Conversational Repair by Individuals With Dementia of the Alzheimer's Type

Abstract

Conversational repair was examined in videotaped samples of spontaneous mealtime talk of 6 normal elderly adults, 5 subjects with early stage dementia of the Alzheimer's type (EDAT) and 5 subjects with middle stage DAT (MDAT) with a family member who acted as a conversational partner. The overall percentage of utterances involved in communication breakdown and repair and the specific proportions of utterances related to conversation problems, signals identifying problems, and repairs, were evaluated. Using the normal dyads as a control group, results showed the differential effects of DAT onset and progression on the conversational repair behavior of both subjects with DAT and their conversational partner. The percentage of conversation involved in repair was significantly higher for MDAT versus control and EDAT dyads. Despite the increase of conversational troubles with DAT onset and progression, the difficulties were repaired successfully the majority of the time. Subjects with EDAT produced more requests for repair than did their conversational partners. However, conversational partners of EDAT subjects used more elaboration repairs than did EDAT subjects. The opposite pattern was observed in the MDAT group where subjects with MDAT created and repaired more conversational problems than did their conversational partner. MDAT subjects produced more discourse trouble sources than did EDAT subjects. It was also observed that MDAT subjects and conversational partners frequently used nonspecific terms to signal misunderstandings. The findings have important implications for developing family caregiver communication enhancement strategies that are specific to the clinical stage of DAT.

Collaboration, trouble and repair in multiparty interactions involving couples with dementia or aphasia

“…It is also worthy of note, that PWD initiated repair, something that has been described as problematic in previous research (Orange et al, 1996). In conversations that involve PWD repairs are often elaborated and involve many turns (Orange et al, 1996). In many cases attempts to self-repair by the person with dementia may require quite an extended number of turns involving the need for repair support by the other person.…”

“…The repair trajectories demonstrated that for both groups the interactional repair was a collaborative process, where both spouses were actively involved. It is also worthy of note, that PWD initiated repair, something that has been described as problematic in previous research (Orange et al, 1996). In conversations that involve PWD repairs are often elaborated and involve many turns (Orange et al, 1996).…”

“…However, troubles were repaired successfully most of the time. It was also demonstrated that partners of persons with EDAT used more elaborated repairs than the persons with EDAT themselves, but that the MDAT group repaired more problems than their conversational partner (Orange et al, 1996).…”

“…Among interactional practices, collaborative strategies are often more feasible when the PWD is in the early or middle stage of dementia. In one of the few studies of repair involving PWD, Orange, Lubinski and Higginbotham (1996) compared a group of elderly people without dementia, a group of people with early stage dementia of Alzheimer type (EDAT) and a group of persons with middle stage dementia of Alzheimer type (MDAT). The results showed that the percentage of repair was significantly higher for interactions involving both groups of PWD than for interaction involving elderly without dementia.…”

A Tutorial on Multiblock Discriminant Correspondence Analysis (MUDICA): A New Method for Analyzing Discourse Data From Clinical Populations

“…A Real-World Example: Trouble-Source Repair and Topic Maintenance in Dementia of the Alzheimer's Type (DAT) Background Individuals with DAT have problems participating in meaningful conversations, and these problems worsen as the disease progresses (Guendouzi & Müller, 2002;Orange & Colton-Hudson, 1998;Orange, Lubinski, & Higginbotham, 1996;Orange, Van Gennep, Miller, & Johnson, 1998;Watson, Chenery, & Carter, 1999). This deterioration in conversational ability creates more conversational breakdowns, which, in turn, require caregivers to spend more time and effort repairing these breakdowns (Orange et al, 1996.…”