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- The Carolinas Conversation Collection
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2
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- Between biomedical interviewing and the kind of focused interviewing
that elicits detail;
- Between ‘taking a history’ and ‘conversational
interviews’
- positioning
- People (re-)position each other as they interact. Changes in position
change the frame of the interaction
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3
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- Kovecses: ‘a frame is a structured mental representation of a
conceptual category’
- Other names for frames:
- script, scenario, scene, cultural model, cognitive model, domain,
schema, gestalt
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- Evoked by particular meanings of words or by who is sanctioned to sp=
eak when
- Impose a perspective on the situation
- Provide a history, a context
- Assume larger cultural frames
- Are idealizations – linked to prototypes
- They can activate or be activated by our stereotypes
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5
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-  =
; &n=
bsp;
What point of view?
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6
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- your impression
- of what is
- going on?
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8
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9
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10
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11
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- These movies/TV shows stereotype older adults:
- On Golden Pond
- The Golden Girls
- The Bucket List
- As a warm up – identify some additional movies and TV shows th=
at
present both positive and negative stereotypes of older people.
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12
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- Researchers have studied how older and younger speakers change speech
patterns when they talk to each other.
- Coupland, Coupland& Giles. 1991. Language, society and the elder=
ly.
Blackwell; Kemper, Ferrell, , Harden, et al, 1998. Use of elderspeak=
by
young and older adults to impaired and unimpaired listeners. Aging,
Neuropsychology, and Cognition, 5, 43-55 or http://merrill.ku.edu/In=
theKnow/sciencearticles/elderspeak.html
- Frequently, younger speakers are patronizing, and use infantile spee=
ch
to address older citizens.
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- Younger people often repeat the same information several times, assu=
ming
the older person will not hear or understand
- They often talk louder as if the person were deaf.
- They often use infantile speech as they do with small children and
infants
- Older adults feel treated like children
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14
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- They tend to be garrulous
- What they say often seems foolish
- They use too many words
- Their stories include irrelevant details
- Ruscher, Janet, & Hurley. 2000. Journal of Language and Social
Psychology, 19:141-149.
- What happens when we see the stereotype, & not the person?
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16
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- Enter the word <grandfather> at http://newsouthvoices.uncc.edu=
to
read or hear stories by Michael Shelton and Sarah Murphy.
- Enter <grandmother>  =
;
and you’ll find stories by Chantal Luhr, =
Gloria
Cotton and Cullen Case.
- Coming soon: the Carolinas Collection
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18
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- We focus on techniques developed from our longitudinal corpus of
conversation with cognitively impaired conversation partners
- Many people have commented that these techniques work with any older
person
- And with most younger ones
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- Different communicative goals from earlier in life:
- focus on positive nature of life experience;
- desire to communicate significance of life experience rather than
imparting information.
- May wander off topic or appear verbose – yet their stories are
rated as richer, more interesting
- May preserve semantic representations while episodic representation
declines selectively.
- These memories show up as stories
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20
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- These video scenarios from the Culturally Competent Project
(Alzheimer’s Association) show consented caregivers and reside=
nts
- Echoing and using Go-Aheads for active listening
- Providing sensitive refocusing
- Asking questions in different ways
- Quilting pieces of story together
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- As the disease progresses, the speaker with dementia
- will have difficulty finding words
- will repeat words and questions
- may make up words
- may speak less often to avoid embarrassment
- may have difficulty understanding directions
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- the person begins to
- make do with fewer words
- have difficulty in interpreting words
- offer speech that sounds inappropriate or incoherent
- have trouble understanding written messages
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- A number of researchers, such as Kempler,
- are finding that
- Simpler sentence structures seem to
- work better
- Both repetition and paraphrase were effective at improving
comprehension in AD
- http://alab.psc.sc.edu/joomla/index.php?option=3Dcom_content&tas=
k=3Dblogcategory&id=3D27&Itemid=3D50
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- AD speakers can retrieve some parts of their life story or past
experience
- With help, they can retrieve more details of the story or experience=
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- When you hear a phrase that sounds like it could be part of a larger
“story,”
- 1. Repeat the speaker’s full phrase or sentence slowly, as if =
it
were important, and then pause.
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- 2. Record the detail a=
s a
reminder for future conversation
- On a post-it
- On a card
- On a chart
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- 3. Return to that detail in the next conversation you have, and phra=
se
it as a statement.
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- Use go-aheads and echo to help the person stay on topic
- Be aware of partner’s desire to end a topic
- Allow for response time
- (one hippopotamus, two hippopotamus … five hippopotamus)
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- I had to remind myself to go at her pace and not at mine and with her
agenda, not mine (Turner 2003)
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- I started the conversation with some information that I had obtained
from my coworker (Ashford 2003)
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- Learn what time of day is best for the older adult; some people with=
AD
don’t like to talk in the morning (Jackson 2003)
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- Instead of asking dire=
ct
questions starting with Who-What-Do you
- What do you think about…
- Do you remember…
- Try rephrasing as a statement or tag-question question You had=
two
sisters, I believe You had two sisters, didn’t you
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34
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- People often use formu=
laic
phrases or proverbs or sayings to sum up a topic and then move on
– even with dementia
- “L. Wilcox”: well, that’s the way it is
- Intvwr (BD): yeah, guess so
- “L. Wilcox”: yup
- It is now fine for either to start a new topic
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- Like the tips of iceb=
ergs,
little bits of story show up. Maybe there’s a name that gets
repeated. Or a fragment of a sentence that sounds like it could be p=
art
of a story.
- “Glory M.” :… (unintelligible) an old farm girl<=
/li>
- Intvwr (BD): a farm girl
- “Glory M.”: yeh, we lived on the farm
- Now try indirect questions, Quilting
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- Role-play with your partner: try Quilting
- with & without the Go-ahead signals
- with and without the repetition & paraphrase
- with & without waiting for them
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- Open-ended questions about health care experiences or experience with
medical condition:
- Sustaining the topic by Echoing & Go-Aheads
- Learning to recognize and expand Cues
- Helping to close the conversation topic with Confirm/Reconfirm seque=
nces
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- Try to include these three components, even if very briefly:
- a. Signaling the clo=
se
- b. Acknowledging feelings
- c. Emphasize importance of leave- taking, verbally or non-verbally=
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39
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- Patients & providers are both ‘socialized’ for minim=
al
no-problem responses in comprehensive history taking.
- But sometimes the patient will expand responses with unexpected deta=
ils.
- And any social worker will tell you that sometimes, the patient will
present a small narrative filled with ‘lifeworld’ concer=
ns,
and expects an assessment or some kind of response (Stivers
& Heritage 2001)
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