User talk:Km14dv/Alzheimer's disease

Congratulations on getting your sandbox set up. --LynnMcCleary (talk) 21:31, 9 September 2014 (UTC)

Clarification from Professor Lynn

Hey guys! I asked Professor Lynn about what we're supposed to have done for Tuesday. This is what she said: You are beginning your discussion in your group sandbox talk page. That discussion will continue through the term. Even though this is a feature article, it does not have complete information about communication, how communication is affected in Alzheimer's, how it can be enhanced by people who are interacting with people who have Alzheimers. You and your group members will have to think about that and begin to figure out where there are opportunities for improvement. You can also figure out why it meets the good article or feature article criteria and what you won't want to mess with to not change that standard. We should also respond to the person who told us that the article is a featured article. I'm not sure how to get there though, do any of you? Have a great weekend! Ek13ld (talk) 14:12, 12 September 2014 (UTC)

Comment for us on article talk page

Hey Everyone! I found the link to reply to the person who made a comment about the featured article page. https://en.wikipedia.org/wiki/User_talk:KL5607445. Should I reply to him or would someone else like to? Kl13ah123 (talk) 22:18, 15 September 2014 (UTC)

If you you wouldn't mind replying to him Kl13ah, that would be awesome. Ek13ld (talk) 00:25, 16 September 2014 (UTC)

Great idea to respond and thank the editor who encouraged you. --LynnMcCleary (talk) 01:22, 23 September 2014 (UTC)

Initial critiques

For the Alzheimer's page, I think we should focus on the way that communication is affected by Alzheimer's disease and the need for different types of communication and understanding. For example, in the article it states that one of the treatments for Alzheimer's disease is caregiving. This paragraph explains how an individual must take extra caution when caring for those with Alzheimer's disease due to possible aggression and other mental disorders. However, it does not mention what communication techniques are used to communicate with those who have ALzheimer's to prevent aggression, facilitate living and enhance understanding. There should be mention of proper communication techniques in that section. We should also add in a section about communicating with those who have Alzheimer's disease and the potential problems or risks that accompany this. For example, listing some of the ways a patient's communication may change, ways of helping those with the disease communicate and activities or therapy for better communication. This could also be in a section that focuses on ways of coping when a family member or loved one has ALzheimer's disease. Since this is a featured article, we won't want to change anything that is already written, seeing as it has been edited by many people and is already at a featured article standard. Unless our information is more relevant or more useful, our changes will be edited out. We should focus more on adding new sections that contain new information rather than editing work that has already been written. Kl13ah123 (talk) 23:24, 15 September 2014 (UTC)

I agree with User Kl13ah123 on focusing on adding new information in relation to communication as opposed to just trying to edit the work that is already done on the page. I reviewed the 'Research Directions' section of the article. This part only provides information about research in new medications and pharmaceutical treatments. If we can find the resources, I think we should add information about research on what methods of communication works best with Alzheimer's patients. Then potentially add examples of the findings in the form of graphs, data charts, or even videos (if they exist). Moreover, when we add the section about communicating with those who have Alzheimer's disease, we should include materialistic ways to deliver communication. For example, communicating with dementia patients through the means of letters, recordings, pamphlets, posters, and so on. In addition, the communication section we are editing in should be added as a subsection under 'Management'. Ak13sn (talk) 21:45, 17 September 2014 (UTC)

Both of you have basically taken the words right out of my mouth. I love all of the ideas the two of you have brought to our discussion, particularly in terms of adding new sections instead of just adding to existing ones. However, one thing we could add to the "History" section could be how communication with people with Alzheimer's disease has changed since it has been discovered. This may give us some insight to the history of communication abilities as well as the disease itself. Another idea I have is to perhaps add a subsection to the "Prognosis" section of the article about the advantages/disadvantages that communication has on the course of the disease, if we can find the resources of course. I do have some personal experience on this topic; although we are not to be using primary resources, I may have access to extra resources. Ek13ld (talk) 03:20, 18 September 2014 (UTC)

I really like all the thoughts and ideas that everyone came up with and I mostly agree on them. While I was reading the whole article, I noticed that communication was rarely mentioned and I strongly agree that we should focus on that aspect like what User:Kl13ah123 has said in the beginning. Since we are all taking a course about communications in our program, I think it is an excellent idea to add information about communication and the disease because we are adding a new information and, thus, may be helpful for readers to know more about other aspects relating to Alzheimer's disease. Also, I was reading some research papers from reliable sources relating to Alzheimer's disease and they were really interesting. Some of the research papers that I have read discuss about their findings on the effect of social network on the relation between the brain function level in old people and the Alzheimer's disease. The other one that I read was about obesity and how it is linked to late onset Alzheimer's disease. I thought they would be helpful since we could help contribute them on one of the sections such as the "Lifestyle" section. One last thing, if we have enough time to research other information or if we think that we do need to put more contribution on how to make the page more informative, I was thinking of adding a section about how Alzheimer's disease is treated in different countries. Since the cost of treatment for Alzheimer's disease is expensive, I think it would be interesting to research some information and add it to the page about how some countries, like developing countries, treat people with Alzheimer's disease. Km14dv (talk) 02:33, 19 September 2014 (UTC)

