Amyloid

Daily communication between people with Alzheimer's

Over their years together, family members often develop assumptions and expectations about their conversational roles and responsibilities. With the onset and progression of Alzheimer's, the person with dementia becomes less able to speak as others have always expected him or her to. Impaired word finding is often the first, most noted difficulty. Shortened attention span and/or impaired recent memory results in the individual no longer being able to follow another speaker's retelling of the day's events. In an attempt to participate in the conversation, the person with dementia may say something that shows confusion or misunderstanding. He may initiate an unrelated topic because he cannot remember what had just been discussed. These responses are not normally anticipated and may leave caregivers in a momentary quandary as to how to continue conversations.
Jeanne Katzman, CPhil, CCC/SLP of the University of California Los Angeles, examined the effects of Alzheimer's on family conversation at dinnertime. Thirty (30) families in which one member had recent onset of Alzheimer's participated in the three-year study, which began in 2001. Each family had two videotaped dinner conversations which were later transcribed and analyzed for both verbal and gestural communication. The goal was to document ordinary family communication based on naturally occurring conversation and to analyze problematic sequences.
According to Katzman, responses of healthy family members to utterances of the Alzheimer's individual were found to follow certain predictable patterns. When a response was unexpected and disrupted the normal flow of conversation, healthy family members often were observed to continue their talk almost if the person with Alzheimer's had not spoken. The healthy family members tended to pause – a sign that the utterance was indeed heard – but did not respond verbally. In such sequences, the healthy speaker's lack of response framed the Alzheimer's individual as a non-participant.
Katzman found that other families responded to each problematic utterance. In extended, multigenerational families (n=7), a healthy family member might respond with an explanation of the utterance and then speak for the person with Alzheimer's. Conversations between families with only two members (n=21) organized problematic talk in a greater variety of ways. Responses often took the form of rewording; the healthy speaker suggested what the other wanted to say, expanded upon it, and brought the contribution of the family member with Alzheimer's to a close.
"This initial research leads to an improved understanding of daily communication between people with Alzheimer's and their families. This will be used to develop new training programs that focus on facilitating conversation between family members," said Katzman. "The goals are for caregivers to have the opportunity to adjust their conversation with the changing communicative and cognitive abilities of their loved ones and for people with Alzheimer's to experience healthier participation in family discussions." ...http://www.medicalnewstoday.com