Communication Enhancement for Family Caregivers of Individuals with Alzheimer’s Disease

  • Kerry Byrne
  • J. B. Orange


Family caregivers of individuals with dementia have been studied extensively over the past two decades by health and psychosocial care researchers representing a diverse range of professions and working in a variety of rehabilitation, long-term care and community settings. Speech-language pathologists, occupational therapists, communication specialists, nurses, social workers and psychologists, among other professionals, have all contributed to the extant literature regarding the experiences and needs of family caregivers of individuals with dementia. Given the expanding prevalence of dementia in the aging population worldwide, health and psychosocial care professionals are increasingly faced with the need to provide treatment to individuals with some form of dementia. These professionals are necessarily working in close proximity with family caregivers in community contexts because individuals with dementia continue to live at home and are usually cared for by a family member, typically a spouse (Canadian Study of Health and Aging Working Group 1994).


Family Caregiver Nursing Home Resident Caregiver Burden Communication Problem Communication Difficulty 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Baxter, L.A., Braithwaite, D.O. Golish, T.D. & Olson, L.N. (2002) “Contradictions of interaction for wives of elderly husbands with adult dementia.” Journal of Applied Communication Research, 30(1): 1–26.CrossRefGoogle Scholar
  2. Bayles, K.A. (2003) “Effects of working memory deficit on the communicative functioning of Alzheimer’s dementia patients.” Journal of Communication Disorders, 36: 209–19.CrossRefGoogle Scholar
  3. Bayles, K. & Kaszniak, A. (1987) Communication and Cognition in Normal Aging and Dementia. Boston: College Hill/Little, Brown.Google Scholar
  4. Bayles, K.A. & Tomoeda, C.K. (1991) “Caregiver report of prevalence and appearance order of linguistic symptoms in Alzheimer’s patients.” The Gerontologist, 31: 210–16.CrossRefGoogle Scholar
  5. Bayles, K., Tomoeda, C., & Trösset, W. (1992) “Relation of linguistic communication abilities of Alzheimer’s patients to stage of disease.” Brain and Language, 42: 454–72.CrossRefGoogle Scholar
  6. Bourgeois, M. (1990) “Enhancing conversation skills in Alzheimer’s disease using a prosthetic memory aid.” Journal of Applied Behavior Analysis, 23: 29–42.CrossRefGoogle Scholar
  7. Bourgeois, M. (1992) “Evaluating memory wallets in conversations with patients with dementia.” Journal of Speech and Hearing Research, 35: 1344–57.CrossRefGoogle Scholar
  8. Bourgeois, M. (1993) “Effects of memory aids on the dyadic conversation of individuals with dementia.” Journal of Applied Behavior Analysis, 26: 77–87.CrossRefGoogle Scholar
  9. Bourgeois, M.S. (1998) “Functional outcome assessment of adults with dementia.” Seminars in Speech and Language, 19(3): 261–79.CrossRefGoogle Scholar
  10. Bourgeois, M.S. (2002) “Where is my wife and when am I going home? The challenge of communicating with persons with dementia.” Alzheimer’s Care Quarterly, 3(2): 132–43.Google Scholar
  11. Bourgeois, M.S., Camp, C.J., Rose, M., White, B., Malone, M., Carr, J., & Rovine, M. (2003) “A comparison of training strategies to enhance use of external aids by persons with dementia.” Journal of Communication Disorders, 36: 361–78.CrossRefGoogle Scholar
  12. Bourgeois, M.S., Burgio, L.D., Schulz, R., Beach, S., & Palmer, B. (1997) “Modifying repetitive verbalizations of community-dwelling patients with AD.” The Gerontologist, 37: 30–9.CrossRefGoogle Scholar
  13. Bourgeois, M.S., Schulz, R., Burgio, L.D. & Beach, S. (2002) “Skills training for spouses of patients with Alzheimer’s disease: Outcomes of an intervention study.” Journal of Clinical Geropsychology, 8(1): 53–73.CrossRefGoogle Scholar
