Nonverbal Communication in Dementia Care: A Review of Its Application and Influence on Patients’ Quality of Life

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Abstract

Objective: To review the mechanism, application scenarios, and existing problems of nonverbal communication in improving dementia patients’ quality of life and to provide a reference for nursing practice and future research. Methods: Literature related to “dementia”, “non-verbal communication”, and “quality of life” published from 202 to 2024 was searched through CNKI, Wanfang, PubMed, etc., are included in studies on clinical nursing, non-pharmacological interventions, and communication strategies for narrative integration. Results: Existing studies show that nonverbal communication elements (eyes, gestures, touch, spatial distance, intonation, and environmental cues) can improve patients’ subjective security and quality of life through cognitive activation, emotion regulation, memory arousal, behavioral stability, self-care promotion, and social participation. Application needs and implementation priorities differ across hospitals, elderly care institutions, and home care. Current evidence is limited by small sample sizes, high heterogeneity, and a lack of standardized assessment tools and high-quality randomized controlled trials. Conclusion: Nonverbal communication is a key nursing strategy to compensate for language barriers and improve quality of life in dementia care. In the future, it is necessary to establish a unified evaluation system, conduct high-quality multi-center research, and explore AI’s potential to support objective quantification and individualized intervention of nonverbal signals.

References

Mecca AP, van Dyck CH, 2020, Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. Alzheimer’s & dementia: The Journal of the Alzheimer’s Association, 17(2): 316–317. https://doi.org/10.1002/alz.12190

Irish M, 2023, Autobiographical Memory in Dementia Syndromes—An Integrative Review. Wiley Interdisciplinary Reviews: Cognitive Science, 14(3): e1630. https://doi.org/10.1002/wcs.1630

Eggenberger E, Heimerl K, Bennett MI, 2013, Communication Skills Training in Dementia Care: A Systematic Review of Effectiveness, Training Content, and Didactic Methods in Different Care Settings. International Psychogeriatrics, 25(3): 345–358. https://doi.org/10.1017/s1041610212001664

Cai FF, Zhang H, 2015, Advance in Research on Therapeutic Touch for Aggressive Behaviors in Patients with Alzheimer’s Disease. Chinese Journal of Nursing, 50(8): 991–994. https://doi.org/10.3761/j.issn.0254-1769.2015.08.021

Brooker D, Latham I, 2015, Person-centred Dementia Care: Making Services Better with the VIPS Framework. Jessica Kingsley Publishers, London.

Woods B, O’Philbin L, Farrell EM, et al., 2018, Reminiscence Therapy for Dementia. Cochrane Database of Systematic Reviews, 2018(3): CD001120. https://doi.org/10.1002/14651858.CD001120.pub3/abstract

De Vries K, 2013, Communicating with Older People with Dementia. Nursing Older People, 25(4): 30–37. https://doi.org/10.7748/nop2013.05.25.4.30.e429

Woods DL, Craven RF, Whitney J, 2005, The Effect of Therapeutic Touch on Behavioral Symptoms of Persons with Dementia. Alternative Therapies in Health & Medicine, 11(1): 66–74. https://doi.org/10.1159/000220479

van Weert JC, van Dulmen AM, Spreeuwenberg PM, et al., 2005, Effects of Snoezelen, Integrated in 24 h Dementia Care, on Nurse-patient Communication during Morning Care. Patient Education and Counseling, 58(3): 312–326. https://doi.org/10.1016/j.pec.2004.07.013

Wanko Keutchafo EL, Kerr J, Jarvis MA, 2020, Evidence of Nonverbal Communication between Nurses and Older Adults: A Scoping Review. BMC Nursing, 19(1): 53. https://doi.org/10.1186/s12912-020-00443-9

Gitlin LN, Marx KA, Alonzi D, et al., 2017, Feasibility of the Tailored Activity Program for Hospitalized (TAP-H) Patients with Behavioral Symptoms. Gerontologist, 57(3): 575–584. https://doi.org/10.1093/geront/gnw052

Gitlin LN, Arthur P, Piersol C, et al., 2018, Targeting Behavioral Symptoms and Functional Decline in Dementia: A Randomized Clinical Trial. Journal of the American Geriatrics Society, 66(2): 339–345. https://doi.org/10.1111/jgs.15194

Liao AW, Lian ZM, 2004, The Importance of Nonverbal Communication in Psychological Nursing. Huaxia Medical Science, 2004(5): 811–812.

