Positive changes in CNAs (Douglas & MacPherson, 2021)

Purpose: This study investigated whether a 6-week coaching strategy resulted in positive changes in self-perceived knowledge and efficacy (SPKE) and positive communication behaviors in certified nursing assistants (CNAs) working with people with dementia in a skilled nursing facility. It also assessed the impact of the coaching strategy on negative responsive behaviors of people with dementia, such as yelling out, hitting, or spitting.

Method: Seven CNAs and seven people with dementia completed this study. Pretesting and posttesting were conducted for CNAs’ SPKE. A single-subject, multiple-baseline design across five communication behaviors, the positive communication approach checklist, was completed to assess CNA communication behaviors after completion of a coaching strategy. Pretesting and posttesting of responsive behaviors of people with dementia were completed with the Cohen–Mansfield Agitation Inventory.

Results: Six out of seven CNAs improved their SPKE from pre- to postcoaching; however, this difference was not statistically significant. Per the positive communication approach checklist, there was a statistically significant increase, from baseline to follow-up, in CNA positive communication behaviors when interacting with people with dementia. The frequency of overall responsive behaviors of people with dementia significantly decreased from pre- to postcoaching, per the Cohen–Mansfield Agitation Inventory.

Conclusions: There is preliminary evidence to support the feasibility of a coaching strategy for the implementation of positive communication behaviors by CNAs when communicating with people with dementia. Negative responsive behaviors of people with dementia also decreased. Speech-language pathologists should consider acting as coaches to support positive communication for people with dementia.

Supplemental Material S1. Dementia Collaborative Coaching Training Manual on the Go.

Douglas, N. F., & MacPherson, M. K. (2021). Positive changes in certified nursing assistants' communication behaviors with people with dementia: Feasibility of a coaching strategy. American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2020_AJSLP-20-00065