  14. Bourgeois, M.S., Schulz, R., & Burgio, L. (1996) “Interventions for caregivers of patients with Alzheimer’s disease: a review and analysis of content, process, and outcomes.” International Journal of Aging and Human Development 43: 35–92.CrossRefGoogle Scholar
  15. Burgio, L., Allen-Burge, R., Roth, D., Bourgeois, M., Dijkstra, K., Gerstle, J., Jackson, E., & Bankester, L. (2001) “Come talk with me: Improving communication between nursing assistants and nursing home residents during care routines.” The Gerontologist, 41: 449–60.CrossRefGoogle Scholar
  16. Canadian Study of Health and Aging Working Group. (1994) “Patterns of caring for people with dementia in Canada.” Canadian Journal of Aging, 13: 470–87.CrossRefGoogle Scholar
  17. Clarke, L.W. (1991) “Caregiver Stress and Communication Management in Alzheimer’s Disease.” In D. Ripich (ed). Handbook of Geriatric Communication Disorders (pp. 127–42). Austin, Texas: Pro-Ed.Google Scholar
  18. Clarke, L.W. (1995) “Interventions for persons with Alzheimer’s disease: Strategies for maintaining and enhancing communicative success.” Topics in Language Disorders, 15(2): 47–66.CrossRefGoogle Scholar
  19. Clipp, E.C. & George, L.K. (1993) “Dementia and cancer: A comparison of spouse caregivers.” The Gerontologist, 33: 534–41.CrossRefGoogle Scholar
  20. Clyburn, L.D., Stones, M.J., Hadjistavropoulos, T., & Tuokko, H. (2000) “Predicting caregiver burden and depression in Alzheimer’s disease.” Journal of Gerontology: Social Sciences, 55B(1): S2–S13.Google Scholar
  21. Croog, S.H., Sudilovsky, A., Burleson, J.A., & Baume, R.M. (2001) “Vulnerability of husband and wife caregivers of Alzheimer disease patients to caregiving stressors.” Alzheimer Disease and Associated Disorders, 15(4): 201–10.CrossRefGoogle Scholar
  22. Done, D.J. & Thomas, J.A. (2001) “Training in communication skills for informal carers of people suffering from dementia: a cluster randomized clinical trial comparing a therapist led workshop and a booklet.” International Journal of Geriatrie Psychiatry, 16: 816–21.CrossRefGoogle Scholar
  23. Dunkin, J.J. & Anderson-Hanley, C. (1998) “Dementia caregiver burden: a review of the literature and guidelines for assessment and intervention.” Neurology, 51(Suppl 1): S53–S60.CrossRefGoogle Scholar
  24. Gallagher-Thompson, D., Dal Canto, P.G., Darnley, S., Basilio, L.A., Whelan, L., & Jacob, T. (1997) “A feasibility study of videotaping to assess the relationship between distress in Alzheimer’s disease caregivers and their interaction style.” Aging and Mental Health, 1: 346–55.CrossRefGoogle Scholar
  25. Hart, B.D. & Wells, D.L. (1997) “The effects of language used by caregivers on agitation in residents with dementia.” Clinical Nurse Specialist, 11(1): 20–3.CrossRefGoogle Scholar
  26. Hayes, S.C. (1981) “Single case experimental design and empirical clinical practice.” Journal of Consulting and Clinical Psychology, 49(2): 193–211.CrossRefGoogle Scholar
  27. Hoerster, L., Hickey, E., & Bourgeois, M. (2001) “Effects of memory aids on conversations between nursing home residents with dementia and nursing assistants.” Neuropsychological Rehabilitation, 11: 399–427.CrossRefGoogle Scholar
  28. Jansson, W., Nordberg, G., & Grafstrôm, M. (2001) “Patterns of elderly spousal caregiving in dementia care: an observational study.” Journal of Advanced Nursing, 34(6): 804–12.CrossRefGoogle Scholar
  29. Kiresuk T.J. & Sherman, R.E. (1968) “Goal Attainment Scaling: A general method for evaluating comprehensive community mental health programs.” Community Mental Health Journal, 4: 443–53.CrossRefGoogle Scholar
  30. Kemper, S., Anagnopoulos, C., Lyons, K., & Heberlein, W. (1994) “Speech accommodations to dementia.” Journal of Gerontology: Psychological Sciences, 49(5): P223–P229.CrossRefGoogle Scholar
  31. Leinonen, E., Korpisammal, L., Pulkkinen, L., & Pukuri, T. (2001) “The comparison of burden between caregiving spouses of depressive and demented patients.” International Journal of Geriatric Psychiatry, 16: 387–93.CrossRefGoogle Scholar