I like that you're thinking beyond the assignment Km14dv and that you've considered the article broadly. For now, I advise you to stick with content related to communication. It would be great to add additional references or some information to other areas if you come across it in your research for the assignment. I like the idea of adding information, e.g., about other countries, but I don't want you to get overwhelmed having to search out more information that you need for this assignment. LynnMcCleary (talk) 01:22, 23 September 2014 (UTC)

Great comments and discussion everyone. You can now come to some conclusion about the various places that your information could fit and, importantly, the information in the article that whatever you want to add should be coherent with. You'll now need to move towards identifying what kind of information you need - so that you can all search efficiently towards your group goal. You'll notice that I changed the organization of your talk page a bit and added some headings. This might help you keep organized as you expand your discussion. Also, for your information, you'll see that my text of Km14dv's user name here and above is a link. If you use the editing for user, then the user will be notified when they are mentioned in Wikipedia. You can just copy from their signature, like I did here. LynnMcCleary (talk) 01:22, 23 September 2014 (UTC)

Where we should start

I think that we should start by finding some resources about communication in nursing. Specifically ones that can be used to better communicate with those who have alzheimer's disease. We should also pick certain parts of the wiki page that we want to work on personally so that we are not all editing the same paragraphs. We should our focus on communication and nursing and slowly begin to add other topics that are also relevant to Alzheimer's disease. Kl13ah123 (talk) 02:46, 24 September 2014 (UTC)

I completely agree with you Kl13ah. We should look for books on communication as well as the disease itself. Some places we can look for books include the Brock library, the St. Catharine's Public library, or maybe even nursing homes/hospitals. I'm not sure if such places would have books, but they may have other resources that would be helpful. I could imagine nursing homes having some sort of articles that would help families communicate with their loved ones who have Alzheimer's. Ek13ld (talk) 16:02, 24 September 2014 (UTC)

This is great guys, I like that we are all able to agree how we should go about editing this article. You guys have already discussed the main points, and just to add on, I reviewed the good article criteria. Part of the requirements was to remain neutral and avoid bias. I doubt we would have much of any biased information but I think we do our research, we definitely have to remember to get information from the patients, caregivers' and society's views and challenges regarding communication related to Alzheimer's disease. And any other information we find related to the topic on a broad spectrum, we can add under the 'Further Readings' section. Ak13sn (talk) 02:03, 25 September 2014 (UTC)

Hi everyone! I must say that I completely agree with the ideas you came up with for finding resources, and what I like more is the idea of getting some resources or information from nursing homes, patients, caregivers and so on, like some of us mentioned earlier. I think it is a good idea to go and find resources from those stated above but, then again, we should always keep in mind to stay neutral and not be biased on what we write on the page. Also, I would like to add that we should consider papers online, like journal arcticles, from reliable sources. I was on Google Scholar this morning researching some papers using keywords such as "communication", "Alzheimer's disease" and "nurses". I typed in as many keywords I could think of that is related to our topic on just one search click and I found some papers regarding to communications and the disease. And we can always use the "Supersearch engine" in our school's website and it might help us find more resources. Lastly, I was thinking of dividing the research about the different aspects of communication for us to avoid writing or researching the same exact thing and for each of us to have equal contribution on the group. To clarify, for example, someone could do the research about "communication strategies for caregivers or nurses to Alzheimer's disease patients" and the other could be about "the problems of communication between nurses and patients with Alzheimer's disease". Klausa (talk) 03:08, 25 September 2014 (UTC)

Sources

Hi Wiki friends! I’ve found one print book and two e-books that have potential to be helpful to our Wikipedia page. They are listed below.

1. Zarit, S. (n.d.). Caregiving for Alzheimer's disease and related disorders: Research, practice, policy. Retrieved from:

	http://link.springer.com/chapter/10.1007/978-1-4614-5335-2_7

•This source has a chapter entitled “Family Caregivers as Members of the Alzheimer’s Treatment Team.” It explains the responsibilities that the family has when caring for their loved one and the need for family interaction.

2. Cohen, D., & Eisdorfer, C. (1986). The loss of self: A family resource for the care of Alzheimer's disease and related disorders. New York: Norton. •This book has a few sections that may be helpful to us. The first is a chapter called “Ways of Caring,” which has information on the importance of overcoming any fears of the disease prior to communicating with the individual. Another useful chapter is “Caring at Home.” It outlines the significance of communication between family members and those with Alzheimer’s disease.

