“We are going to live together”: A multiple-case study on the key components of dementia care interactions

People living with dementia face challenges in communication and social interactions. Nursing staff play a crucial role in shaping their socialization. Understanding the components of dementia care interactions is crucial for enhancing Relationship-Centered Care (RCC). This study provides an inventory of the key components of the interaction between dyads of nursing home residents with dementia and nursing assistants. Data were collected from two dyads through observations and analyzed with thematic analysis with an inductive approach. Following the observations, one-to-one interviews with the nursing assistants took place to provide supporting material to the observation results. Thematic analysis identified 12 distinct interaction patterns between professionals and individuals with dementia such as comforting language, describing the care provided, making small talk and using elderspeak during the care interaction. Rather than being rigidly categorized, these behaviors can be understood along two overarching spectrums: Offering or Withholding Autonomy, Promoting or Impeding Relationships. The degree to which each behavior pattern is aligned with each end of the spectrum can depend on contextual factors such as timing, and the residents’ response. Training for nursing assistants needs to focus on enhancing RCC behaviors during dementia care, and work environments should prioritize flexible schedules allowing nursing assistants to create meaningful relationships with individuals with dementia living in nursing homes.