Abstract
Research with health care aides in long-term care facilities suggests that a determinant of quality and a mediator between staffing and quality is the relationship between aides and residents (Bowers BJ, Esmond S, Jacobson N. J Nurs Care Qual. 2000;14(4):55-64). However, articulating and measuring what constitutes a meaningful relationship between a care provider and a person with dementia, who is unable to communicate verbally, is difficult. An observational scale developed to assess care providers' relational behaviors is described as one way of measuring the quality of the care provider-resident relationship. Conditions that enhance care providers' relational behaviors in practice are also addressed.