ENHANCING CONVERSATION SKILLS IN PATIENTS WITH ALZHEIMER'S DISEASE USING A PROSTHETIC MEMORY AID
Open accessAbstract
The effectiveness of teaching Alzheimer's disease subjects to use a prosthetic memory aid when conversing with familiar partners was evaluated. Effects of the training of three topics by caregivers was assessed in daily probes with the experimenter and twice weekly probes with a familiar conversational partner. All 3 subjects learned to use the memory aid with both conversational partners and improved the quality of their conversational content. Subjects made significantly more statements of fact and fewer ambiguous utterances after training on each topic according to a multiple baseline design. All subjects also generated novel, untrained statements in conversations with both partners. Treatment effects were maintained at high levels throughout training and at 3‐ and 6‐week followup sessions. Naive judges rated baseline and posttreatment conversational samples as significantly improved on all eight conversational dimensions.
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For older adults with dementia, the ability to initiate or sustain meaningful activity is limited due to pathological changes associated with cognitive impairments.
“For older adults with dementia, this is challenging, as their ability to initiate or sustain meaningful activity is limited due to pathological changes associated with cognitive impairments. 4,5”
From Activity calendars for older adults with dementia: What you see is not what you get (2003) · cites this paper as [4]
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“In a recent home-based study, Bourgeois (57) showed that the use of an external memory aid resulted in greatly improved conversation behaviors in three AD patients.”
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“Earlier work suggested the efficacy of similar programs for both African American and Caucasian caregivers (Bourgeois, 1990; Bourgeois, Burgio, Schulz, Beach, & Palmer, 1997; Burgio & Burgio, 1986a; Burgio & Burgio, 1986b; Burgio, Page, & Capriotti, 1985; McDowell, Burgio, & Candib, 1990; Ripich & Wykle, 1997).”
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“…2003; Mittleman et al., 1993), while cognitive rehabilitation programs have focused on reducing cognitive and functional symptoms experienced by the IWD (Bourgeois, 1990; Camp, 1989; Camp, Foss, O’Hanlon, & Stevens, 1996; Clare et al., 2000; Orsulic-Jeras, Judge, & Camp, 2000; Zanetti et al.”
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“This confirms the results from previous research that persons with dementia can still learn how to use prosthetic aids in combination with training schemes managed by carers (Bourgeois, 1990; Clare et al., 2000; Hanley & Lusty, 1984).”
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“…communicative interactions, and concomitant reductions in problem behaviors, such as repetitive questioning, were the result of training caregivers to use memory aids with persons with dementia (Bourgeois, 1990, 1992, 1993; Bourgeois & Mason, 1996; Bourgeois, Burgio, Schulz, Beach, & Palmer, 1997).”
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“Bourgeois (1990) reported that middlestage AD patients could be trained to use a prosthetic memory aid (a wallet with printed sentences, pictures, and photographs related to the patient’s life) during conversations, and the use of aids could be maintained once training stopped (Bourgeois 1992).”
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“Research carried out by Bourgeious found that three middle-stage AD patients were able to operate and use a memory wallet when conversing with others [43].”
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“For example, stimulus equivalence technology has been used to reteach name-face matching skills to adults with TBI (Cowley, Green, & Braunling-McMorrow, 1992; Sidman, 1994) and personally relevant pictorial stimuli have been used to reestablish dyadic conversation skills in dementia care settings (Bourgeois, 1990; Bou…”
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“This form of intervention has resulted in improved performance in tasks including memory for personal facts (35), memory for appointments (36), and improved conversation behaviors among AD patients (37).”
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“Other studies have documented positive findings with regard to communication measures such as increased quantity and quality of conversations (e.g., Bourgeois, 1990, 1992; Bourgeois et al., 2001; McPherson et al., 2001).”
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“• Reviewing and building on the use of practical memory strategies, and/or introducing and teaching the use of a new strategy or memory aid (Bird, 2000; Bourgeois, 1990, 1992; Josephsson et al., 1993).”
