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Dynamics of Dementia Communication [Hardback]

(Professor Alison Wray BA (Hons), D.Phil (York), FHEA, FAcSS, FLSW, School of English, Communication and Philosophy, Cardiff University)
  • Formāts: Hardback, 352 pages, height x width x depth: 152x236x23 mm, weight: 612 g
  • Izdošanas datums: 15-Jul-2020
  • Izdevniecība: Oxford University Press Inc
  • ISBN-10: 0190917806
  • ISBN-13: 9780190917807
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  • Formāts: Hardback, 352 pages, height x width x depth: 152x236x23 mm, weight: 612 g
  • Izdošanas datums: 15-Jul-2020
  • Izdevniecība: Oxford University Press Inc
  • ISBN-10: 0190917806
  • ISBN-13: 9780190917807
Citas grāmatas par šo tēmu:
WINNER of the 2021 British Association for Applied Linguistics Book prize

It is well recognized that when people are living with a dementia, effective communication can be a challenge for both them and those they interact with. Despite a plethora of good advice, it can be surprisingly hard to sustain constructive communicative behaviours and to integrate them successfully into routine daily care and interaction.

The Dynamics of Dementia Communication asks why that is. What is it about communication, as a human social and cognitive practice, that makes it so difficult to manage the disruptions caused by dementia? Why is it so common to feel awkward, confused or irritated when talking with a person living with a dementia? Why is the experience of living with a dementia so personally and socially devastating? What approaches to communication would work best, and why?

To answer these questions, the book integrates information from a wide range of different sources, covering the biological, social, and emotional factors associated with the dementia experience. New concepts and theoretical perspectives offer novel ways of thinking about the challenges of communication generally, and in the context of dementia. Topics explored include whether it is acceptable to deceive people living with a dementia and why society's failure to support people living with a dementia and their carers is so devastating. The final chapter suggests what people living with a dementia need if communication is to promote and protect everyone's well-being.

By providing a deeper understanding of what topples the best-intentioned attempts at interaction, and by explaining why poor communication affects everyone involved, this book sets new agendas for improving the welfare of people living with a dementia, their families, and professional carers.

Recenzijas

This author's commitment to person-centered care, specifically addressing the person living with a dementia as well as the challenges and needs of the caregiver, can only be described as exceptional...Highly recommended. Upper-division undergraduates. Graduate students, faculty, and professionals. * L.R. Barley, York College, CUNY, CHOICE * ...ambitious, original, comprehensive and thoughtful... * Lars-Christer Hydén, Journal of Pragmatics * Alison Wray has taken our understanding about the social and communicative aspects around Alzheimer's dementia several steps forward with this book. Her volume offers a most nuanced discussion about communicating with people that have this dementia and a most up-to-date review of scholarship on the social aspects of this condition. It is very much a must-read for any serious scholar in linguistics, communication, and dementia." * Vaidehi Ramanathan, Professor of Linguistics, The University of California, Davis, CA * Professor Wray's excellent and stimulating book could become the 'go to' resource for in-depth discussions about language, linguistics, communication, and brain changes associated with particular types of dementia. Complex issues are thoughtfully presented and explained in a clear, compelling narrative. The text is scholarly without being stuffy or pedantic, and Parts and Chapters can be read as individual units of interest. Wray obviously has a working knowledge of communication and relationships with people living with a dementia, their caregivers, and professional partners. The warmth, humour, and expertise invite us to join in the explorations alongside the author. She invites us to ponder our own knowledge and assumptions and improve our person-centred practice. We couldn't ask for much more from a book in this field." * Danuta Lipinska, Specialist in Ageing & Dementia Care, Training Consultant, Counsellor, Supervisor, 'My Home Life' Action Learning Facilitator, London, England * In this thought-provoking book Wray challenges us to move away from a singular focus on the myriad ways in which discourse can be shaped by dementia toward a reconsideration of these effects against the backdrop of communication more generally. Especially refreshing is her intricate discussion of the impact of understanding individuals living with dementia as being 'different in degree' vs. 'different in kind' from their healthy interactional partners. An invigorating read for anyone who reaches across disciplines at the intersection of dementia and communication." * Heidi E. Hamilton, PhD, Professor of Linguistics, Georgetown University, Washington, D.C. * Pinning down 'dementia communication' is notoriously difficult, and there is tension between individual variation in behaviours and symptoms and the call for, as it were, instructional manuals on how to communicate effectively in the context of dementia. Wray achieves a synthesis of solid theoretical foundations with practical information that will inform health care and eldercare practice and stimulate further research. Central to Wray's arguments is a model of communicative impact, defined as an individual's success in using communication to make desired changes in the world through the agency of others. A key message that cannot be emphasized enough is that "communication is not an optional extra" but rather that real communication, which allows persons with dementia to achieve communicative impact, is of the utmost importance for their well-being." * Nicole Müller, PhD, Professor and Head of Speech and Hearing Sciences, School of Clinical Therapies, University College Cork, Ireland * Wray's development of the Communicative Impact model emphasizes what speakers seek to do or to change in their social environments through their talk. She offers intriguing insights into how persons with dementia may be working out the meaning of what is said to them, picking through their available linguistic resources to craft an effective and appropriate response, or interiorly debating about how their contributions might be heard. Nevertheless, despite their well-intentioned mutual decipherment, both parties sometimes misfire, and misconstruals are not uncommon. Wray offers a series of novel concepts that capture the complexity (and humanity) of communication in dementia. Based on wide-ranging scholarship and deep reflection, this book opens new pathways for improving communication. More than an intellectual tour-de-force, it is an act of compassion." * Robert Schrauf, PhD, Professor and Department Head of Applied Linguistics, Penn State University, University Park, PA *

