episodic memory. This theoretical relationship has practical implications for the development of intervention strategies when interacting with persons who have AD.

Sentence Context and Word-Picture Cued-Recall Paired-Associate Learning Procedure Boosts Recall in Normal and Mild Alzheimer's Disease Patients.

INTRODUCTION: The aim of this study was to employ the word-picture paradigm to examine the effectiveness of combined pictorial illustrations and sentences as strong contextual cues. The experiment details the performance of word recall in healthy older adults (HOA) and mild Alzheimer's disease (AD). The researchers enhanced the words' recall with word-picture condition and when the pair was associated with a sentence contextualizing the two items. METHOD: The sample was composed of 18 HOA and 18 people with mild AD. Participants memorized 15 pairs of words under word-word and word-picture conditions, with and without a sentence context. In the paired-associate test, the first item of the pair was read aloud by participants and used to elicit retrieval of the associated item. RESULTS: The findings suggest that both HOA and mild-AD pictures improved item recall compared to word condition such as sentences which further enabled item recall. Additionally, the HOA group performs better than the mild-AD group in all conditions. CONCLUSIONS: Word-picture and sentence context strengthen the encoding in the explicit memory task, both in HOA and mild AD. These results open a potential window to improve the memory for verbalized instructions and restore sequential abilities in everyday life, such as brushing one's teeth, fastening one's pants, or drying one's hands.

The role of conflict resolution styles on nursing staff morale, burnout, and job satisfaction in long-term care.

This study focuses on the ability of nursing staff to interact with residents in a way that affects positively on the nurses' well-being and occupational satisfaction. It investigates the role of coping skills related to staff-resident interactions, in particular, the use of conflict resolution styles and their influence on the level of morale, burnout and job satisfaction of nursing professionals. A self-administered questionnaire was used to collect information from 161 direct care nursing staff. The authors used a multiple regression procedure to examine the influence of predictors on nursing staff outcomes. Multivariate analyses indicated that nurses' psychological morale, occupational stress, and job satisfaction are influenced by conflict resolution styles, after controlling by individual characteristics, work demands, and work resources factors. The findings highlight the importance of considering personal coping abilities to foster positive staff-resident interactions and to increase nurses' morale and job satisfaction.

Conflict resolution styles: a comparison of assisted living and nursing home facilities.

In this exploratory study, the authors investigated how interpersonal conflict is resolved in assisted living and nursing home facilities. In particular, the authors examined whether conflict resolution styles differed between type of facility and between residents and staff in each type of facility. Four focus groups were conducted--two with residents and two with staff from each type of facility. The focus groups centered on discussing the occurrence of conflict and how each participant handled it. Discourse analysis was employed to identify participants' use of three styles of conflict resolution: controlling, solution-oriented, and non-confrontational. The results indicate that staff in each care context showed a preference for the solution-oriented approach. Residents in each setting reported equal use of the non-confrontational and solution-oriented styles. The findings suggest that preferred conflict resolution styles may vary more as a function of the role of each communicator than the context of the care setting.

Perceptions of family caregivers' psychosocial behavior when communicating with spouses who have Alzheimer's disease.

The literature for caregivers of persons with Alzheimer's disease (AD) notes the importance of attending to the linguistic and psychosocial dimensions of communication. The objective of this study was to investigate the relationship between psychosocial aspects of caregivers' behavior and communication outcomes for persons with AD and their spousal caregivers. In the first part of the study, we selected 40 segments of audio-recorded conversations between persons with AD and their spouses. We then asked 20 healthy seniors who were not caregivers to listen to and read the conversation segments and evaluate each segment along four psychosocial dimensions. They were also asked to independently rate how smooth the communication was in each segment. We hypothesized that when caregivers' speech is perceived to be respectful, caring, not controlling, and/or it ascribes competence to their spouses, it would be associated with more effective communication. Our results supported these hypotheses in that communication was more likely to be rated higher in smoothness when the content and manner of caregivers' speech were perceived to have positive psychosocial qualities. The findings have implications for training caregivers on effective psychosocial behavior when interacting with persons who have AD.

Do you remember? How caregivers question their spouses who have Alzheimer's disease and the impact on communication.

This study examined the types of questions caregivers use and their outcomes when conversing with their spouse with Alzheimer's disease (AD). Of particular interest was caregivers' use of yes-no and open-ended questions and the demands they make on the memory of the person with AD. It was hypothesized that communication between caregivers and their spouses would be more successful when caregivers used yes-no rather than open-ended questions; however, it was also predicted that a more positive communication outcome would occur when caregivers used open-ended questions that requested information from semantic rather than episodic memory. Eighteen caregivers and their spouses diagnosed with AD were audiotaped while they conversed for approximately 10 min on a topic of their choosing. The conversations were transcribed and coded according to the occurrence of questions, the type of question (yes-no, choice, or open-ended), the type of memory required to respond to a question (semantic or episodic), and the outcome of a response to a question (communication breakdown). The results indicated that caregivers used yes-no and open-ended questions to a similar extent, whereas episodic questions were used almost twice as frequently as semantic questions. Communication was more successful when caregivers used yes-no compared with open-ended questions and when questions placed demands on semantic rather than episodic memory. The findings from this study suggest that caregivers can reduce communication problems by avoiding the use of questions that depend on episodic memory. In addition, while yes-no questions were associated with more favorable outcomes than open-ended questions, the latter do not need to be avoided if they refer to information that draws only on semantic memory.