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Abstract

Background: The communication skills of older adults living in care homes is an underexplored topic. Aging can lead to reduced communication ability and activity; and in the care home environment, there may also be fewer communication opportunities. This situation is likely to negatively impact wellbeing. Previous reviews have found evidence of the effectiveness of behavioural interventions in increasing wellbeing, but no systematic review to date has focused specifically on the evidence base for group language and communication interventions in this population.
Aims: To identify and evaluate the evidence for behavioural interventions with older adults, delivered in groups in residential settings, that specifically included a language or communication activity. To explore the impact of such intervention on the specific domains of language, communication and social interaction. To determine whether behavioural mechanisms of action can be identified.

Methods: Embase, Medline, Ovid Nursing database, Psych info, and CINAHL complete were searched and produced 158 records for screening, of which 22 remained for review. In order to identify and evaluate the quality of the evidence base presented the following research questions were posed: What research has been conducted in this area? What is the methodological quality of the studies identified? How complete is the intervention reporting? How was change measured in the domains of language, communication and social interaction? Is there evidence of efficacy, indicated by statistically significant improvement, in these domains? How did the interventions work? Synthesis tools employed included the PEDro-P Scale, the TIDieR checklist and the ITAX.

Main Contribution: 22 studies met the criteria for review. One of the studies used solely language or communication interventions, but the remaining 21 studies used behavioural interventions which incorporated language and communication activities to varying degrees. Studies fell into 4 broad intervention types: Reminiscence or Life Review, Cognitive Stimulation, Narrative or Storytelling, and Multi-modality Group Communication. The majority of studies were of fair methodological quality, with a moderate level of detail provided in treatment reporting. Statistically significant improvement was reported by authors in all 4 intervention types and across language, communication and social domains. Social interaction, social support, and behavioural skills were the most consistent mechanisms of action in the reviewed behavioural interventions.

Conclusion: Despite limitations in the evidence base there are important positive signs for the beneficial effects of supporting language and communication in care homes. Blinding of assessors, and the accuracy and accessibility of statistical reporting are important areas to address in order to improve the quality of the evidence base.

What this paper adds
Aging can lead to reduced communication ability and activity, and in the care home setting, there may also be fewer communication opportunities. This situation is likely to negatively impact wellbeing. Previous reviews have found evidence of the effectiveness of behavioural interventions in increasing wellbeing. The communication skills of older adults living in care homes is an underexplored topic. No systematic review to date has focused specifically on the evidence base for group language and communication interventions in this population. This review reveals important positive signs for the beneficial effects of supporting language and communication in care homes. Social interaction, social support, and behavioural skills were the most consistent mechanisms of action in the reviewed behavioural interventions.

Publication Type:	Article
Additional Information:	This is the peer reviewed version of the following article: Davis, L., Botting, N. , Cruice, M. and Dipper, L. (2021). A systematic review of language and communication intervention research delivered in groups to older adults living in care homes. International Journal of Language and Communication Disorders, which is published in final form at https://doi.org/10.1111/1460-6984.12679. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
Subjects:	B Philosophy. Psychology. Religion > BF Psychology P Language and Literature > P Philology. Linguistics R Medicine > RA Public aspects of medicine
Departments:	School of Health & Psychological Sciences > Language & Communication Science
SWORD Depositor:	Symplectic Administrator

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