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xi | |
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xiii | |
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xv | |
Foreword |
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xvii | |
Should you read this book? |
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xvii | |
Summary of the main ideas in the book |
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xvii | |
Who is the book for? |
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xx | |
How the book came about |
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xx | |
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PART 1 Contexts Shaping Communication |
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1 The Challenges of Communication in the Dementia Context |
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3 | (12) |
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1.1 Why is it difficult to sustain effective communication practices in dementia interaction? |
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3 | (3) |
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6 | (3) |
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9 | (3) |
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9 | (2) |
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1.3.2 Defining communication |
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11 | (1) |
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12 | (2) |
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12 | (2) |
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1.4.2 Recognizing the role of ego |
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14 | (1) |
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14 | (1) |
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2 The Biological Determinants of Dementia Communication |
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15 | (18) |
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2.1 How do the brain changes associated with diseases of dementia affect communication? |
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15 | (2) |
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2.2 Exploring the language of people with Alzheimer's disease |
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17 | (4) |
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2.2.1 Overview of Alzheimer's disease |
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17 | (1) |
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2.2.2 The impact of Alzheimer's disease on language |
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18 | (1) |
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2.2.3 The impact of Alzheimer's disease on pragmatic capabilities |
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19 | (1) |
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2.2.4 Language as a marker of future Alzheimer's disease |
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20 | (1) |
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2.3 Language and communication in frontotemporal lobar degeneration |
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21 | (2) |
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2.3.1 Overview of frontotemporal lobar degeneration |
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21 | (1) |
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2.3.2 The impact of semantic dementia on communication |
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22 | (1) |
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2.4 The impact on language and communication of other dementias |
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23 | (1) |
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2.5 Pinning down `dementia communication' |
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24 | (1) |
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2.6 Variation in susceptibility to diseases of dementia and their symptoms |
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25 | (7) |
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2.6.1 Why do the brain changes affect people and their communication differently? |
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25 | (1) |
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2.6.2 Genetic disposition to diseases causing dementia |
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25 | (2) |
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2.6.3 Environmental factors |
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27 | (1) |
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2.6.4 `Rementia' and temporary lucidity |
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28 | (1) |
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2.6.5 Brain and cognitive reserve |
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28 | (4) |
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32 | (1) |
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3 The Role of Memory in Communication |
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33 | (22) |
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3.1 What constraints on communication are imposed by memory deficits in dementia? |
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33 | (3) |
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36 | (2) |
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36 | (1) |
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37 | (1) |
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37 | (1) |
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3.3 Short-term and working memory |
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38 | (1) |
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3.4 How we bring information back to mind |
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39 | (1) |
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3.5 Memory changes in normal ageing and in dementia |
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40 | (2) |
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3.6 The impact of memory impairment on communication |
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42 | (1) |
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3.7 A deeper look at episodic memory and communication |
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43 | (10) |
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3.7.1 Episodic memory and autonoetic experience |
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44 | (2) |
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3.7.2 The unreliability of episodic memory |
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46 | (2) |
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3.7.3 The impact of losing reliable episodic memory |
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48 | (5) |
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53 | (2) |
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4 The Social Construction of Dementia |
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55 | (28) |
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4.1 How do social attitudes and contexts shape how we interact with people living with a dementia? |
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55 | (1) |
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4.2 Social and emotional factors exacerbating dementia symptoms |
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56 | (2) |
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4.3 The construction of dementia as a disease |
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58 | (15) |
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4.3.1 The medicalization of age-related degenerative diseases |
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58 | (3) |
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4.3.2 The commodification of dementia research |
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61 | (2) |
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4.3.3 Defining people by test results |
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63 | (5) |
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4.3.4 Mild Cognitive Impairment and the boundary with `normal functioning' |
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68 | (2) |
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4.3.5 How people living with a dementia are treated |
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70 | (3) |
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4.4 Dementia as a social burden |
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73 | (3) |
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4.4.1 Western attitudes to dementia and care |
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73 | (1) |
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4.4.2 Alternative perceptions of dementia |
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74 | (2) |
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4.5 The protection afforded by social reserve |
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76 | (4) |
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4.5.1 What is social reserve? |
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76 | (2) |
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4.5.2 Social reserve and social capital |
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78 | (2) |
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80 | (3) |
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5 The Experience of Dementia Communication |
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83 | (24) |
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5.1 How do constraints on communication shape the experiences of people living with a dementia and their carers? |
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83 | (2) |
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5.2 Communicating when you have a dementia |
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85 | (10) |
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5.2.1 Communicating the dementia experience |
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87 | (5) |
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5.2.2 What people living with a dementia say they need |
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92 | (3) |
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5.3 How family and professional carers communicate with people living with a dementia |
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95 | (8) |
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5.3.1 The emotional burdens that carers bring to an interaction |
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96 | (2) |
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5.3.2 The expression of carers' emotional burden |
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98 | (4) |
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5.3.3 Interaction between professional and family carers |
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102 | (1) |
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5.4 Conceptualizing emotional reserve |
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103 | (3) |
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106 | (1) |
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6 Approaches to Effective Communication in Care |
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107 | (30) |
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6.1 How do approaches to care attempt to address challenges in communication? |
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107 | (7) |
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6.2 Person-centred and relationship-centred care |
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114 | (7) |
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6.3 How to communicate well with people living with a dementia |
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121 | (12) |
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6.3.1 Communication parameters in care approaches |
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121 | (3) |
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124 | (1) |
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6.3.3 Presentation of information |
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125 | (3) |
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6.3.4 Pragmatics and contextual expectations |
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128 | (1) |
