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Profiling Mealtime Verbal Interactions between Nursing Home Staff and Persons with Dementia
Abstract   Open access   Peer reviewed

Profiling Mealtime Verbal Interactions between Nursing Home Staff and Persons with Dementia

Annika Ellis, Kyuri Lee and Wen Liu
Innovation in aging, Vol.9(Supplement_2)
12/01/2025
DOI: 10.1093/geroni/igaf122.3645
PMCID: PMC12762754
url
https://doi.org/10.1093/geroni/igaf122.3645View
Published (Version of record) Open Access

Abstract

Effective communication is crucial to Person-Centered Care (PCC) for Persons with Dementia (PWD) during mealtimes as verbal interactions can influence engagement. This study analyzed 12,959 verbal behaviors in 245 full-mealtime videos in long-term care settings using the CUED coding scheme. Staff produced 9,176 positive verbalizations, including “Orientation/Giving Instruction” (24.80%) and “Giving Choices” (16.46%). Of staffs’ 1,781 negative verbalizations, most involved side conversations (42.57%). Residents contributed 2,066 verbalizations in the dyadic conversations (86% positive, 14% negative). Notable resident unintelligible utterances were coded as “Unsure – positive” (30.66%). Additional common verbal resident behaviors included “Expressing personal need or preference” (16.33%) and “Showing approval/agreement” (16.28%). Together, these dyadic interactions indicate an overall positive conversational tone with relatively infrequent negative themes, facilitating a deeper understanding of the context within dementia care communication. Pearson correlations revealed significant associations between staff and resident behaviors. Staff positive behaviors were positively correlated with both resident positive (r = .288, p < .001) and negative behaviors (r = .275, p < .001), suggesting that staff engagement prompted a range of resident responses. Staff negative behaviors were associated with resident negative behaviors (r = .153, p = .016). Additionally, longer durations of staff’s negative side conversations were correlated to increased number of total negative staff behaviors (r = .173, p = .007). These associations indicate that while staff demonstrate many PCC behaviors, negative or off-topic conversations can still shape resident responses in unhelpful ways. Strengthening staff communication strategies to remain focused, positive, and inclusive may enhance mealtime engagement for PWD.
 Dementia Verbal communication

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