  32. Lubinski, R. & Orange, J.B (2000) “A Framework for the Assessment and Treatment of Functional Communication in Dementia.” In L.E. Worrall & C.M. Frattali (eds.) Neurogenic Communication Disorders: A Functional Approach (pp. 220–46). NY: Thieme.Google Scholar
  33. McCallion, P., Toseland, R., Lacey, D., & Banks, S. (1999) “Educating nursing assistants to communicate more effectively with nursing home residents with dementia.” The Gerontologist, 39(5): 546–58.CrossRefGoogle Scholar
  34. Murray, J., Schneider, J., Banerjee, S., & Mann, A. (1999) “Eurocare: a cross-national study of co-resident spouse carers for people with Alzheimer’s disease: II — a qualitative analysis of the experience of caregiving.” International Journal of Geriatric Psychiatry, 14: 662–7.CrossRefGoogle Scholar
  35. Ogles, B.M., Lunnen, K.M., & Bonesteel, K. (2001) “Clinical significance: History, application, and current practice.” Clinical Psychology Review, 21(3): 421–46.CrossRefGoogle Scholar
  36. Orange, J.B. (1995) “Perspectives of Family Members Regarding Communication Changes”. In R. Lubinski (ed.). Dementia and Communication (pp. 168–86). San Diego, CA: Singular Publishing.Google Scholar
  37. Orange, J.B. (2001) “Family Caregivers, Communication and Alzheimer’s Disease.” In M.L. Hummert & J.F. Nussbaum (eds.). Aging, Communication and Health (pp. 224–48). New Jersey: Lawrence Erlbaum.Google Scholar
  38. Orange, J.B. & Colton-Hudson, A. (1998) “Enhancing communication in dementia of the Alzheimer’s type: caregiver education and training.” Topics in Geriatric Rehabilitation, 14(2): 56–75.CrossRefGoogle Scholar
  39. Orange, J.B. & Kertesz, A. (2000) “Discourse analyses and dementia”. Brain and Language, 71: 172–4.CrossRefGoogle Scholar
  40. Orange, J.B., Ryan, E.B., Meredith, S.D., & MacLean, M.J. (1995) “Application of the communication enhancement model for long-term care residents with Alzheimer’s disease.” Topics in Language Disorders, 15: 20–35.CrossRefGoogle Scholar
  41. Ory, M.G., Hoffman, R.R., Yee, J.L., Tennstedt, S., & Schulz, R. (1999) “Prevalence and impact of caregiving: a detailed comparison between dementia and nondementia caregivers.” The Gerontologist, 39: 177–85.CrossRefGoogle Scholar
  42. Powell, J.A., Hale, M.A., & Bayer, A.J. (1995) “Symptoms of communication breakdown in dementia: carers’ perceptions.” European Journal of Disorders of Communication, 30: 65–75.CrossRefGoogle Scholar
  43. Quayhagen, M. & Quayhagen, M. (1988) “Alzheimer’s stress: Coping with the caregiving role.” The Gerontologist, 28: 391–6.CrossRefGoogle Scholar
  44. Rabins, P., Mace, N., & Lucas, M. (1982) “The impact of dementia on the family.” Journal of the American Medical Association, 24(8): 333–5.CrossRefGoogle Scholar
  45. Richter, J.M., Roberto, K.A., & Bottenberg, D.J. (1995) “Communicating with persons with Alzheimer’s disease: experiences of family and formal caregivers.” Archives of Psychiatric Nursing, 9: 279–85.CrossRefGoogle Scholar
  46. Ripich, D.N., Ziol, E., Fritsch, T., & Durand, E.J. (1999) “Training Alzheimer’s disease caregivers for successful communication.” Clinical Gerontologist, 21(1): 37–56.CrossRefGoogle Scholar
  47. Ripich, D.N., Ziol, E., & Lee, M.M. (1998) “Longitudinal effects of communication training on caregivers of persons with Alzheimer’s disease.” Clinical Gerontologist, 19: 37–55.CrossRefGoogle Scholar
  48. Ripich, D.N., Kercher, K., Wykle, M., Sloan, D.M., & Ziol, E. (1998) “Effects of communication training on African-American and white caregivers of persons with Alzheimer’s disease.” Journal of Aging and Ethnicity, 1: 163–78.Google Scholar
  49. Ripich, D.N. (1996) Alzheimer’s Disease Communication Guide: The FOCUSED Program for Caregivers. San Antonio, TX: The Psychological Corporation.Google Scholar
  50. Ryan, E.B., Meredith, S.D., Maclean, M.J., & Orange, J.B. (1995) “Changing the way we talk with elders: promoting health using the communication enhancement model.” International Journal of Aging and Human Development, 41(2): 89–107.CrossRefGoogle Scholar
