Improving nonverbal communication between caregivers and people with advanced dementia: the effect of staff training in intensive interaction on quality of life

Impairment of language-based communication is a hallmark of advanced dementia, which often leads to social isolation. However, nonverbal communication remains relatively preserved. Intensive Interaction, a nonverbal communication technique, offers a potential means for maintaining connections. This study assessed the feasibility of a full scale randomized control trial (RCT), to ascertain whether or not training care staff to use Intensive Interaction techniques could improve Quality of Life (QoL) for residents with advanced dementia. Using a non-randomised control design, staff in a nursing home were paired with a resident and offered training in Intensive Interaction, with video recordings of their interactions and QoL measures for the resident taken before and after training and at 3 month follow-up. These were compared to outcomes in a control home in which care continued as usual. Results from the intervention home indicated an increase in communication behaviours that facilitated and showed pleasure in interactions and a decrease in behaviours that hindered and expressed displeasure in interactions. Furthermore, scores on QoL assessment also improved. These changes were significantly different to those observed in the control home. Large effect sizes for these changes were suggestive of clinical relevance and thus further research through a full-scale trial is recommended