Conversing in dementia: A conversation analytic approach

Perkins, Lisa; Whitworth, Anne; Lesser, Ruth

doi:10.1016/s0911-6044(98)00004-9

Cited by 89 publications

(88 citation statements)

References 27 publications

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“…Even when accompanied to the clinic, patients with FMD only rarely sought their companions' assistance in answering questions; conversely, patients with dementia relied to a very large extent on their companions' assistance in answering. Patients with ND struggled to answer specific questions in much detail (if at all), had difficulties responding to compound questions, frequently responded "I don't know" when unable to recall information, and generally had difficulties sustaining the interaction -their memory failure impacting significantly on their ability to communicate with the neurologist during the outpatient clinic encounter [51][52][53][54]. Patients with FMD on the other hand interacted much more confidently with the neurologists, could provide numerous extended and specific examples of memory difficulties, give detailed answers going beyond the parameters of the question and they could handle and recall all parts of compound questions.…”

Section: Discussion -Summarymentioning

confidence: 99%

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Towards diagnostic conversational profiles of patients presenting with dementia or functional memory disorders to memory clinics

Elsey

Drew

Jones

et al. 2015

Patient Education and Counseling

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YesObjective\ud \ud This study explores whether the profile of patients’ interactional behaviour in memory clinic conversations with a doctor can contribute to the clinical differentiation between functional memory disorders (FMD) and memory problems related to neurodegenerative diseases.\ud \ud Methods\ud \ud Conversation Analysis of video recordings of neurologists’ interactions with patients attending a specialist memory clinic. “Gold standard” diagnoses were made independently of CA findings by a multi-disciplinary team based on clinical assessment, neuropsychological testing and brain imaging.\ud \ud Results\ud \ud Two discrete conversational profiles for patients with memory complaints emerged, including (i) who attends the clinic (i.e., whether or not patients are accompanied), and (ii) patients’ responses to neurologists’ questions about memory problems, such as difficulties with compound questions and providing specific and elaborated examples and frequent “I don’t know” responses.\ud \ud Conclusion\ud \ud Specific communicative difficulties are characteristic of the interaction patterns of patients with a neurodegenerative pathology. Those difficulties are manifest in memory clinic interactions with neurologists, thereby helping to differentiate patients with dementia from those with FMD.\ud \ud Practical implications\ud \ud Our findings demonstrate that conversational profiles based on patients’ contributions to memory clinic encounters have diagnostic potential to assist the screening and referral process from primary care, and the diagnostic service in secondary care

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Section: Discussion -Summarymentioning

confidence: 99%

“…The prevalence of head-turning indicates recall difficulties and conversational problems in general. ND patients frequently defer questions to their companions to fill in their memory gaps [46,51,52].…”

Section: Figurementioning

confidence: 99%

Towards diagnostic conversational profiles of patients presenting with dementia or functional memory disorders to memory clinics

Elsey

Drew

Jones

et al. 2015

Patient Education and Counseling

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“…In more advanced phases of dementia communicative problems may even result in what sometimes could be called communicative breakdowns because collaboration between the participants was not possible due to the fact that the PWD has access to a very limited set of cognitive and linguistic resources (Perkins, Whitworth & Lesser, 1998). Among interactional practices, collaborative strategies are often more feasible when the PWD is in the early or middle stage of dementia.…”

Section: Repair Aphasia and Dementiamentioning

confidence: 99%

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

Samuelsson

Hydén

2016

International Journal of Speech-Language Pathology

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Purpose: The aim of the present study was to identify problems with communication with persons with aphasia and persons with dementia in a collaborative interview setting with their significant others. In particular, to compare interactional practises used in order to resolve problems caused by specific symptoms.Method: Five persons with aphasia and five persons with dementia and their spouses participated in the present study. Interviews were carried out couple by couple, and the interviews had a task-oriented character with a main focus on interactive and communicative aspects rather than on topical content. The interviews were video and audio recorded. All interviews were transcribed according to conversation analytic principles. Result:The results demonstrated that repair sequences were frequent in interaction involving PWA, and even more so in interaction involving PWD. In general, it was the PWA/PWD that initiated the repair sequence more often than the spouse, thus keeping to the general rule of a preference for self-initiated repair compared to other-initiated repair. Conclusion:The active involvement of the conversational partners in trouble solving sequences in interaction with PWA/PWD demonstrated in the present study indicates that the interactional style of the conversational partner to PWA/PWD are important. This implies that conversation partner training programmes would be useful both for PWA and for PWD.