Achterberg W, Lautenbacher S, Husebo B, et al. Pain in Dementia. Pain Reports, 5(1): e803. https://doi.org/10.1097/pr9.0000000000000803

Zhang Y, Cai J, An L, et al., 2017, Does Music Therapy Enhance Behavioral and Cognitive Function in Elderly Dementia Patients? A Systematic Review and Meta-analysis. Ageing Research Reviews, 2017(35): 1–11. https://doi.org/10.1159/000220479

Moreira SV, Justi FRdR, Gomes CFdA, et al., 2023, Music Therapy Enhances Episodic Memory in Alzheimer’s and Mixed Dementia: A Double-Blind Randomized Controlled Trial. Healthcare, 11(22): 2912. https://doi.org/10.3390/healthcare11222912

Ng QX, Ho CYX, Koh SSH, et al., 2017, Doll Therapy for Dementia Sufferers: A Systematic Review. Complementary Therapies in Clinical Practice, 2017(26): 42–46. https://doi.org/10.1016/j.ctcp.2016.11.007

Molteni V, Vaccaro R, Ballabio R, et al., 2022, Doll Therapy Intervention Reduces Challenging Behaviours of Women with Dementia Living in Nursing Homes: Results from a Randomized Single-blind Controlled Trial. Journal of Clinical Medicine, 11(21): 6262. https://doi.org/10.3390/jcm11216262

Calderone A, Marra A, De Luca R, et al. Multisensory Stimulation in Rehabilitation of Dementia: A Systematic Review. Biomedicines, 13(1): 149. https://doi.org/10.3390/biomedicines13010149

Zhao Y, Lian HJ, Shen XH, et al., 2020, The Research Progress of Doll Therapy Applied in Patients with Alzheimer’s Disease. Chinese Nursing Research, 34(4): 686–688. https://doi.org/10.12102/j.issn.1009-6493.2020.04.026

Wang D, Li XW, 2023, Qualitative Study on Care Experience of Agitated Behaviors in Dementia Based on the SEIPS Model. Journal of Nursing, 30(8): 23–28. https://doi.org/10.16460/j.issn.1008-9969.2023.08.023

Ojha GJ, Moharana S, 2020, Strategies to Improve Communication During ADLs in Dementia: A Short Review. International Journal of Science and Healthcare Research, 5(3): 286–291.

Wang YN, Xu P, Huang XG, et al., 2006, Nursing Guidance for Family Caregivers of Patients with Alzheimer’s Disease. Chinese Journal of Nursing, 2006(1): 49–51.

Hubbard G, Cook A, Tester S, et al., 2002, Beyond Words: Older People with Dementia Using and Interpreting Nonverbal Behaviour. Journal of Aging Studies, 16(2): 155–167. https://doi.org/10.1016/S0890-4065(02)00041-5

Bender EN, Savundranayagam MY, Murray L, et al., 2022, Supportive Strategies for Nonverbal Communication with Persons Living with Dementia: A Scoping Review. International Journal of Nursing Studies, 2022(136): 104365. https://doi.org/10.1016/j.ijnurstu.2022.104365

Zhang Y, Zhang Y, Qian YJ, et al., 2018, Exploration on the Effect of Nonverbal Communication in Clinical Nursing of Patients with Alzheimer’s Disease. Journal of Practical Clinical Nursing Electronic Edition, 3(5): 118 + 20.

Zaletel M, Kovacev AN, Mikus RP, et al., 2012, Nonverbal Communication of Caregivers in Slovenian Nursing Homes. Archives of Gerontology and Geriatrics, 54(1): 94–101. https://doi.org/10.1016/j.archger.2010.12.020

Zhu HW, Zhang ZX, Jin SL, 2017, Application Effect of Comprehensive Nursing Intervention in Patients with Mild to Moderate Senile Dementia. Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease, 25(10): 110–113. https://doi.org/10.3969/j.issn.1008-5971.2017.10.028

Chen YL, Bai X L, Lou T, et al., 2024, Research Status of Home Care Needs Assessment Tools and Age-Friendly Assistive Device Design for Patients with Alzheimer’s Disease. Chinese Nursing Research, 38(9): 1605–1609. https://doi.org/10.12102/j.issn.1009-6493.2024.09.016

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