  51. Santro Pietro, M.J. & Ostuni, E. (2003) Successful Communication with Persons with Alzheimer’s Disease: An In-service Training Manual, 2nd edition. St. Louis, MO: Butterworth-Heinemann.Google Scholar
  52. Savundranayagam, M.Y., Hummert, M.L., & Montgomery, R.J.V. (2005) “Investigating the effects of communication problems on caregiver burden.” Journal of Gerontology: Social Sciences, 60 B(1), 548–55.Google Scholar
  53. Schlosser, R.W. (2004) “Goal attainment scaling as a clinical measurement technique in communication disorders: a critical review.” Journal of Communication Disorders, 37: 217–39.CrossRefGoogle Scholar
  54. Schulz, R., O’Brien, A., Czaja, S., Ory, M., Norris, R.N., Martire, L.M., Belle, S.H., Burgio, L., Gitlin, L., Coon, D., Burns, R. Gallagher-Thompson, D., & Stevens, A. (2002) “Dementia caregiver intervention research: in search of clinical significance.” The Gerontologist, 42(5): 589–602.CrossRefGoogle Scholar
  55. Schulz, R. O’Brien, A.T., Bookwala, J., & Fleissner, K. (1995) “Psychiatric and physical morbidity effects of dementia caregiving: prevalence, correlates and causes.” The Gerontologist, 35: 771–91.CrossRefGoogle Scholar
  56. Small, J.A., Geldart, K., & Gutman, G. (2000) “Communication between individuals with dementia and their caregivers during activities of daily living.” American Journal of Alzheimer’s Disease and Other Dementias, 15: 291–302.CrossRefGoogle Scholar
  57. Small, J.A. & Gutman, G. (2002) “Recommended and reported use of communication strategies in Alzheimer caregiving.” Alzheimer Disease and Associated Disorders, 16(4): 270–78.CrossRefGoogle Scholar
  58. Small, J.A., Gutman, G., Makela, S., & Hillhouse, B. (2003) “Effectiveness of communication strategies used by caregivers of persons with Alzheimer’s disease during activities of daily living.” Journal of Speech. Language, and Hearing Research, 46: 353–67.CrossRefGoogle Scholar
  59. Small, J.A., Kemper, S., & Lyons, K. (1997) “Sentence comprehension in Alzheimer’s disease: effects of grammatical complexity, speech rate, and repetition.” Psychology and Aging, 12(1): 3–11.CrossRefGoogle Scholar
  60. Sörensen, S., Martin Pinquart, D., & Duberstein, P. (2002) “How effective are interventions with caregivers? An updated meta-analysis.” The Gerontologist, 42(3): 356–72.CrossRefGoogle Scholar
  61. Stolee, P., Borrie, M.J., Esbaugh, J, Wagg, J., Woodbury, M.G., Petrella, R.J., & Connidis, I.A. (2001) “Maintenance of functional and quality of life outcomes in geriatric rehabilitation.” The Gerontologist, 47(suppl. 1): 364.Google Scholar
  62. Stolee, P., Rockwood, K., Fox, R.A., & Streiner, D.L. (1992) “The use of Goal Attainment Scaling in a geriatric care setting.” Journal of the American Geriatrics Society, 40: 574–8.CrossRefGoogle Scholar
  63. Stolee, P., Stadnyk, K., Myers, A.M., & Rockwood, K. (1999) “An individualized approach to outcome measurement in geriatric rehabilitation.” Journal of Gerontology: Medical Sciences, 54A: M641–M647.Google Scholar
  64. Stolee, P., Zaza, C., Pedlar, A., & Myers, A.M. (1999) “Clinical experience with Goal Attainment Scaling in geriatric care”. Journal of Aging and Health. 11(1): 96–124.CrossRefGoogle Scholar
  65. Tomoeda, C.K. (2001) “Comprehensive assessment for dementia: a necessity for differential diagnosis.” Seminars in Speech and Language, 22(4): 275–88.CrossRefGoogle Scholar
  66. Turner, S.A. & Street, H.P. (1999) “Assessing carers’ training needs: a pilot inquiry”. Aging and Mental Health, 3(2): 173–8.CrossRefGoogle Scholar
  67. Williamson, G.M & Schulz, R. (1993) “Coping with specific stressors in Alzheimer’s disease caregiving.” The Gerontologist, 33: 747–55.CrossRefGoogle Scholar

Copyright information

© Kerry Byrne and J.B. Orange 2005

Authors and Affiliations

  • Kerry Byrne
  • J. B. Orange

There are no affiliations available

Personalised recommendations