Approaches To Discourse In Dementia

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 new 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.

Preface and Acknowledgments

xi

1 Dementia and Its Discourses

1

(23)

This Book and Its Context

1

(2)

Discourse in Dementia Studies

3

(8)

Principles of Qualitative Research and Discourse as a Metacategory

8

(3)

Dementia and Dementing Diseases

11

(7)

Diagnostic Features of Dementia

12

(1)

Dementia of the Alzheimer's Type

12

(3)

Other Dementias

15

(3)

Language and Communication in Dementia

18

(1)

The Rest of This Book

19

(5)

2 Data Collection, Transcription, and Presentation

24

(18)

From Data Collection to Presentation: An Analytical Spiral

24

(1)

Preparation for Data Gathering and Getting "Raw Data"

25

(2)

Preparing the Ground: Getting Permission, Building

26

(1)

Relationships, and Gaining Trust Setting Up and Recording Interactions

27

(1)

Transcribing Data: Products and Processes

27

(4)

Transcripts and Transcribing as a Creative, Analytic Activity

28

(2)

Some Relationships That Operate in Creating and Using Transcripts

30

(1)

A Multilayered Approach to Transcribing

31

(6)

The Basic Layout

31

(6)

Practicalities of Transcribing

37

(1)

The Data in This Book

38

(4)

Participants

38

(2)

Settings

40

(1)

Data Collection and Transcription

41

(1)

3 Ethnography of Communication in Dementia and Alzheimer's Disease

42

(33)

Ethnography, AD, and Dementia

42

(1)

Ethnography of Communication

43

(29)

Context

47

(2)

SPEAKING: An Ethnographic Grid

49

(2)

Speech Communities in AD and Dementia

51

(1)

Speech Situations and Speech Events in Dementia

52

(1)

Sociolinguistic (SLX) Research Interviews

53

(6)

Exploring the SLX Interview in Interactions With and About Dementia

59

(7)

The Nursing Home Interview

66

(6)

Conclusion

72

(3)

4 Interactional Approaches

75

(19)

Interactional Sociolinguistics

75

(6)

Contextualization Cues

76

(3)

Participation Frames and Footing

79

(2)

Interaction Between Self and Society

81

(5)

Signaling Participation

82

(1)

The Data

83

(3)

The Presentation of Self Within the Nursing Home

86

(5)

Conclusions

91

(3)

5 Conversation Analysis

94

(26)

Introduction

94

(1)

Ethnomethodology and CA

95

(1)

CA Methodology

96

(7)

The Sequential Organization of Turn Taking

97

(5)

Topic Management

102

(1)

The Data

103

(15)

Turn Taking Routines

105

(8)

Preference Organization in Repairs

113

(5)

Pauses

118

(1)

Conclusion

118

(2)

6 Speaker's Meaning and Listener's Understanding: Cooperation and Doing Things With Words

120

(21)

Introduction

120

(1)

Gricean Pragmatics and the Philosophy of Conversational Cooperation

121

(6)

The Cooperative Principle and Conversational Maxims

122

(3)

Potential Problems With the Cooperative Principle, Implicature, and Calculating What Is Meant From What Is Said

125

(2)

Speech Acts: Doing Things With Utterances

127

(4)

Describing and Analyzing Speech Acts

127

(1)

Classifying Illocutionary Acts

128

(2)

Direct and Indirect Speech Act

130

(1)

Applications: Grice's Cooperative Principle and Maxims and Speech Act Theory in Dementia

131

(2)

Illocutionary Acts and Grice's Maxims: Labeling Intentions and Efficiency of Their Expression

133

(7)

The Data

134

(5)

Levels of Cooperativeness: Maxims and Beyond

139

(1)

Pragmatics and Beyond?

140

(1)

7 Critical Approaches to Discourse

141

(27)

Introduction

141

(5)

Critical Discourse Approaches

142

(1)

CDA and Discursive Psychology

143

(1)

Philosophical and Political Roots of Critical Approaches

144

(2)

The Media and Discourses of Fear

146

(2)

Critical Approaches to the Concept of Self in Dementia

148

(15)

Discursive Positioning of the Person With Dementia

150

(3)

The Social Construction of Self

153

(10)

Critical Approaches and Clinical Research

163

(2)

Self as a Complex System

163

(2)

Conclusion

165

(3)

Final Thought

167

(1)

8 Repetitiveness in Conversations With Dementia

168

(21)

Repetitive Verbal Behaviors in Dementia-and Elsewhere

168

(4)

Some Terms and Definitions

171

(1)

RVBs in Conversations With and Without Dementia

172

(7)

Data: FM and the Repetitive Use of Questions

173

(6)

A View From EC

179

(3)

A View From Conversation Management

182

(3)

RVBs, Formulas, and Nonpropositional Speech

185

(2)

Emergent Repetitiveness?

187

(2)

9 Intelligibility and Mutual Understanding in Dementia Discourse

189

(17)

Understandings of Intelligibility

189

(2)

Some Methodological Issues

191

(1)

Conversational (Online) and Analytic Intelligibility

191

(1)

The Transcriber's View

192

(3)

Overlapping Talk

194

(1)

Clarity of the Speech Signal

194

(1)

Sentence Structure and Linguistic Fluency

195

(1)

The Analyst's View

195

(7)

Turn Length

195

(1)

Turn Length, Illocutionary Acts, and Information Content

196

(3)

Collaboratively Negotiating Mutual Understanding

199

(3)

Intelligibility as a Potential

202

(2)

Conclusion

204

(2)

10 Epilogue: Future Directions

206

(3)

Appendix A: Notations and Conventions for Transcribing

209

(3)

Appendix B: Conversation Between F and J

212

(10)

Appendix C: Conversation Between F and J

222

(9)

Appendix D: Conversation Between E and M

231

(10)

Appendix E: Conversation Between MA and B (With Contributions From C and an Unidentified Resident)

241

(18)

Appendix F: Conversation Between FM, MH, and R

259

(17)

References

276

(15)

Author Index

291

(4)

Subject Index

295

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Approaches To Discourse In Dementia

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Table of Contents

Supplemental Materials