Alzheimer's disease is a degenerative brain disease which has major social consequences for the individuals affected and for those who are emotionally and/or physically close to them. The role which language plays in such relationships stands at the center of this book. In contrast to traditional analyses carried out by psycholinguists, neurologists, and speech pathologists, with speech samples elicited in clinical settings, Heidi Ehernberger Hamilton examines language in the life of one elderly female Alzheimer's patient, from an interactional sociolinguistic perspec- tive. The language of open-ended, naturally occurring conversations between the patient and the author, over four-and-one-half years, is investigated not only in an attempt to understand how the patient's communicative abilities and disabilities are related to each other and how they change over time, but, importantly, how they are influenced by both preemptive and reactive communicative behaviors on the part of the patient's healthy interlocutor. This "personal and particular" study of conversations with one Alzheimer's patient is offered as a humanistic approach to language loss. It is one in which communicative breakdowns are analyzed not separately from details about the patient, her conver- sational partners, and the setting, nor from relevant social facts which may influence interactions, that is, one in which language disability is seen as a human problem within multiple linguistic and social contexts. Conversations with an Alzheimer's patient Conversations with an Alzheimer's patient An interactional sociolinguistic study Heidi Ehernberger Hamilton Department of Linguistics, Georgetown University CAMBRIDGE UNIVERSITY PRESS CAMBRIDGE UNIVERSITY PRESS Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, Sao Paulo Cambridge University Press The Edinburgh Building, Cambridge CB2 2RU, UK Published in the United States of America by Cambridge University Press, New York www.cambridge.org Information on this title: www.cambridge.org/9780521421010 © Cambridge University Press 1994 This publication is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published 1994 This digitally printed first paperback version 2005 A catalogue record for this publication is available from the British Library Library of Congress Cataloguing in Publication data Hamilton, Heidi Ehernberger. Conversations with an Alzheimer's patient: an interactional sociolinguistic study / Heidi Ehernberger Hamilton. p. cm. Includes bibliographical references (p. ) and index. ISBN 0 521 42101 2 (hardback) 1. Alzheimer's disease - Patients - Language - Case studies. 2. Language attrition - Case studies. 3. Sociolinguistics - Case Studies. I. Title. RC523.H35 1994 618.97'6831-dc20 93-1373 CIP ISBN-13 978-0-521-42101-0 hardback ISBN-10 0-521-42101-2 hardback ISBN-13 978-0-521 -02318-4 paperback ISBN-10 0-521-02318-1 paperback for Dan who challenges me to balance intellect with creativity and care Contents Acknowledgments page xi 1 Introduction 1 2 Communicative profile of Elsie 37 3 Questions 78 4 Responses 108 5 Conclusions and implications 148 References 173 Index 183
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