The Silent Impact of Ageist Communication in Long-Term Care Facilities

Mixed Methods Research Design

 An analysis of M. Lagacé, A. Tanguay, M.-L. Lavallée, J. Laplante and S. Robichaud’s research article “The silent impact of ageist communication in long-term care facilities: Elders’ perspectives on quality of life and coping strategies” In their research article, “The silent impact of ageist communication in long-term care facilities: Elders’ perspectives on quality of life and coping strategies” (2012), M. Lagacé, A. Tanguay, M.-L. Lavallée, J. Laplante and S. Robichaud use a mixed methods research design, combining quantitative and qualitative techniques, to produce an argument on how improved communications between seniors and staff can be a powerful tool that directly determines seniors’ perceived quality of life in long-term care facilities in Canada. Their argument is vital to social service workers who regularly wrestle with the issue of how best to help seniors cope with the ageism they sometimes face, ironically, in their encounters with the staff who are entrusted with their care while residing in these facilities. Two key reasons are offered to support the authors’ conclusion. First, from the very beginning of their stay at long-term care facilities, social interactions are obviously an important component of seniors’ experience because these interactions punctuate their transition from living independently, whether alone or with family members, to living in a new kind of community in such an institutional home (p. 336). Secondly, communication with caregivers can help with the ever-declining level of physical (or bodily) functions of the elders, which usually dramatically disrupts their sense of dignity and integrity, and this can be discouraging and worrisome for them (p. 338). Thus, declining physical functions usually trigger psychological distress, which in turn only worsens seniors’ physical functions. The result is a vicious cycle of mutually reinforcing adverse conditions—causes and effects—that can make the experience of aging in a facility downright hellish (p. 339). For their primary research and key evidence, the researchers interviewed several elders who are cognitively intact and are living in a long-term care facility in the province of Québec. Through the data gathered, the authors concluded that communication with caregivers has a huge impact on seniors’ perceived quality of life in long-term care facilities; furthermore, though not yet noted by previous researchers, the researchers discovered that elders often come up with coping mechanisms against ageism through accommodation (p. 340). Even though Lagacé et al neatly document the adverse effects of ageist communication patterns often found in caregivers’ way of talking to elders, their use of a small convenience sample, the validity and bias of the information they gather, and various details about statistics which they omitted make their argument less persuasive than it otherwise would be. The researchers’ method of selecting the sample was problematic in this study. Participants were ultimately picked by the facility’s supervisors, though the participants were initially informed through a letter of information written by the researchers. The potential participants were initially short-listed and eventually picked based on the nurses’ assessment of their ability to complete the interview. For this process to be established at the outset of the study must be considered a major flaw. First, the elders did not have any common identity nor disease that determined their physical level of function and their required assistance of care that would determine the amount of social interaction with the caregivers, which is a key determinant in the reliability of the interview results. Secondly, the elders shared no other noted similarities other than living in the same long-term care facility in the province of Québec. To make matters worse, the researchers allowed for a huge age range to open up amongst the participants. The age range is from 60 to 100. The sample size totalled only 33 elders, far too small for a study on such a serious research question. Also, the fact that it was merely a convenience sample—where the researchers’ convenience trumps efforts to construct a random sample—makes this study’s primary research even less persuasive. Another significant problem with the study’s primary research evidence is its validity and the study’s fairly obvious bias. The kinds of questions posed by the researchers tend to lead respondents directly towards the sorts of answer that the researchers are expecting and clearly hoping for in order to confirm their hypothesis. Participants were asked, “Do you sometimes have the impression that caregivers...” “talk to you as if you were a child?” ... “try to control the conversation?” ... “ignore what you are saying?" ... “order you around?”