Harsh communication: characteristics of caregivers and persons with dementia

Abstract

Objectives: While ways to reduce caregiver burden have dominated dementia care research, there is little understanding of daily communication and its relationship to caregiver burden and depression. In this study, we sought to: (1) describe the frequency of harsh communication used by caregivers; (2) examine the relationship between harsh communication, caregiver and person with dementia characteristics; and (3) determine the contributions of caregiver depression and burden on such communication.

Method: Cross-sectional baseline data were drawn from 250 dyads, who participated in the Dementia Behavior Study (NCT01892579). Hierarchical linear regression models were used to examine the relationship between dyad characteristics and harsh communication scores (using the 6-item Negative Communication Scale), controlling for three groups of covariates: sociodemographic, relationship characteristics and health factors.

Results: More than half of the caregivers (mean age = 65.4, 81.2% women, 45.6% spouses) reported they felt like screaming/yelling (N = 138, 55.2%) or used a harsh tone (N = 129, 51.6%) at persons with dementia (Mini Mental Status Examination mean = 14.3, SD: 7.8) at least sometimes. When controlling for all covariates, for each unit increase in caregiver burden, harsh communication increased by 0.486 units (p < 0.001); similarly, for each unit increase in caregiver depression, harsh communication increased by 0.301units (p < 0.001).

Conclusion: Over half of dementia caregivers reported they felt like or used one or more harsh forms of communication. Caregiver burden and depression were incrementally associated with greater use of negative communication. Providing caregivers with knowledge, support and specific communication skills may lessen the frequency of harsh communication and possibly reduce burden and depression.

Keywords:

• Mistreatment
• dementia
• caregiving
• harsh communication
• dyad communication

Clinical trial registration:

• NCT01892579

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data that support the findings of this study are available from the corresponding author, [D.V.P], upon reasonable request.

Additional information

Funding

Dr Gitlin was supported in part by the National Institute on Aging under Grant [R01 AG041781-01A1 and R01 AG049692]. Darina Petrovsky, PhD, RN is a Ruth L. Kirschstein Postdoctoral Fellow [F32 AG060630] through the National Institutes of Health, National Institute on Aging. Justine S. Sefcik, PhD, RN is supported by the National Institutes of Health [T32 NR009356]. Nancy A. Hodgson, PhD, RN, FAAN is supported by the National Institute of Nursing [R01 NR015226]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Dr Gitlin was supported in part by the National Institute on Aging under Grant [R01 AG041781-01A1 and R01 AG049692]. Darina Petrovsky, PhD, RN is a Ruth L. Kirschstein Postdoctoral Fellow [F32 AG060630] through the National Institutes of Health, National Institute on Aging. Justine S. Sefcik, PhD, RN is supported by the National Institutes of Health [T32 NR009356]. Nancy A. Hodgson, PhD, RN, FAAN is supported by the National Institute of Nursing [R01 NR015226]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.