Communication from individuals with advanced DAT: Can it provide clues to their sense of self-awareness and well-being?

Often communication from people with advanced dementia of the Alzheimer typ e (DAT) is regarded as incoherent and meaningless. However, with careful li stening and observation, such communication often becomes more understandab le. To better understand DAT communication, the investigators designed an e xploratory qualitative study to videotape and critically analyze conversati ons between a clinical nurse specialist and 15 subjects with DAT ranging fr om mild to severe. One of the findings was that, even in later stages, indi cations were given that subjects had self-awareness of their cognitive decl ine. The investigators further examined the communication of the five most cognitively impaired subjects for other indications of self-awareness and w ell-being. To demonstrate this premise of awareness of cognitive decline an d self in the later stages of DAT, excerpts from communication received fro m five subjects with advanced cognitive impairment are presented.