Mode Shifts in Conversations with People with Dementia can Cause Confusion_ Crimson Publishers

Mode Shifts in Conversations with People with Dementia can Cause Confusion by Margaret Maclagan* in Gerontology & Geriatrics Studies_ International Journal of Gerontology

 

Abstract
We illustrate how speakers with dementia may shift the whole mode of a conversation as well as its topic or their role in it. This can confuse their unimpaired conversation partner if that partner is less aware of features of dementia discourse. Examples are drawn from three women with moderate Alzheimer’s disease who were living in the south-eastern United States. These examples demonstrate the range.

Introduction
No one is surprised when conversation with a person with dementia becomes repetitive. They expect stories to be repeated, words to be forgotten or misused or for the direction of the conversation to change abruptly. What they do not usually expect is for the whole mode of the conversation to change with no warning. We use ‘mode’ to refer to the listener’s expectations about the conversation in this particular situation [1]. Listeners normally expect conversations to be ordered and coherent and for changes in direction to be signaled, often by a phrase lime ‘oh, by the way…’ or even directly by something like ‘to change the topic totally…’. We have found a continuum of discourse in dementia from coherent to very confused. Chinaei et al. [2] :376 found that “33% of conversations with people with middle-stage AD [Alzheimer’s disease] involve a breakdown in communication.” Brewer et al. [3] studied conversations with her mother-in-law. She thought they were like being on a carousel-up and down and around in circles.

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