Papildus informācija

Winner of Winner, 2021 Book Prize, British Association for Applied Linguistics Finalist, 2022 AAAL Book Award.
List of Figures
xi
List of Tables
xiii
List of Boxes
xv
Foreword xvii
Should you read this book? xvii
Summary of the main ideas in the book xvii
Who is the book for? xx
How the book came about xx
PART 1 Contexts Shaping Communication
1 The Challenges of Communication in the Dementia Context
3(12)
1.1 Why is it difficult to sustain effective communication practices in dementia interaction?
3(3)
1.2 Overview of the book
6(3)
1.3 Key concepts
9(3)
1.3.1 Defining dementia
9(2)
1.3.2 Defining communication
11(1)
1.4 Core orientations
12(2)
1.4.1 Personhood
12(2)
1.4.2 Recognizing the role of ego
14(1)
1.5 Concluding remarks
14(1)
2 The Biological Determinants of Dementia Communication
15(18)
2.1 How do the brain changes associated with diseases of dementia affect communication?
15(2)
2.2 Exploring the language of people with Alzheimer's disease
17(4)
2.2.1 Overview of Alzheimer's disease
17(1)
2.2.2 The impact of Alzheimer's disease on language
18(1)
2.2.3 The impact of Alzheimer's disease on pragmatic capabilities
19(1)
2.2.4 Language as a marker of future Alzheimer's disease
20(1)
2.3 Language and communication in frontotemporal lobar degeneration
21(2)
2.3.1 Overview of frontotemporal lobar degeneration
21(1)
2.3.2 The impact of semantic dementia on communication
22(1)
2.4 The impact on language and communication of other dementias
23(1)
2.5 Pinning down `dementia communication'
24(1)
2.6 Variation in susceptibility to diseases of dementia and their symptoms
25(7)
2.6.1 Why do the brain changes affect people and their communication differently?
25(1)
2.6.2 Genetic disposition to diseases causing dementia
25(2)
2.6.3 Environmental factors
27(1)
2.6.4 `Rementia' and temporary lucidity
28(1)
2.6.5 Brain and cognitive reserve
28(4)
2.7 Concluding remarks
32(1)
3 The Role of Memory in Communication
33(22)
3.1 What constraints on communication are imposed by memory deficits in dementia?
33(3)
3.2 Long-term memory
36(2)
3.2.1 Declarative memory
36(1)
3.2.2 Implicit memory
37(1)
3.2.3 Emotional memory
37(1)
3.3 Short-term and working memory
38(1)
3.4 How we bring information back to mind
39(1)
3.5 Memory changes in normal ageing and in dementia
40(2)
3.6 The impact of memory impairment on communication
42(1)
3.7 A deeper look at episodic memory and communication
43(10)
3.7.1 Episodic memory and autonoetic experience
44(2)
3.7.2 The unreliability of episodic memory
46(2)
3.7.3 The impact of losing reliable episodic memory
48(5)
3.8 Concluding remarks
53(2)
4 The Social Construction of Dementia
55(28)
4.1 How do social attitudes and contexts shape how we interact with people living with a dementia?
55(1)
4.2 Social and emotional factors exacerbating dementia symptoms
56(2)
4.3 The construction of dementia as a disease
58(15)
4.3.1 The medicalization of age-related degenerative diseases
58(3)
4.3.2 The commodification of dementia research
61(2)
4.3.3 Defining people by test results
63(5)
4.3.4 Mild Cognitive Impairment and the boundary with `normal functioning'
68(2)
4.3.5 How people living with a dementia are treated
70(3)
4.4 Dementia as a social burden
73(3)
