Uses of Narrative and Metaphor in the Treatment of Alzheimer

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Uses of Narrative and Metaphor in the Treatment
of Alzheimers

• Peter Nosal
• 5/8/2006

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What is Alzheimers?

1. It is a progressive brain disorder that
   gradually destroys a persons memory and ability
   to learn, reason, make judgments, communicate and
   carry out daily activities.
2. There is no known cure, but effective care can
   improve the patients quality of life.
3. Alzheimers is a fatal disease that can last from
   3 to 20 years.

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Maclagan, Davis, Lunsford

• Alzheimers 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.

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Arkin and Mahendra

• The effects of Alzheimers on patients 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.

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Inferences That Can Be Made

• Alzheimers patients can continue to communicate
  throughout the progression of the disease.
• Patients desire to communicate and may become
  frustrated when communication becomes difficult.

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Narrative as Communication Facilitator

• Friends, relatives, and caretakers of Alzheimers
  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
  Alzheimers progresses.

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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.

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Why will this help patients?

• Continuity Theory
• Reminiscence
• Communicative Competence

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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.

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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.

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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.

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Care for Patients

• Effective care for Alzheimers 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
  Alzheimers.

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Works Cited

1. www.alz.org Alzheimers Association
2. Arkin, S, Mahendra, N (2002) Discourse analysis
   of Alzheimers patients before and after
   intervention Methodology and outcomes.
   Aphasiology 15(6), 533-569.
3. Maclagan, M, Davis, B, Lunsford, R, Fixed
   phrases, extenders, and metonymy in the speech of
   people with Alzheimers disease.
4. Nussbaum, Jon F., Loretta L. Pecchioni, James D.
   Robinson, Teresa L. Thompson. Communication
   Aging.2nd ed. Muhwah, New Jersey Lawrence
   Erlbaum Associates, Publishers, 2000.