ABSTRACT
Little is known about communication in end-stage Alzheimer’s disease. Obler and Albert (1984) reported that individuals lose the press of speech that is characteristic of earlier stages and are often mute. Palilalia and clang associations are common in the limited speech that is produced, and comprehension appears to be extremely impaired. There are reports, however, that alongside this severe impairment, individuals may retain some ability to communicate. Obler (1981) noted some ability to interpret intonation patterns. Schwartz, Marin, and Saffran (1979) reported some effective use of gestural communication. De Ajuriaguerra and Tissot (1975) observed some sensitivity to eye contact and appropriate use of extralinguistic context in both comprehension and production. Bayles, Tomoeda, and Caffrey (1982) noted preservation of “automatic language associated with commonly encountered situations” (p. 136). Preliminary results from Bayles, Kaszniak, and Tomoeda’s (1987) study of structured conversational interaction in late-stage Alzheimer’s patients indicated that a number of conversational skills are still available to at least some patients. These include maintenance of eye contact during conversation, correction of semantically incorrect statements made by the conversational partner, production of relevant responses to compliments and statements of thanks, providing certain kinds of clarification upon request, responding appropriately when offered a handshake, and others.