4.4.1 Western attitudes to dementia and care
73(1)
4.4.2 Alternative perceptions of dementia
74(2)
4.5 The protection afforded by social reserve
76(4)
4.5.1 What is social reserve?
76(2)
4.5.2 Social reserve and social capital
78(2)
4.6 Concluding remarks
80(3)
5 The Experience of Dementia Communication
83(24)
5.1 How do constraints on communication shape the experiences of people living with a dementia and their carers?
83(2)
5.2 Communicating when you have a dementia
85(10)
5.2.1 Communicating the dementia experience
87(5)
5.2.2 What people living with a dementia say they need
92(3)
5.3 How family and professional carers communicate with people living with a dementia
95(8)
5.3.1 The emotional burdens that carers bring to an interaction
96(2)
5.3.2 The expression of carers' emotional burden
98(4)
5.3.3 Interaction between professional and family carers
102(1)
5.4 Conceptualizing emotional reserve
103(3)
5.5 Concluding remarks
106(1)
6 Approaches to Effective Communication in Care
107(30)
6.1 How do approaches to care attempt to address challenges in communication?
107(7)
6.2 Person-centred and relationship-centred care
114(7)
6.3 How to communicate well with people living with a dementia
121(12)
6.3.1 Communication parameters in care approaches
121(3)
6.3.2 Content
124(1)
6.3.3 Presentation of information
125(3)
6.3.4 Pragmatics and contextual expectations
128(1)
6.3.5 Delivery
129(1)
6.3.6 Environment
129(1)
6.3.7 Attention to the person's needs
130(1)
6.3.8 Affective orientation
130(1)
6.3.9 Nonverbal communication
131(1)
6.3.10 Widening the scope of communication
132(1)
6.4 Concluding remarks
133(4)
PART 2 Conceptualizing Communication
7 Communication Processes
137(22)
7.1 How do we achieve impact through communication?
137(3)
7.2 Overview of the Communicative Impact model
140(6)
7.2.1 The three components
141(2)
7.2.2 The role of the hearer
143(3)
7.3 Exploring the Context component
146(3)
7.4 Exploring the Resources component
149(2)
7.5 Exploring the Processing component
151(1)
7.6 Matters arising
152(5)
7.6.1 The dynamics of three or more
153(1)
7.6.2 How can we judge our Communicative Impact?
153(2)
7.6.3 Why does Communicative Impact work? What's in it for the hearer?
155(2)
7.7 Concluding remarks
157(2)
8 Conceptualizing Communication
159(26)
8.1 How is the Communicative Impact model theoretically justified?
159(1)
8.2 Humans' drive to create a comfortable world
159(8)
8.2.1 An evolutionary impetus
159(2)
8.2.2 Humans' priorities in modifying their world
161(4)
8.2.3 Altruism: promoting the well-being of others
165(2)
8.3 Pragmatic theory and the context component
167(2)
8.4 Getting what we want
169(4)
8.5 Knowing what to say: the use of context
173(5)
8.5.1 Defining context
173(1)
8.5.2 Using context for Communicative Impact
174(3)
8.5.3 Building and structuring context through schemas
177(1)
8.6 Formulating output
178(3)
8.6.1 Navigating explicitness
179(1)
8.6.2 From selection to execution
180(1)
8.7 Concluding remarks
181(4)
PART 3 Applications and Implications
9 Drivers of Disrupted Communication
185(24)
9.1 Why is dementia so disruptive to communication?
185(1)
9.2 The role of context in sustaining effective communication
186(5)
