Narrative Discourse Patterns In Dementia

Application of analytic discourse techniques to clinical practice is relatively recent. This book's contributors begin with the notion that systematic examination of discourse provides a rich source of data for describing the complex relationships among language, social context, and the cognitive processes that underlie discourse comprehension and production. Evidence is provided that when discourse is studied across different clinical populations, analysis yields an optimal opportunity for developing dynamic models of brain and language that more thoroughly account for the complexity of language use in social contexts. Accordingly, studies presented in this volume have a dual focus -- to examine the implications of discourse research on neurolinguistic theories and to evaluate the contribution of discourse analysis to understanding the clinical status of patients with brain damage. As such, this volume reports patterns of preserved and impaired discourse behavior in normal adults and in different adult clinical populations. It also describes numerous tasks designed to elicit a variety of discourse genres and a host of techniques created to describe how subjects order information and relate ideas across sentences. In addition, it includes numerous abstract units and linguistic devices targeted to examine those aspects of discourse that govern cohesion, organization, and topic manipulation. This volume is unique because it presents both theoretical and clinical papers that examine a variety of communication pathologies. Clinicians often report dissatisfaction with formal test batteries in that results are often at variance with clinical observation of performance in real life situations. To address this concern, this work proposes methods for examining discourse that move the examiner closer to naturalistic sampling. The research presented demonstrates that discourse analysis provides clinically significant information that contributes to the understanding of the cognitive, linguistic, and social status of people with communication disorders. These studies also offer a framework to support continuously evolving diagnostic and treatment paradigms for adults with neurological communication pathologies.

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 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.

Multicultural backgrounds are taken into consideration when dealing with assessment, intervention and education."--BOOK JACKET.

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.

Multicultural backgrounds are taken into consideration when dealing with assessment, intervention and education."--BOOK JACKET.

Taking its cues from both classical and post-classical narratologies, this study explores both forms and functions of the representation of dementia in Anglophone fictions. Initially, dementia is conceptualised as a narrative-epistemological paradox: The more those affected know what it is like to have dementia, the less they can tell about it. Narrative fiction is the only discourse that provides an imaginative glimpse at the subjective experience of dementia in language. The narratological modelling of four ‘narrative modes’ elaborates how the paradox becomes productive in fiction: Depending on the narrative perspective taken, but also on the type of narration, the technique for representing consciousness and the epistemic strategy of narrating dementia, the respective narrative modes come with different prerequisites and possibilities for narrating dementia. The analysis of four contemporary Anglophone dementia fictions based on the developed model reveals their potential functions: Fiction allows readers to learn about the challenges of dementia, grants them perspective-taking, it trains cognitive flexibility, and explores the meaning of memory, knowledge, narrative and imagination, and thus also offers trajectories of a cultural coping with dementia.

This book is open access under a CC BY 4.0 license. This is the first book-length exploration of the thoughts and experiences expressed by dementia patients in published narratives over the last thirty years. It contrasts third-person caregiver and first-person patient accounts from different languages and a range of media, focusing on the poetical and political questions these narratives raise: what images do narrators appropriate; what narrative plot do they adapt; and how do they draw on established strategies of life-writing. It also analyses how these accounts engage with the culturally dominant Alzheimer’s narrative that centres on dependence and vulnerability, and addresses how they relate to discourses of gender and aging. Linking literary scholarship to the medico-scientific understanding of dementia as a neurodegenerative condition, this book argues that, first, patients’ articulations must be made central to dementia discourse; and second, committed alleviation of caregiver burden through social support systems and altered healthcare policies requires significantly altered views about aging, dementia, and Alzheimer’s patients.