BackgroundMethodHoerster, L., Hickey, E. M., & Bourgeois, M. S. (2001) · Neuropsychological Rehabilitation · doi:10.1080/09602010042000051 · Cited by 54 · see citing works
“These results extend those of Bourgeois (1990, 1992, 1993) in validating the memory aid treatment for improving communicative abilities of individuals with dementia.”
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Lanzi, A. M., Burshnic, V., & Bourgeois, M. S. (2017) · Topics in Language Disorders · doi:10.1097/tld.0000000000000136 · Cited by 53 · see citing works
“Compensatory strategies (e.g., pictures paired with text) are an effective method for supporting semantic memory and word-finding skills to improve the overall flow of conversation (Bourgeois, 1990).”
BackgroundMethodInfluentialSelf-citationLanguage Analysis of Speakers with Dementia of the Alzheimer’s Type
Guinn, C. I., & Habash, A. (2012) · National Conference on Artificial Intelligence · Cited by 53 · see citing works
Enhancing Communication in Dementia of the Alzheimer's Type
Orange, J. B., & Colton‐Hudson, A. (1998) · Topics in Geriatric Rehabilitation · doi:10.1097/00013614-199812000-00007 · Cited by 53 · see citing works
Applying the WHO ICF framework to the rehabilitation of patients with cognitive deficits
Wade, D. T. (2005) · doi:10.1093/acprof:oso/9780198526544.003.0004 · Cited by 51 · see citing works
Difficult behaviour and dementia in nursing homes: five cases of psychosocial intervention
Moniz-Cook, E. D., Stokes, G., & Agar, S. E. (2003) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.370 · Cited by 50 · see citing works
Liang, J., Shen, W.-T., Li, J., Qu, X.-Y., Li, J., Jia, R., Wang, Y., Wang, S., Wu, R.-K., Zhang, H., et al. (2019) · Ageing Research Reviews · doi:10.1016/j.arr.2019.01.009 · Cited by 47 · see citing works
Increasing Communication Among Nursing Home Residents
Allen, R. S., Burgio, L. D., Bourgeois, M. S., Sims, R. V., & Nunnikhoven, J. (2001) · Journal of Clinical Geropsychology · doi:10.1023/a:1011343212424 · Cited by 45 · see citing works
Self-citationPredictors of quality of life for individuals with dementia
Menne, H. L., Judge, K. S., & Whitlatch, C. J. (2009) · Dementia · doi:10.1177/1471301209350288 · Cited by 45 · see citing works
“…their engagement, exploring their performance on instrumental and personal activities of daily living, or improving their communication skills (Bourgeois, 1990; Camp et al., 1997; Hoerster, Hickey, & Bourgeois, 2001; Josephsson, Baechman, Borell, & Nygard, 1995; Judge, Camp, & Orsulic-Jeras,…”
BackgroundPerspectives On Rehabilitation And Dementia
Marshall, M. (2004) · Cited by 45 · see citing works
Butters, M. A., Soety, E. M., & Becker, J. T. (1997) · Critical issues in neuropsychology · doi:10.1007/978-1-4899-1857-4_34 · Cited by 43 · see citing works
Restoring dressing independence in persons with Alzheimer's disease: A pilot study
Engelman, K. K., Mathews, R. M., & Altus, D. E. (2002) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/153331750201700102 · Cited by 42 · see citing works
Subramaniam, P., & Woods, B. T. (2010) · International Journal of Computers in Healthcare · doi:10.1504/ijcih.2010.037457 · Cited by 41 · see citing works
“Without the person’s own input, the book may be seen more as a memory aid, along the lines of those successfully developed and evaluated by Bourgeois (1990, 1992, 1993, 1996), McPherson et al. (2001) and Andrews-Salvia et al. (2003).”
