CONVERSATIONAL REPAIR BY INDIVIDUALS WITH DEMENTIA OF THE ALZHEIMERS TYPE

Conversational repair was examined in videotaped samples of spontaneou s mealtime talk of 6 normal elderly adults, 5 subjects with early stag e dementia of the Alzheimer's type (EDAT) and 5 subjects with middle s tage DAT (MDAT) with a family member who acted as a conversational par tner. The overall percentage of utterances involved in communication b reakdown and repair and the specific proportions of utterances related to conversation problems, signals identifying problems, and repairs, were evaluated. Using the normal dyads as a control group, results sho wed the differential effects of DAT onset and progression on the conve rsational repair behavior of both subjects with DAT and their conversa tional partner. The percentage of conversation involved in repair was significantly higher for MDAT versus control and EDAT dyads, Despite t he increase of conversational troubles with DAT onset and progression, the difficulties were repaired successfully the majority of the time. Subjects with EDAT produced more requests for repair than did their c onversational partners. However, conversational partners of EDAT subje cts used more elaboration repairs than did EDAT subjects. The opposite pattern was observed in the MDAT group where subjects with MDAT creat ed and repaired more conversational problems than did their conversati onal partner. MDAT subjects produced more discourse trouble sources th an did EDAT subjects. It was also observed that MDAT subjects and conv ersational partners frequently used nonspecific terms to signal misund erstandings. The findings have important implications for developing f amily caregiver communication enhancement strategies that are specific to the clinical stage of DAT.