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“…Hierzu zählt z. B. die Einschätzung der angemessenen Pausenlänge nach Fragen, die vom alltäglichen Interaktionsgefühl des Testenden gelenkt wird, für Demenzpatienten jedoch typischerweise zu kurz ist (Sabat 1991(Sabat , 1999Perkins et al 1998;Ramanathan 1997: 53-88 (Garfinkel 1967: 40) grçßere kognitiv-mnemonische Fähigkeiten interpretiert werden als tatsächlich noch vorhanden sind. Dies führt dazu, dass auf Seiten der Angehçrigen und Pfleger ständig Erwartungen erzeugt werden, die von den Menschen mit Demenz nicht erfüllt werden kçn-nen, was dann als "Boshaftigkeit" oder "Egozentrik" gedeutet wird.…”

Section: Was Ist Demenz?unclassified

“…Perkins et al 1998;Hamilton 1994: 51 für ein Beispiel). Auf der anderen Seite besteht die Fähigkeit, die Gefühle des Gegenübers zu antizipieren, noch bis in das mittlere und sogar späte Stadium fort, wie etwa eine nachhaltige Freude daran zeigt, Komplimente zu verteilen und eine das Gegenüber aufwertende Sprache zu verwenden.…”

Section: B) Bezug Zu Geteiltem Wissenunclassified

Menschen mit Demenz als Interaktionspartner. Eine Auswertung empirischer Studien vor dem Hintergrund eines dimensionalisierten Interaktionsbegriffs / People with Dementia as Interactional Partners: An Analysis of Empirical Studies Based on a Dimensional Concept of Interaction

Meyer

2014

Zeitschrift Für Soziologie

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Zusammenfassung: Der Anteil von Menschen mit Demenz an der Gesamtbevçlkerung Deutschlands wird mittelfristig stark zunehmen und die Begegnung mit Betroffenen aufgrund persçnlicher und familiärer Kontakte zu einem alltägli-chen Teil der Gesellschaft werden. Angesichts der spezifischen Symptomatik der Demenz -insbesondere des sukzessiven Verlusts des deklarativen und biografischen (episodischen) Gedächtnisses -stellt sich die Frage, wie sich soziale Interaktion mit Menschen mit Demenz gestaltet, und ob in solchen Fällen angesichts der Veränderungen sozio-kognitiver und kommunikativer Ressourcen überhaupt im engeren soziologischen Sinn von Interaktion gesprochen werden kann. Diese Fragen werden auf der Basis einer Auswertung vorliegender Studien zur Interaktion und Kommunikation mit Menschen mit Demenz diskutiert. Dazu wird der Interaktionsbegriff in vier Dimensionen aufgefächert: thematische Kontinuierung, Bezug auf geteiltes Wissen, formal-prozedurale Kontinuierung und kçrperlich-affektive Responsivität.Schlagwçrter: Interaktion; Demenz; Altern; Kommunikative Beeinträchtigung; Interaktionstheorie. Summary:The relative proportion of people with dementia in the total population of many countries will strongly increase in the medium term, and encounters with people affected will become an everyday experience. Given the specific symptoms of dementia -particularly the successive loss of declarative and biographical (episodic) memory -the question arises as to how social interaction with people with dementia is shaped and whether we can, given the reduced level of socio-cognitive and communicative resources, speak of interaction with people with dementia in a strictly sociological sense at all in these cases. These issues are discussed on the basis of an evaluation of existing studies about interaction and communication with people with dementia. For this purpose, the concept of interaction is extended in four dimensions: thematic continuation, reference to shared knowledge, formal-procedural continuation and bodily-affective responsiveness.

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Conversing in dementia: A conversation analytic approach

Cited by 89 publications

References 27 publications

Towards diagnostic conversational profiles of patients presenting with dementia or functional memory disorders to memory clinics

Towards diagnostic conversational profiles of patients presenting with dementia or functional memory disorders to memory clinics

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

Menschen mit Demenz als Interaktionspartner. Eine Auswertung empirischer Studien vor dem Hintergrund eines dimensionalisierten Interaktionsbegriffs / People with Dementia as Interactional Partners: An Analysis of Empirical Studies Based on a Dimensional Concept of Interaction

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