MethodAssessment of executive dysfunction
Crawford, J. R., & Henry, J. D. (2005) · doi:10.1093/acprof:oso/9780198526544.003.0019 · Cited by 40 · see citing works
Effects of Visual Aids for End-of-Life Care on Decisional Capacity of People With Dementia
Chang, W.-Z. D., & Bourgeois, M. S. (2019) · American Journal of Speech-Language Pathology · doi:10.1044/2019_ajslp-19-0028 · Cited by 39 · see citing works
Self-citationReview of AAC interventions in persons with dementia
May, A. A., Dada, S., & Murray, J. E. (2019) · International Journal of Language & Communication Disorders · doi:10.1111/1460-6984.12491 · Cited by 36 · see citing works
“…wallets (Bourgeois and Mason 1996), family caregivers were trained to teach persons with DAT to use a memory book in conversations with others (Bourgeois 1990), and nursing aides received brief instruction before using memory aids in conversation as part of the study (Hoerster et al. 2001).”
BackgroundMethodInfluentialAllen, R. S., & Shuster, J. L. (2002) · Behavioral Sciences & the Law · doi:10.1002/bsl.484 · Cited by 36 · see citing works
“This procedure has been used extensively in communication interventions with demented older adults (Bourgeois, 1990, 1992a, 1992b; Bourgeois, Burgio, Schulz, Beach, & Palmer, 1997; Bourgeois & Mason, 1996), and as an inclusion criterion for an investigation of end-of-life decision-making capacity…”
MethodCo-learning facilitates memory in mice: A new avenue in social neuroscience
Lipina, T. V., & Roder, J. (2012) · Neuropharmacology · doi:10.1016/j.neuropharm.2012.06.054 · Cited by 35 · see citing works
“2012 Alzheimer’ disorder (Bourgeois, 1990), and autistic children (Stichter et al.”
BackgroundSenseCam: A new tool for memory rehabilitation?
Dubourg, L., Silva, A. R., Fitamen, C., Moulin, C. J. A., & Souchay, C. (2016) · Revue Neurologique · doi:10.1016/j.neurol.2016.03.009 · Cited by 34 · see citing works
“[23] showed an increase in the number of autobiographical events recalled after presenting photos of the patient’s everyday life or borrowed from the family album, an improvement that persisted six weeks after presentation of the photos.”
BackgroundField-based development of an information support robot for persons with dementia
Inoue, T., Nihei, M., Takuya, N., Onoda, M., Rina, I., Ikuko, M., Shino, M., Kojima, H., Ohnaka, S., Fujita, Y., et al. (2012) · Technology and Disability · doi:10.3233/tad-120357 · Cited by 35 · see citing works
“Several projects have been undertaken to develop different types of assistance for persons with dementia that employ information technologies [4–11].”
BackgroundAbbott, K. H., Bettger, J. P., Hampton, K. N., & Kohler, H. (2013) · Dementia · doi:10.1177/1471301213494524 · Cited by 34 · see citing works
Psychosocial difficulties from the perspective of persons with neuropsychiatric disorders
Coenen, M., Cabello, M., Umlauf, S., Ayuso‐Mateos, J. L., Anczewska, M., Tourunen, J., Leonardi, M., Cieza, A., & PARADISE Consortium (2015) · Disability and Rehabilitation · doi:10.3109/09638288.2015.1074729 · Cited by 34 · see citing works
“To date, some communication skills trainings have been implemented in dementia [29] and Parkinson’s disease [30].”
BackgroundMoffat, N. (1992) · Springer eBooks · doi:10.1007/978-1-4899-4523-5_4 · Cited by 34 · see citing works
Alzheimer rehabilitation by students: Interventions and outcomes
Arkin, S. M. (2001) · Neuropsychological Rehabilitation · doi:10.1080/09602010143000059 · Cited by 33 · see citing works
“For information on the rationale, use, and benefits of memory ALZHEIMER REHABILITATION 281 books, see Bourgeois, 1990.”
BackgroundVolunteers in partnership: An Alzheimer's rehabilitation program delivered by students
Arkin, S. M. (1996) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/153331759601100103 · Cited by 33 · see citing works
Educating Individuals With Dementia
Davis, L. A. (2005) · Topics in Geriatric Rehabilitation · doi:10.1097/00013614-200510000-00007 · Cited by 30 · see citing works
ASSESSMENT OF PREFERENCE FOR EDIBLE AND LEISURE ITEMS IN INDIVIDUALS WITH DEMENTIA
Ortega, J. V., Iwata, B. A., Nogales‐González, C., & Frades, B. (2012) · Journal of Applied Behavior Analysis · doi:10.1901/jaba.2012.45-839 · Cited by 29 · see citing works
“…studies have demonstrated the success of behavioral interventions in maintaining adaptive skills in elderly individuals; however, many were multicomponent interventions that relied on participants’ ability to respond to instructions (e.g., Bourgeois, 1990; Brenske, Rudrud, Schulze, & Rapp, 2008).”
