Alzheimer Discourse: Some Sociolinguistic Dimensions

Alzheimer Discourse: Some Sociolinguistic Dimensions

Alzheimer Discourse: Some Sociolinguistic Dimensions

Alzheimer Discourse: Some Sociolinguistic Dimensions


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.


A new definition of interviewing is proposed and developed in the following chapters that . . . centers on a view of the interview as a discourse between speakers and on the ways that the meanings of questions and responses are contextually grounded and jointly constructed by interviewer and respondent . . . the aim being to recover and strengthen the voice of the lifeworld, that is, individuals' contextual understandings of their problems in their own terms.

-- Elliot Mishler (1986a)

This book is about remembering and ways in which it is manifested in particular language use. Most of us go through life not pausing to consider how much of our lives depend on our ability to remember our pasts. Remembering, as Casey (1989) pointed out, goes on continually, often on several levels and in several ways at once. Our memories -- especially personal ones -- are tied integrally to our identities, to who we are and how we perceive and experience things, people, and the world in general. To fully comprehend the extent to which memory pervades our lives is not really possible. Questions about memory take us into the social environment as well as into people's personal lives.

To realize how critical memory and the act of remembering are, one need only consider instances in which people have lost their ability to remember parts of their pasts. Patients suffering from Alzheimer's disease (AD) are one such population: they constitute the heart of this study. Previous studies examining the language of these patients have been largely psycholinguistic in nature, and their primary focus has been on explaining the patients' deteriorating linguistic skills in terms of failing cognitive skills. Only in recent years has attention been devoted to examining some sociolinguistic dimensions of Alzheimer discourse (Hamilton, 1994; Ramanathan, 1995a, 1995b; Ramanathan-Abbott, 1994; Sabat, 1991), and the present study is an effort at contributing to this growing scholarship.

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