Transcript Metaphor - Personal Web Pages

Uses of Narrative and Metaphor
in the Treatment of Alzheimer’s
Peter Nosal
5/8/2006
What is Alzheimer’s?
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It is a “progressive brain disorder that gradually
destroys a person’s memory and ability to learn,
reason, make judgments, communicate and carry
out daily activities”.
There is no known cure, but effective care can
improve the patient’s quality of life.
Alzheimer’s is a fatal disease that can last from
3 to 20 years.
www.alz.org
Maclagan, Davis, Lunsford
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Alzheimer’s patients substitute common phrases,
insert extenders, or use metonymy when they can
not continue communicating clearly.
This suggests that the patients are aware of their
inability to find clarifying words and generalize in
an attempt to convey clear meaning.
Arkin and Mahendra
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The effects of Alzheimer’s on patient’s ability to
communicate can be lessened through mental and
physical exercises.
Mental and physical exercises may have allowed
patients to continue using longer sentences and
fewer sentence fragments while patients not
involved in exercises are more likely to use short
sentences and sentence fragments.
Inferences That Can Be Made
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Alzheimer’s patients can continue to communicate
throughout the progression of the disease.
Patients desire to communicate and may become
frustrated when communication becomes difficult.
Narrative as Communication Facilitator
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Friends, relatives, and caretakers of Alzheimer’s
patients should initiate narrative exchanges.
By telling repetitive stories, narrative will become
more ingrained in their mind.
By prompting patients to tell familiar stories, they
will be working toward maintaining the mental
connections that seem to erode as Alzheimer’s
progresses.
Metaphor and Narrative
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Metaphor works with narrative to treat patients
with Dementia.
By helping patients maintain the ability to
remember and recite familiar narratives, hopefully
additional people, places, and narratives will more
likely remain familiar to the patient.
Why will this help patients?
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Continuity Theory
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Reminiscence
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Communicative Competence
Continuity Theory
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Maintaining an acceptable personality is an
important part of aging. If someone was outgoing
throughout their early life and into middle age, it is
likely that they desire to remain outgoing. The same
is true for a shy person.
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Using metaphor and narrative to help a patient
maintain their ability to communicate with language
is likely to help them keep their traditional
personality.
Reminiscence
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The recalling of past experiences through writing,
speaking, or thinking is the act of reminiscence.
Reminiscence is important to the elderly because it
can serve as an art, a coping mechanism, and as a
way to maintain identity.
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Metaphor and narrative help patients remember
stories of their past and other people, places, and
stories related to them.
Communicative Competence
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Elderly people typically communicate in similar ways to
younger people. However, elderly people are usually more
cautious in conversation and desire to have certainty in
their interactions.
It appears that the elderly like to be more certain in their
spoken conversation than younger people and may
contemplate more when deciding what to say.
Practicing narrative will help patients maintain their
ability to locate and use appropriate words and phrases.
Care for Patients
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Effective care for Alzheimer’s patients should be
holistic.
It is important to be aware of medical advances,
but communication between the patient and
friends, family, and caregivers should also be
stressed.
Research suggests that communication with
patients which prompts them to respond in
narrative may alleviate some of the symptoms of
Alzheimer’s.
Works Cited
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www.alz.org Alzheimer’s Association
Arkin, S, & Mahendra, N (2002) Discourse analysis of Alzheimer’s
patients before and after intervention: Methodology and outcomes.
Aphasiology 15(6), 533-569.
Maclagan, M, Davis, B, Lunsford, R, Fixed phrases, extenders, and
metonymy in the speech of people with Alzheimer’s disease.
Nussbaum, Jon F., Loretta L. Pecchioni, James D. Robinson, &
Teresa L. Thompson. Communication & Aging.2nd ed. Muhwah,
New Jersey: Lawrence Erlbaum Associates, Publishers, 2000.