(p.338) The questions on ageism were open-ended questions and seemed to aim at what the authors wanted to hear. The interview was concluded with a pair of open-ended questions in order to elicit the participants’ general perception of their quality of life: “Are you generally satisfied with the quality of life in this residence?” and “How would you describe the place where you're living now?” (p.338) Finally, the interviewers asked the elders questions about how they were able to cope with what they felt about their caregivers. These types of questions seemed designed to bring negative thoughts to the surface, contrary to the natural human tendency to give negative comments first, as if the researchers wished to sustain the flow of critical feedback on caregivers coming from the seniors. These might even be called leading questions. Factors like these made the argument less convincing. There were several pieces of significant information that were omitted in the article. The authors consistently used percentages to summarize their data, without providing the absolute numbers they are founded on. For example, “Precisely, 70% provided examples of caregivers' controlling [their] language and attitudes; furthermore, 63.6% emphasized the presence of infantile patterns of communication” (p. 338). With a sample size of only 33, it is all the more crucial that averages and absolute numbers are made explicit. Oversights like these make readers wonder about the validity of the argument and about what other significant information was omitted. There were no tables or charts in the article portraying the data that was gathered and the trends found in the data which the reader might consult in order to more carefully consider how the data was being interpreted and analyzed. Moreover, since the study was conducted in the province of Québec, most of the information was translated by the authors from French to English. The problem here is that translation tends to smooth over and clear out some relevant information and important discrepancies in the interviewees’ responses that may be useful in developing a balanced and critical perspective on the article. In the end, readers have good reason to wonder about the overall reliability of the article’s evidence and how that evidence was interpreted by the authors. The research question tackled by these authors is too important to be handled in anything less than a fully methodical manner. It is too important for us all. As the article’s subtitle makes clear, the authors deserve credit for putting “Elders’ perspectives” at the centre of their research project. However, despite the originality of some aspects of the article’s argument, including its spotlight on techniques seniors sometimes use to deflect or absorb ageist communication traits in their caregivers’ habits, and despite the researchers’ obviously good intentions, as a piece of social science research, the article leaves much to be desired. Reading this article is likely to make social service workers feel unsatisfied and eager to look for similar studies that are better designed and executed. Reference Lagacé, M., Tanguay, A., Lavallée, M.-L., Laplante, J., & Robichaud, S. (2012). The silent impact of ageist communication in long-term care facilities: Elders' perspectives on quality of life and coping strategies. Journal of Aging Studies, 26, 335-342. SECONDA ARTICLE EXAMPLE In their research article, “The silent impact of ageist communication in long-term care facilities: Elders’ perspectives on quality of life and coping strategies” (2012), M. Lagacé, A. Tanguay, M.-L. Lavallée, J. Laplante and S. Robichaud use a mixed methods research design, combining quantitative and qualitative techniques, to produce an argument on how improved communications between seniors and staff can be a powerful tool that directly determines seniors’ perceived quality of life in long-term care facilities in Canada. Their argument is vital to social service workers who regularly wrestle with the issue of how best to help seniors cope with the ageism they sometimes face, ironically, in their encounters with the staff who are entrusted with their care while residing in these facilities. Two key reasons are offered to support the authors’ conclusion. First, from the very beginning of their stay at long-term care facilities, social interactions are obviously an important component of seniors’ experience because these interactions punctuate their transition from living independently, whether alone or with family members, to living in a new kind of community in such an institutional home (p. 336). Secondly, communication with caregivers can help with the ever-declining level of physical (or bodily) functions of the elders, which usually dramatically disrupts their sense of dignity and integrity, and this can be discouraging and worrisome for them (p. 338). Thus, declining physical functions usually trigger psychological distress, which in turn only worsens seniors’ physical functions. The result is a vicious cycle of mutually reinforcing adverse conditions—causes and effects—that can make the experience of aging in a facility downright hellish (p. 339). For their primary research and key evidence, the researchers interviewed several elders who are cognitively intact and are living in a long-term care facility in the province of Québec. Through the data gathered, the authors concluded that communication with caregivers has a huge impact on seniors’ perceived quality of life in long-term care facilities; furthermore, though not yet noted by previous researchers, the researchers discovered that elders often come up with coping mechanisms against ageism through accommodation (p. 340). Even though Lagacé et al neatly document the adverse effects of ageist communication patterns often found in caregivers’ way of talking to elders, their use of a small convenience sample, the validity and bias of the information they gather, and various details about statistics which