The purpose of Nursing Research, Education and Wellness Services (N-REWS) is to offer expert-consulting services in nursing and health-related research methods, nursing and health education, and clinical services for mental health and wellness.
About Christine Williams
Christine L. Williams, DNSc, APRN, PMHNP-BC, AHNCC-NC-BC
Professor Emerita
Florida Atlantic University, Christine E Lynn College of Nursing
orcid.org/0000-0003-3740-6138
Biography
Dr. Christine L Williams is an internationally-known researcher in Psychiatric mental health nursing and gerontology. Following a 40-year academic career as a researcher/educator/advanced practice nurse, and after 12 years of dedicated teaching, research and leadership at Florida Atlantic University (FAU), she retired from the Florida Atlantic University College of Nursing August 9, 2019 to devote time to research, mentorship and consulting. Dr. Williams designed and tested a groundbreaking research program to help older married couples affected by Alzheimer’s disease to overcome communication barriers common in dementia. Currently, she divides her time as author, educator, mentor, researcher, coach and psychiatric mental health nurse practitioner.
Dr. Williams is an expert on the unique relationship between persons with dementia and their caregiver spouses. She has developed an intervention to improve mutual understanding, and thereby strengthen marital relationships. She has published numerous articles supporting the value of her intervention “Communicating about emotions and relationships (CARE).” Her research methods include quantitative and qualitative approaches including instrument development.
Over 6 million people have Alzheimer’s disease in the US and 11 million Americans are unpaid caregivers, 10% spouses. Communication is vital to maintaining an intimate relationship with a spouse and is linked to marital satisfaction and better mental health in both partners. Language problems such as finding the right word, repeating the same word or question over and over, and substituting one word for another are common in Alzheimer’s disease. As a result, couples begin to suffer isolation, depression, and estrangement.
Caregivers of persons with Alzheimer’s disease or other types of dementia may be well-meaning but can still frustrate their spouses with the wrong approach. For example, a caregiver may choose to go over a family photo album and ask the afflicted spouse if he or she remembers the family vacation in Wyoming in 2005. When the person with dementia cannot remember, both parties end up feeling terrible. Clearly, that’s not an effective communication strategy. Dr. Williams calls this “disabling conversation.”
Step by step, communication can increase understanding without increasing tension and unhappiness. The CARE intervention is a 10-week program to help couples improve their communication. To get started, here are some simple tips:
Tips for communicating with your spouse with Alzheimer’s disease
1. Share news of the day
Share news about family and friends and the daily agenda so that your family member with memory loss is still involved in everyday life.
2. Expectant waiting
Set aside a small amount of time when you are not busy and distracted – just to talk. Focus on being open to whatever your family member considers important. You don’t need to keep talking. It’s OK to sit quietly together and let your family member break the silence.
3. Connect
Communicating is more than talking or exchanging information. You can communicate without words. What is your voice saying? Does it show compassion, impatience, love, or disrespect? Are you communicating what you intend? Is the message one of caring?
4. Search for ways to communicate
Try multiple ways of engaging. Try a new topic, a touch, a smile, or a song.
5. Accept their story
Listen without correcting. Honor your family member’s efforts to communicate even if you disagree with “the facts”. Being “right” is not as important as being supportive.
6. Share memories
Couples share special memories. Rather than ask, “Do you remember the time…” Share the memory freely. Offer memories of special times. Think of it as a gift. Start with “I remember when…”
7. Tell stories
Tell a story about shared interests, what you are reading, what you noticed about people, events, or nature. These are everyday stories that can help you stay engaged with your family member.
8. Create a caring environment
By creating predictability and a supportive environment, you are making it possible for your family member to take the risk to join into conversations. Being corrected or ignored is painful and can encourage a someone with a memory problem to give up trying.
9. Give compassionate care
When a family member with a memory problem needs help, provide it with compassion. Use words and gestures to express your affection as you offer help. While love may have been taken for granted before, it needs to be openly expressed now.
10. Delight in unexpected responses
There will be moments of clarity, shared humor, or times when your family member will let you know that you are appreciated. Feelings are beyond words. Appreciate and cherish those special moments.
Program of Research
Research focus over the last 30 years
- Depression in individuals with Alzheimer’s disease and related dementias (ADRD)
- Depression in family caregivers (especially those caring for someone with ADRD or stroke)
- Marital communication in couples affected by ADRD
- Social engagement for older adults with ADRD: Guidelines for virtual group facilitators
- Cognitive screening for older adults at risk for ADRD
- Cognitive screening and knowledge about ADRD
- in Black, Hispanic/Latino ethnic groups
- in rural and urban environments
- Risk factors for cognitive decline
- chronic health conditions
- lifestyle
- social determinants of health
- exposure to air pollution
- but environment and green space
Sample publications
Williams, C. (2011). Marriage and mental health: When a spouse has Alzheimer’s disease. Archives of Psychiatric Nursing, 25(3), 220-222.
Williams, C. (2011). What spouse caregivers know about communication in Alzheimer’s disease: Development of the AD Communication Knowledge Test. Issues in Mental Health Nursing, 32, 28–34.
Williams, C., Parker, C. (2012). Development of an observer rating scale for caregiver communication in persons with Alzheimer’s disease, Issues in Mental Health Nursing, 33, 244-250. DOI: 10.3109/01612840.2011.653040.
Williams, C.L., Newman, D., Marmstål Hammar, L.M. (2017). Preliminary psychometric properties of the Verbal and Nonverbal Interaction Observational Measure for communication in persons with dementia. Issues in Mental Health Nursing, 5, 381-390.
Williams, C.L., Newman, D., Marmstål Hammar, L.M. (2018). Preliminary study of a communication intervention for family caregivers and spouses with dementia. International Journal for Geriatric Psychiatry, 33(2), e343-e349.
Williams, C.L., Newman, D., Neupane Poudel, B. (2021). When an aging spouse has dementia: Impact of a home-based intervention on marital communication. Issues in Mental Health Nursing, 42(10):960-966.
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