Alzheimer Discourse: Some Sociolinguistic Dimensions

By Via Ramanathan | Go to book overview

7
Some Implications and Conclusions

Theorizing about the structure, forms, and rules of social action requires . . . [a] type of narrative analysis that preserves the complex ordering of actions and reactions that constitute social reality . . . [T] he story contains a sequence of socially meaningful acts without which it would not be a story; its analysis therefore provides the basis for a direct interpretation of a complex unit of social interaction, in comparison to the standard approach where such inferences are based on decontextualized bits and pieces.

-- Elliot Mishler ( 1986b)

A primary aim of the present volume has been to provide a complementary view toward understanding the deteriorating linguistic abilities of Alzheimer's disease (AD) patients. Instead of viewing "incoherence" in AD speech strictly in cognitive terms, (i.e., due to some malfunction in the brain) this study has attempted to show that the patient's inability to talk extensively and meaningfully is partially tied to audience turns and to the patient's social world. Lubinski ( 1991) mentions some ways in which the "perception of incompetence associated with dementia determines the social and communicative opportunities the individual will have and eventually the care that the individual will receive" (p. 142). Certainly, Ellie seemed to follow this route: When her rating fell from the "good" to the "chair" type, communicative opportunities were almost nonexistent. Although it is not this kind of classification that Lubinski is talking about, it is certainly applicable. Caregivers, as she points out, often segregate individuals in their "best interest," locking doors, isolating them from the world of activity, and restraining them to particular areas. As the ethnographic details in chapter 6 underscore, all of these are features remniscent of the operations at the day-care center that Ellie attended, where AD patients are housed in an enclosed area with their movements very closely monitored.

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