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This book deals with the narrative discourse--specifically lifestories--of 16 patients suffering from Alzheimer's disease (AD). It attempts to understand the discourse of these patients in contextual terms. Thus far, the dominant explanation for "incoherence" in AD speech has been largely provided by research in psycholinguistics, much of which has understood AD speech in terms of the progressively deteriorating nature of the disease. This study provides a complementary view by examining ways in which some social factors--audiences, setting, and time--influence the extensiveness and meaningfulness of AD talk. By offering both an examination of interactions across the data as well as analyzing particular cases in detail, this unusual study attempts to juxtapose some general insights regarding AD discourse with case-specific ones. Sociolinguistic analyses of the data demonstrate how certain audiences and particular settings set in motion discourse activities that either facilitate the patients' ability to recall their pasts or impede it. This analysis also includes a critical look at the researcher's contribution in negotiating and reinforcing these activities. Ethnographic details about the social worlds of some of these patients shed light on how larger social contexts at least indirectly contribute to exacerbating the patients' conditions or stabilizing them. The analyses of both context and language provides a more global understanding of the Alzheimer experience. This study also discusses some interactional strategies by which professionals can begin to engage AD patients in meaningful talk as well as ways by which they can better "hear" AD patients' cues at narrating. Throughout, this book underscores the need to factor in social factors when making assessments regarding AD patients' communicative abilities.
Alison Wray notes that “Alzheimer’s Disease affects language in many different ways. Directly, language processing is undermined by damage to the language areas of the brain. Indirectly, language is compromised by short term memory loss, distortions in perception, and disturbed semantic representation . . . All of this makes AD an obvious focus of interest for linguists and in particular, those interested in the field of pragmatics – yet a striking amount of what is published about AD language is written by non-linguists. AD language is independently researched in at least psychology, neuroscience, sociology, clinical linguistics and nursing. Each discipline has its own methods, theories, assumptions and values, which affect the research questions asked, the empirical approach taken in answering them, and how the evidence is interpreted. Without a more reliable holistic picture informed by linguistic and applied linguistic theory and methods, approaches to diagnosis and care risk being constrained, and may result in a less than satisfactory experience for all those whose daily life involves the direct or indirect experience of AD.” This book is an attempt to address some of the above issues noted by bringing together a group of researchers whose work focuses on interaction in the context of dementia. The authors represent the fields of linguistics, clinical linguistics, nursing, and speech pathology, and each chapter draws on methods associated with discourse analysis and pragmatics to examine how people with dementia utilize language in the presence of cognitive decline. In addition, the book seeks to generate academic discussion on how researchers can move forward to focus greater attention on this topic. In particular, this collection will inspire researchers involved in mainstream theoretical linguistics and pragmatics to turn their attention to the discourse of dementia and investigate what it has to say about our knowledge of language theories, and, in addition, to challenge what we know about ourselves as subjective beings.
This book offers an in depth analysis of the interactional challenges that arise due to various dementias and in a variety of social contexts. By assessing conversations between persons with dementia and their family members, caregivers, and clinicians, it shares insights into both the language and actions selected by the participants. Using several different research methods, authors highlight competencies and areas of struggle, as well as choices that ease interactions along with those that seem to complicate them. Each chapter provides practical strategies to help readers better navigate day-to-day interactions with persons with dementia. The book is part of a continuing effort to offer guidance and hope to those for whom such conversations have become part of their daily lives. It presents concrete recommendations for specific groups such as family members, caregivers, and clinicians; it will also be of interest to researchers in the field of dementia and early career scholars interested in the methodologies discussed.
The qualitative analysis of naturally occurring discourse in neurogenic communication disorders, specifically in dementia studies, has experienced recent burgeoning interest from wide-ranging disciplines. This multidisciplinarity has been exciting, but has added contextual confusion. This book advances the study of discourse in dementia by systematically exploring and applying different approaches to the same free conversational data sets, collected and transcribed by the authors. The applied methodologies and theories comprise a useful sourcebook for students, researchers, and practitioners alike.
The qualitative analysis of naturally occurring discourse in neurogenic communication disorders, specifically in dementia studies, has experienced recent burgeoning interest from wide-ranging disciplines. This multidisciplinarity has been exciting, but has added contextual confusion. This book advances the study of discourse in dementia by systematically exploring and applying different approaches to the same free conversational data sets, collected and transcribed by the authors. The applied methodologies and theories comprise a useful sourcebook for students, researchers, and practitioners alike.
This study juxtaposes philosophical analysis and clinical experience to present an overview of the issues surrounding dementia. It conveys a strong ethical message, arguing in favour of treating people with dementia with all the dignity they deserve as human beings.
The contributors to this volume reference a shared, longitudinal corpus of spontaneous conversation elicited in natural settings from speakers with moderate to late moderate Alzheimer's Disease, utilizing other collections as appropriate, to analyze conversation, discourse and written text by and about Alzheimer's speech. Cross-disciplinary contributions from the USA, Canada, New Zealand and Germany, representing linguistics, gerontology, geriatric nursing, computer science, and communications disorders report on empirically-based investigations of social and pragmatic language competencies and strategies retained by AD patients which could ground communication enhancements or interventions.
As the essays in this volume show, conceptualizing dementia has always been a complex process. With contributions from noted professionals in psychiatry, neurology, molecular biology, sociology, history, ethics, and health policy, Concepts of Alzheimer Disease looks at the ways in which Alzheimer disease has been defined in various historical and cultural contexts. The book covers every major development in the field, from the first case described by Alois Alzheimer in 1907 through groundbreaking work on the genetics of the disease. Essays examine not only the prominent role that biomedical and clinical researchers have played in defining Alzheimer disease, but also the ways in which the perspectives of patients, their caregivers, and the broader public have shaped concepts.
Alzheimer's disease is a degenerative brain disease which has major social consequences for the individuals affected and for those people who are emotionally and/or physically close to them. The role which language plays in such relationships stands at the centre of this book. In contrast to traditional analyses carried out by psycholinguists, neurologists and speech pathologists, with speech samples elicited in clinical settings, Heidi Hamilton examines language in the life of one elderly female Alzheimer's patient from an interactional sociolinguistic perspective. The language of open-ended, naturally occurring conversations between the patient and the author, over four-and-a-half years, is investigated in an attempt to understand how the patient's communicative abilities and disabilities are related and how they change over time, and, importantly, how they are influenced by pre-emptive and reactive communicative behaviours on the part of the patient's healthy interlocutor.