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129 | (1) |
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129 | (1) |
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6.3.7 Attention to the person's needs |
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130 | (1) |
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6.3.8 Affective orientation |
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130 | (1) |
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6.3.9 Nonverbal communication |
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131 | (1) |
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6.3.10 Widening the scope of communication |
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132 | (1) |
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133 | (4) |
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PART 2 Conceptualizing Communication |
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7 Communication Processes |
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137 | (22) |
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7.1 How do we achieve impact through communication? |
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137 | (3) |
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7.2 Overview of the Communicative Impact model |
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140 | (6) |
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7.2.1 The three components |
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141 | (2) |
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7.2.2 The role of the hearer |
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143 | (3) |
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7.3 Exploring the Context component |
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146 | (3) |
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7.4 Exploring the Resources component |
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149 | (2) |
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7.5 Exploring the Processing component |
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151 | (1) |
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152 | (5) |
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7.6.1 The dynamics of three or more |
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153 | (1) |
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7.6.2 How can we judge our Communicative Impact? |
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153 | (2) |
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7.6.3 Why does Communicative Impact work? What's in it for the hearer? |
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155 | (2) |
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157 | (2) |
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8 Conceptualizing Communication |
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159 | (26) |
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8.1 How is the Communicative Impact model theoretically justified? |
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159 | (1) |
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8.2 Humans' drive to create a comfortable world |
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159 | (8) |
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8.2.1 An evolutionary impetus |
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159 | (2) |
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8.2.2 Humans' priorities in modifying their world |
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161 | (4) |
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8.2.3 Altruism: promoting the well-being of others |
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165 | (2) |
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8.3 Pragmatic theory and the context component |
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167 | (2) |
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169 | (4) |
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8.5 Knowing what to say: the use of context |
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173 | (5) |
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173 | (1) |
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8.5.2 Using context for Communicative Impact |
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174 | (3) |
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8.5.3 Building and structuring context through schemas |
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177 | (1) |
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178 | (3) |
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8.6.1 Navigating explicitness |
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179 | (1) |
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8.6.2 From selection to execution |
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180 | (1) |
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181 | (4) |
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PART 3 Applications and Implications |
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9 Drivers of Disrupted Communication |
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185 | (24) |
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9.1 Why is dementia so disruptive to communication? |
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185 | (1) |
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9.2 The role of context in sustaining effective communication |
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186 | (5) |
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9.2.1 Contextual gaps as a catalyst for low social and emotional reserve |
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186 | (1) |
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9.2.2 Proforms as a `case study' of context in communication |
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187 | (4) |
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9.3 Dementia communication: problems and responses |
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191 | (8) |
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9.4 Unintended consequences of meeting problems with solutions |
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199 | (2) |
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9.5 Awkward pragmatic gaps |
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201 | (4) |
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9.6 Insights from second-language interaction |
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205 | (3) |
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208 | (1) |
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10 Different in Degree or Kind? How People Living with a Dementia are Positioned |
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209 | (38) |
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10.1 How does the conceptual positioning of people living with a dementia impact on communication? |
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209 | (7) |
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10.1.1 Exploring degree and kind |
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210 | (4) |
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10.1.2 Manifestations of the degree and kind perspectives |
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214 | (2) |
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216 | (3) |
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10.3 Deception in dementia interaction |
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219 | (21) |
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10.3.1 Defining deception |
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220 | (2) |
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10.3.2 Nuances of deception and truth telling |
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222 | (2) |
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10.3.3 Arguments for and against deceiving people living with a dementia |
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224 | (5) |
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10.3.4 Case study: Specialized Early Care for Alzheimer's (SPECAL) |
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229 | (8) |
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10.3.5 How do deceptive practices relate to degree and kind? |
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237 | (2) |
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10.3.6 Unrealistic expectations? |
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239 | (1) |
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10.4 Reconceptualizing degree and kind |
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240 | (4) |
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244 | (3) |
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11 An Agenda for Improving Communication in the Dementia Context |
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247 | (22) |
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11.1 What are the priorities for improving communication by and with people living with a dementia? |
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247 | (3) |
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11.1.1 Why we communicate |
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247 | (1) |
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11.1.2 How dementia disrupts communication |
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248 | (1) |
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11.1.3 Emotional and social reserve |
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248 | (1) |
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11.1.4 Difference in degree and kind |
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249 | (1) |
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11.1.5 Carers' paradox and awkward pragmatic gaps |
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249 | (1) |
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11.2 What do people living with a dementia need from their interlocutors? |
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250 | (8) |
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11.2.1 Opportunities for communication |
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250 | (1) |
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11.2.2 Real communication |
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251 | (1) |
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11.2.3 Communicative support |
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251 | (1) |
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11.2.4 Kindness and compassion |
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252 | (1) |
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11.2.5 Empowerment: alternative routes to Communicative Impact |
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253 | (1) |
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11.2.6 Insight and flexibility |
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254 | (1) |
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11.2.7 Building social and emotional reserve |
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255 | (2) |
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11.2.8 Respect and dignity |
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257 | (1) |
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11.2.9 Navigating truth and deception |
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258 | (1) |
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11.3 Towards better communication |
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258 | (8) |
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11.3.1 Linking new ideas to existing practice |
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259 | (2) |
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11.3.2 Mapping effective practices for the interlocutor as hearer and speaker |
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261 | (5) |
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11.4 Kindness and the communicative agenda in care |
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266 | (2) |
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268 | (1) |
Notes |
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269 | (10) |
References |
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279 | (38) |
Index |
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317 | |