BackgroundPietro, M. J. S., & Boczko, F. (1998) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/153331759801300307 · Cited by 28 · see citing works
McPherson, A., Furniss, F., Sdogati, C., Cesaroni, F., Tartaglini, B., & Lindesay, J. E. B. (2001) · Aging & Mental Health · doi:10.1080/13607860120064970 · Cited by 28 · see citing works
“Provision and use of memory aids is a simple, inexpensive intervention that can be implemented by both paid, family, and volunteer carers with minimal or no training (Bourgeois, 1990; 1992; 1993; Bourgeois & Mason, 1996).”
BackgroundFundamentals of cognitive rehabilitation
Mateer, C. A. (2005) · doi:10.1093/acprof:oso/9780198526544.003.0003 · Cited by 28 · see citing works
Nolan, B. A. D., & Mathews, R. M. (2004) · Journal of Gerontological Nursing · doi:10.3928/0098-9134-20041001-07 · Cited by 27 · see citing works
Fabricatore, C., Radovic, D., López, X., Grasso-Cladera, A., & Salas, C. (2020) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2019.1589532 · Cited by 21 · see citing works
Disruptive vocalizations: A means to communicate in dementia?
Matteau, E., Landreville, P., Laplante, L., & Laplante, C. (2003) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/153331750301800307 · Cited by 25 · see citing works
Management of memory impairment in older people with dementia
Woods, B. T. (1994) · International Review of Psychiatry · doi:10.3109/09540269409023255 · Cited by 24 · see citing works
Stromer, R., Mackay, H. A., McVay, A. A., & Fowler, T. R. (1998) · Journal of Applied Behavior Analysis · doi:10.1901/jaba.1998.31-1 · Cited by 24 · see citing works
“Besides shopping, the feasible applications of lists of textual stimuli in work, residential, and therapeutic settings are plentiful and should be explored (e.g., Albin & Horner, 1988; Bourgeois, 1990; Cuvo, Davis, O’Reilly, Mooney, & Crowley, 1992; Lalli & Browder, 1993).”
Background4 Utilization of Cognitive Support for Episodic Remembering in Alzheimer's Disease
Herlitz, A., Lipinska, B., & Bäckman, L. (1992) · Advances in psychology · doi:10.1016/s0166-4115(08)60931-0 · Cited by 23 · see citing works
A history of cognitive rehabilitation
Prigatano, G. P. (2005) · doi:10.1093/acprof:oso/9780198526544.003.0001 · Cited by 22 · see citing works
Kindell, J., Wilkinson, R., & Keady, J. D. (2018) · Ageing and Society · doi:10.1017/s0144686x18000533 · Cited by 20 · see citing works
“discourse, including statements of information, when using the memory wallet, compared to conversations without the aid, with a variety of conversation partners including: spouses (Bourgeois 1990), staff (Bourgeois et al.”
BackgroundA Seat at the Table: Supporting Persons with Severe Dementia in Communicating Their Preferences
Burshnic, V., & Bourgeois, M. S. (2020) · Clinical Gerontologist · doi:10.1080/07317115.2020.1764686 · Cited by 19 · see citing works
“For example, pages of photographs paired with simple declarative sentences, known as Memory Books, have shown to promote less ambiguous, more factual statements (AndrewsSalvia, Roy, & Cameron, 2003; Bourgeois, 1990) and improve quality and equity in dyadic conversations (Bourgeois, Schulz, Burgio, & Beach, 2001).”
