Uses of Narrative and Metaphor in the Treatment of Alzheimer’s

1. Uses of Narrative and Metaphor in the Treatment of Alzheimer’s Peter Nosal 5/8/2006

2. What is Alzheimer’s? • 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

3. Maclagan, Davis, Lunsford • 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.

4. Arkin and Mahendra • 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.

5. Inferences That Can Be Made • 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.

6. Narrative as Communication Facilitator • 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.

7. Metaphor and Narrative • 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.

8. Why will this help patients? • Continuity Theory • Reminiscence • Communicative Competence

9. Continuity Theory • 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. • Using metaphor and narrative to help a patient maintain their ability to communicate with language is likely to help them keep their traditional personality.

10. Reminiscence • 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. • Metaphor and narrative help patients remember stories of their past and other people, places, and stories related to them.

11. Communicative Competence • 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.

12. Care for Patients • 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.

13. Works Cited • 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.