EVALUATING ORAL READING AND READING COMPREHENSION IN PATIENTS WITH DEMENTIA: A COMPARISON OF GENERIC AND PERSONALLY RELEVANT STIMULI

Headnote

ABSTRACT

The purpose of this study was to compare the reading comprehension performance of persons with dementia (N = 20) using personal and generic stimuli. Each subject participated in two data collection sessions over a 7-day period. Subjects were presented with five generic and five personal stimulus pages and were prompted to "Read this sentence and tell me something about it." Results indicated that subjects' reading accuracy was consistent over a 7-day period, and that, more novel comments overall and more novel comments indicating reading comprehension were made with personal stimuli when compared to generic stimuli. Personal stimuli may have advantages over generic stimuli for enhancing reading comprehension and communication in persons with dementia.

Keywords: persons with dementia, reading comprehension in dementia, communication in dementia.

INTRODUCTION

Nursing home residents with dementia have cognitive impairments that make communication with caregivers difficult. Memory problems, such as difficulty encoding, registering and learning new information, storing information (e.g., remembering what was eaten at breakfast), and information retrieval (e.g., remembering words and names) are common (Baddeley, 1995). As neurologic disease progresses, mild word-finding problems during conversation make utterances inaccurate, repetitious, and "empty." In the end stages, mutism and social withdrawal prevent satisfactory social interactions (Bourgeois and Hickey, 2009). These memory-related communication deficits often result in depression on the part of the person with dementia and their caregivers, reluctance to interact with caregivers, the inability to get wants and needs met and to communicate preferences, and a decrease in socialization.

Memory aids, such as memory books and memory wallets have been developed to help improve communicative interactions with nursing home staff and loved ones, in addition to improving the overall quality of life in people with dementia (Bourgeois, 1992a, 1993; Bourgeois and Mason, 1996; Hoerster, Hickey and Bourgeois, 2001). Memory books provide pictures and sentences for people to use to access facts and episodic memories for conversation. Bourgeois and colleagues have found that memory aids were successful for improving conversational interactions with familiar communication partners across a variety of settings (Bourgeois, 2007).When the individuals used the memory aid by reading the written sentences and describing the illustrations, the number of on-topic utterances and statements of fact increased, the number of off-topic utterances decreased, and conversational turn taking improved. These...