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.

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 investigates the ways in which context shapes how cognitive challenges and strengths are navigated and how these actions impact the self-esteem of individuals with dementia and their conversational partners. The author examines both the language used and face maintenance in everyday social interaction through the lens of epistemic discourse analysis. In doing so, this work reveals how changes in cognition may impact the faces of these individuals, leading some to feel ashamed, anxious, or angry, others to feel patronized, infantilized, or overly dependent, and still others to feel threatened in both ways. It further examines how discursive choices made by healthy interactional partners can minimize or exacerbate these feelings. This path-breaking work will provide important insights for students and scholars of sociolinguistics, applied linguistics, medical anthropology, and health communication.

Dementia: From Diagnosis to Management - A Functional Approach is a comprehensive description of a functional and behavioral approach to assessing and treating persons with dementia. While very practical, the information is embedded in a scientific context of the causes, neuropsychological manifestations, and complications of dementia. The management of the impairments of dementia is centered on its functional consequences and impact on daily living. The chapters describe behavioral interventions and environmental strategies that aim to improve daily activities and quality of life from a proactive communication and memory basis. Specific suggestions are provided to enhance family involvement and staff relationships, interdisciplinary cooperation, reimbursement, and documentation across various home and institutional settings. The book is written in a straightforward style and is evenhanded in its critical analyses of the evidence available to inform practice. The extensive clinical backgrounds of the authors allow them to use ‘real world’ case studies to illustrate common challenges of persons with dementia and potential solutions for caregivers. Further resources and clinical materials are included in comprehensive appendices. The volume provides essential reading for clinicians and administrators who seek to improve the lives of people with dementia and those who care for them. It is also an invaluable reference for beginning students in adult language disorders and gerontology.

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.

Reconsidering Dementia Narratives explores the role of narrative in developing new ways of understanding, interacting with, and caring for people with dementia. It asks how the stories we tell about dementia – in fiction, life writing and film – both reflect and shape the way we think about this important condition. Highlighting the need to attend to embodied and relational aspects of identity in dementia, the study further outlines ways in which narratives may contribute to dementia care, while disputing the idea that the modes of empathy fostered by narrative necessarily bring about more humane care practices. This cross-medial analysis represents an interdisciplinary approach to dementia narratives which range across auto/biography, graphic narrative, novel, film, documentary and collaborative storytelling practices. The book aims to clarify the limits and affordances of narrative, and narrative studies, in relation to an ethically driven medical humanities agenda through the use of case studies. Answering the key question of whether dementia narratives align with or run counter to the dominant discourse of dementia as ‘loss of self’, this innovative book will be of interest to anyone interested in dementia studies, ageing studies, narrative studies in health care, and critical medical humanities.

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.