they omitted make their argument less persuasive than it otherwise would be. The researchers’ method of selecting the sample was problematic in this study. Participants were ultimately picked by the facility’s supervisors, though the participants were initially informed through a letter of information written by the researchers. The potential participants were initially short-listed and eventually picked based on the nurses’ assessment of their ability to complete the interview. For this process to be established at the outset of the study must be considered a major flaw. First, the elders did not have any common identity nor disease that determined their physical level of function and their required assistance of care that would determine the amount of social interaction with the caregivers, which is a key determinant in the reliability of the interview results. Secondly, the elders shared no other noted similarities other than living in the same long-term care facility in the province of Québec. To make matters worse, the researchers allowed for a huge age range to open up amongst the participants. The age range is from 60 to 100. The sample size totalled only 33 elders, far too small for a study on such a serious research question. Also, the fact that it was merely a convenience sample—where the researchers’ convenience trumps efforts to construct a random sample—makes this study’s primary research even less persuasive. Another significant problem with the study’s primary research evidence is its validity and the study’s fairly obvious bias. The kinds of questions posed by the researchers tend to lead respondents directly towards the sorts of answer that the researchers are expecting and clearly hoping for in order toconfirm their hypothesis. Participants were asked, “Do you sometimes have the impression that caregivers…” “talk to you as if you were a child?” … “try to control the conversation?” … “ignore what you are saying?" … “order you around?”(p.338) The questions on ageism were open-ended questions and seemed to aim at what the authors wanted to hear. The interview was concluded with a pair of open-ended questions in order to elicit the participants’ general perception of their quality of life: “Are you generally satisfied with the quality of life in this residence?” and “How would you describe the place where you're living now?” (p.338) Finally, the interviewers asked the elders questions about how they were able to cope with what they felt about their caregivers. These types of questions seemed designed to bring negative thoughts to the surface, contrary to the natural human tendency to give negative comments first, as if the researchers wished to sustain the flow of critical feedback on caregivers coming from the seniors. These might even be called leading questions. Factors like these made the argument less convincing. There were several pieces of significant information that were omitted in the article. The authors consistently used percentages to summarize their data, without providing the absolute numbers they are founded on. For example, “Precisely, 70% provided examples of caregivers' controlling [their] language and attitudes; furthermore, 63.6% emphasized the presence of infantile patterns of communication” (p. 338). With a sample size of only 33, it is all the more crucial that averages and absolute numbers are made explicit. Oversights like these make readers wonder about the validity of the argument and about what other significant information was omitted. There were no tables or charts in the article portraying the data that was gathered and the trends found in the data which the reader might consult in order to more carefully consider how the data was being interpreted and analyzed. Moreover, since the study was conducted in the province of Québec, most of the information was translated by the authors from French to English. The problem here is that translation tends to smooth over and clear out some relevant information and important discrepancies in the interviewees’ responses that may be useful in developing a balanced and critical perspective on the article. In the end, readers have good reason to wonder about the overall reliability of the article’s evidence and how that evidence was interpreted by the authors. The research question tackled by these authors is too important to be handled in anything less than a fully methodical manner. It is too important for us all. As the article’s subtitle makes clear, the authors deserve credit for putting “Elders’ perspectives” at the centre of their research project. However, despite the originality of some aspects of the article’s argument, including its spotlight on techniques seniors sometimes use to deflect or absorb ageist communication traits in their caregivers’ habits, and despite the researchers’obviously good intentions, as a piece of social science research, the article leaves much to be desired. Reading this article is likely to make social service workers feel unsatisfied and eager to look for similar studies that are better designed and executed. Reference Lagacé, M., Tanguay, A., Lavallée, M.-L., Laplante, J., & Robichaud, S. (2012). The silent impact of ageist communication in long-term care facilities: Elders' perspectives on quality of life and coping strategies. Journal of Aging Studies, 26, 335-342. 1. Review the issue addressed by the researcher 2.plan your analysis 3. Compose your analysis 4. REFERENCE