9.2.1 Contextual gaps as a catalyst for low social and emotional reserve
186(1)
9.2.2 Proforms as a `case study' of context in communication
187(4)
9.3 Dementia communication: problems and responses
191(8)
9.4 Unintended consequences of meeting problems with solutions
199(2)
9.5 Awkward pragmatic gaps
201(4)
9.6 Insights from second-language interaction
205(3)
9.7 Concluding remarks
208(1)
10 Different in Degree or Kind? How People Living with a Dementia are Positioned
209(38)
10.1 How does the conceptual positioning of people living with a dementia impact on communication?
209(7)
10.1.1 Exploring degree and kind
210(4)
10.1.2 Manifestations of the degree and kind perspectives
214(2)
10.2 The carers' paradox
216(3)
10.3 Deception in dementia interaction
219(21)
10.3.1 Defining deception
220(2)
10.3.2 Nuances of deception and truth telling
222(2)
10.3.3 Arguments for and against deceiving people living with a dementia
224(5)
10.3.4 Case study: Specialized Early Care for Alzheimer's (SPECAL)
229(8)
10.3.5 How do deceptive practices relate to degree and kind?
237(2)
10.3.6 Unrealistic expectations?
239(1)
10.4 Reconceptualizing degree and kind
240(4)
10.5 Concluding remarks
244(3)
11 An Agenda for Improving Communication in the Dementia Context
247(22)
11.1 What are the priorities for improving communication by and with people living with a dementia?
247(3)
11.1.1 Why we communicate
247(1)
11.1.2 How dementia disrupts communication
248(1)
11.1.3 Emotional and social reserve
248(1)
11.1.4 Difference in degree and kind
249(1)
11.1.5 Carers' paradox and awkward pragmatic gaps
249(1)
11.2 What do people living with a dementia need from their interlocutors?
250(8)
11.2.1 Opportunities for communication
250(1)
11.2.2 Real communication
251(1)
11.2.3 Communicative support
251(1)
11.2.4 Kindness and compassion
252(1)
11.2.5 Empowerment: alternative routes to Communicative Impact
253(1)
11.2.6 Insight and flexibility
254(1)
11.2.7 Building social and emotional reserve
255(2)
11.2.8 Respect and dignity
257(1)
11.2.9 Navigating truth and deception
258(1)
11.3 Towards better communication
258(8)
11.3.1 Linking new ideas to existing practice
259(2)
11.3.2 Mapping effective practices for the interlocutor as hearer and speaker
261(5)
11.4 Kindness and the communicative agenda in care
266(2)
11.5 Concluding remarks
268(1)
Notes 269(10)
References 279(38)
Index 317
Alison Wray took her BA and D.Phil in linguistics at the University of York, UK. After completing a postdoctoral research project on singers' pronunciation in the Department of Music at York, she held a lectureship in linguistics at the then College of Ripon and York St John (now York St John University). In 1996 she was appointed Assistant Director of the Wales Applied Language Research Unit at Swansea University, and in 1999 became a Senior Research Fellow at Cardiff University. She became a (full) Professor at Cardiff in 2005 and a Research Professor in 2007. She is internationally known for her research into formulaic language, publishing two seminal books on the topic in 2002 and 2008. Since 2008 she has focussed on understanding the challenges of communication by and with people living with a dementia and has presented on this topic in countries around the world.