Co-occurrence of positive staff interactions and positive affect in memory-care residents: An observational study

Objectives: With high numbers of persons with dementia living in residential care, it is vital to maximize psychosocial well-being for this population in this setting. The current study observed whether proportions of positive affect in residents differed based on co-occurring staff (typically certified nurse assistants) interaction types.

Methods: A trained research team observed staff/resident interactions and affect in residents with dementia in common areas of a residential memory care unit (n = 22; observations over one year, or 6999 minutes total).

Results: The most observed resident affect type was neutral (53.1% of all minutes observed), followed by positive affect (44.5%). The most common staff interaction type was neutral/no interaction (81.1% of all minutes observed), followed by positive staff interactions (18.1%). There was very little resident negative affect (2.4%) and staff negative interactions (.8%) observed. When staff had neutral/no/negative interactions, residents were positive 36% of the time, whereas when staff had positive interactions with them, residents were positive 81% of the time (z = 28.84, p < .001). A qualitative review of field notes identified themes and subthemes providing a more thorough understanding and context for the resident affect and staff interactions. While quantitative analyses suggested low rates of negative staff interaction, field notes highlight that neutral or no interactions with residents sometimes comprised missed opportunities, as well as more problematic lack of interaction (ignoring).

Conclusions: Not just avoiding negative interactions, but eliciting positive social interactions between staff and residents is important in promoting positive affect and overall wellbeing in persons with dementia.