Assessment Protocol to Identify Environmental Barriers to Communication

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DESCRIPTION (provided by applicant): Ineffectual communication with people with dementia is a significant problem in long-term care settings that negatively impacts residents' functional abilities and quality of life. It also influences staff stress and burden which can result in higher turnover and poorer quality care. The environment is a key factor affecting the quality of communication, especially for individuals with impaired communication skills as a result of dementia. A poorly designed communication environment has negative consequences for many groups: residents with dementia, direct care staff and nurses, therapists, family members, and facility administrators/owners. The Communication Toolkit will be the only comprehensive resource that provides information to speech-language pathologists (SLPs), occupational therapists (OTs), physical therapist (PTs), nursing staff, and administration about how to assess and modify the long term care environment so that it is supports the communication skills of people with dementia and improves their quality of life. The specific aims of this SBIR project are: 1) To expand the Communication Toolkit by incorporating additional areas of the residential care environment such as the dining room and activity spaces. 2) To refine and revise the Communication Toolkit per results of Phase I and thorough evaluation by the Advisory Panel. 3) To demonstrate the effectiveness of the Communication Toolkit by measuring positive outcomes in awareness, utility and impact in a larger sample of professionals. This sample will include other professions who work with SLPs to implement communication interventions (e.g. occupational therapists, physical therapists, and nurses). The Communication Toolkit includes the Communication Environment Resource Guide and Assessment Instrument, along with sound and light meters to assess how well the environment supports effective communication. Once expanded and approved by the Advisory Panel, the Communication Toolkit will be evaluated in two waves of data collection, with at least 90 health professionals. The efficacy of the Communication Toolkit will be assessed through the following changes: Awareness of environmental interventions will be assessed by change in knowledge; Utility of information will be assessed by change in behavior; Impact of the Communication Toolkit will be assessed by implementation of interventions; Usability of the Communication Toolkit will be assessed by evaluation of the Communication Toolkit. PUBLIC HEALTH RELEVANCE: Significant proportions of individuals living in long-term care settings experience communication problems, often stemming from dementia, which impairs their ability participate fully in their care and maintain a high quality of life. Although there is solid empirical evidence that appropriate environmental interventions can improve communication, assessment of barriers and facilitators to effective communication is not part of normal clinical practice. The Communication Toolkit will guide health care professions by providing solutions that can be incorporated into functional maintenance plans, restorative plans, caregiver training, and direct treatment interventions, improving the lives of individuals with communication deficits.