BackgroundSelf-citationLiang, J., Li, J., Jia, R., Ying-quan, W., Wu, R.-K., Zhang, H., Hang, L., Xu, Y., & Pan, C. (2018) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2018.09.017 · Cited by 19 · see citing works
de León, J. M. R. S. (2012) · Revista de Logopedia Foniatría y Audiología · doi:10.1016/j.rlfa.2012.02.002 · Cited by 19 · see citing works
Can executive impairments be effectively treated?
Evans, J. J. (2005) · doi:10.1093/acprof:oso/9780198526544.003.0020 · Cited by 19 · see citing works
TEACHING YOUNG CHILDREN TO USE CONTACT LENSES
Mathews, J. R., Hodson, G. D., Crist, W. B., & LaRoche, G. R. (1992) · Journal of Applied Behavior Analysis · doi:10.1901/jaba.1992.25-229 · Cited by 14 · see citing works
Alzheimer's disease. Physician-patient communication.
Orange, J. B., Molloy, D. W., Lever, J. A., Darzins, P., & Ganesan, C. R. (1994) · PubMed Central · Cited by 14 · see citing works
Cognitive-Linguistic Interventions for Persons With Dementia
Mahendra, N., Scullion, A., & Hamerschlag, C. (2011) · Topics in Geriatric Rehabilitation · doi:10.1097/tgr.0b013e31821e5945 · Cited by 13 · see citing works
Therapeutic approaches to age-associated neurocognitive disorders
O'Hara, R. M., Derouesné, C., Fountoulakis, K. Ν., & Yesavage, J. A. (2001) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2001.3.3/rohara · Cited by 13 · see citing works
“However, prosthetic memory aids such as diaries, memory wallets, and well-placed lists around the house and garden have been found to be helpful, particularly for early-stage patients who can benefit from the type of mnemonic cueing such aids provide.(152,153) Reminiscence therapy has also been postulated to be a pote…”
BackgroundBruce, C. M., Sanford, J. A., Calkins, M. P., & Brush, J. (2013) · Seminars in Speech and Language · doi:10.1055/s-0033-1337394 · Cited by 12 · see citing works
“45–48 Memory books with autobiographical information and daily schedules with prompts have also been reported to increase clients’ frequency of utterances, duration of speaking time, and range of discourse characteristics.”
Non‐Pharmacological Techniques
Woods, B. T. (2003) · doi:10.1002/9780470752340.ch31 · Cited by 12 · see citing works
Caregiving for Persons With Dementia
Bourgeois, M. S. (2019) · Topics in Language Disorders · doi:10.1097/tld.0000000000000166 · Cited by 11 · see citing works
Self-citationCognition and language in dementia patients: Contributions from behavior analysis
Aggio, N. M., Ducatti, M., & de Rose, J. C. C. (2018) · Behavioral Interventions · doi:10.1002/bin.1527 · Cited by 11 · see citing works
- Authors
- Bourgeois, M. S.
- Affiliations
- University of Pittsburgh (US)
- Corresponding author
- Bourgeois, Michelle S.
- Venue
- Journal of Applied Behavior Analysis
- Publisher
- Wiley
- Published
- 1990-03
- Volume
- 23
- Issue
- 1
- Pages
- 29-42
- ISSN
- 0021-8855 (ISSN-L)
- 1938-3703
- PMC
- PMC1286209
- OpenAlex
- W2017149161
- Cited by
- 200
- References
- 36
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 2 · 2020: 3 · 2019: 8 · 2018: 10 · 2017: 3 · 2016: 3 · 2015: 4 · 2014: 4 · 2013: 9 · 2012: 15
- FWCI
- 3.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Applied Behavior Analysis (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (AG 05-133, P50AG005133)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › Occupational Therapy › Assistive Technology in Communication and Mobility
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- Alzheimer's disease, conversation skills, caregiver education, memory aids, maintenance therapy, dementia
- MeSH terms
- Aged, Alzheimer Disease, Communication Devices for People with Disabilities, Consumer Behavior, Follow-Up Studies, Humans, Interpersonal Relations, Marriage, Memory, Mental Recall, Self-Help Devices, Social Environment, Speech Intelligibility, Verbal Behavior
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