3. Alzheimer Society of Canada. (2011). Guidelines for care: person-centred care for people with dementia living in care homes. Retrieved from: http://books2.scholarsportal.info.proxy.library.brocku.ca/viewdoc.html?id= /ebooks/ebooks1/gibson_chrc/2013-25/1/10681876#tabview=tab1 •This source has information of the importance of family interaction for those with Alzheimer’s. Ek13ld (talk) 02:31, 30 September 2014 (UTC)

Hi everyone! Here are my 3 sources that I believe could help us with our wikipedia article. Unfortunately, they are all academic journals so I was unable to provide a link to my sources.

1. My first secondary source is from a chapter of the “Canadian Journal of Speech-Language Pathology and Audiology”. This chapter is a journal article that describes different communication strategies found to be useful when communicating with and assisting those who have Alzheimer’s disease. 33 communication strategies are mentioned in this chapter and the majority of them are labeled as useful strategies. We could talk about some of these communication strategies in detail and explain how and why they are used to communicate with those who have Alzheimer’s disease. The APA citation for this article is: Wilson, R., Rochon, E., Leonard, C., & Mihailidis, A. (2012). Formal Caregivers' Perceptions of Effective Communication Strategies while Assisting Residents with Alzheimer's disease During Activities of Daily Living. Canadian Journal Of Speech-Language Pathology & Audiology, 36(4), 314-331.

2. My second secondary source is pages 328-341 from a journal article called “Journal of Speech, Language and Hearing Research”. This chapter of the journal examines how caregiver’s successfully assist individuals with Alzheimer’s disease in performing everyday activities, and which communication strategies they use to be successful. It also examines which communication strategies have the highest rates of success and which communication strategies have the lowest rates of success. We could compare the different types of communication strategies to interact with people who have Alzheimer’s and compare which strategies are more beneficial to use. The APA citation for this article is: Wilson, R., Rochon, E., Mihailidis, A., & Leonard, C. (2012). Examining Success of Communication Strategies Used by Formal Caregivers Assisting Individuals with Alzheimer's Disease during an Activity of Daily Living. Journal Of Speech, Language, And Hearing Research, 55(2), 328-341.

3. My third secondary source is from pages 429- 458 in a journal article called “Canadian Modern Language Review”. This article examines the way that certain uses of languages and specific words can shape learning and aid comprehension in those with Alzheimer’s disease. This use of language can include specific rituals, routines, repetitions, and word choices to help aid comprehension. We could use this as a tutorial for communicating with those with Alzheimer’s (like a “do’s and don’t’s of communication). List some helpful hints to communicate with those who suffer from this disease. The APA citation for this article is: Wray, A. (2011). Formulaic Language as a Barrier to Effective Communication with People with Alzheimer's disease. Canadian Modern Language Review/La Revue Canadienne Des Langues Vivantes, 67(4), 429-458. doi:10.3138/cmlr.67.4.429 Kl13ah123 (talk) 03:04, 30 September 2014 (UTC)

Kl13ah123, the first and second sources are one research article. That's a primary source, not a secondary source. Perhaps other group members have ideas based on their searches or the bibliographies in sources they found. Most mental health nursing texts, some medical-surgical nursing texts, and many neurology and geriatrics textbooks would have relevant information. A librarian could help with searching. --LynnMcCleary (talk) 17:10, 7 October 2014 (UTC)

Hello friends. Here are my sources.

1. The first one is an academic journal I found online. It is a study based off of primary research/study and it focuses on communication misunderstandings and problems associated with troubled behaviors from the patient and increased stress on the caregivers part. This is from the "The International Journal of Language and Communication Disorders" Volume 49, Issue 1, Pages 49-59. APA Citation: Savundranayagam, M. Y., & Orange, J. B. (2013). Matched and mismatched appraisals of the effectiveness of communication strategies by family caregivers of persons with Alzheimer's disease. The International Journal of Language and Communication Disorders, 49, 49-59.

2. The second one is a scholarly review article that focuses on lack of proper communication associated with AD and explores effective methods of treatment and explains how poor communication correlates to caregiver stress. APA Citation: Woodward, M. (2013). Aspects of communication in Alzheimer's disease: Clinical features and treatment options. International Psychogeriatrics, 25, 877-885.

3. The third one is a book that I found at a public library. It is basically a guide that is meant to help the reader better communicate with a person with AD (mostly directed at those with loved ones who has AD). I figured this guide could help us add section on not only informing the readers on what the current communication issues and treatments are but also we could write up a section on basics on how to communicate with a person with AD. APA Citation: London, J. L. (2009). Connecting the dots: Breakthroughs in communication as Alzheimer's advances. United States. New Harbinger Publications. Anjana 04:45, 30 September 2014 (UTC) — Preceding unsigned comment added by Ak13sn (talk • contribs) Ak13sn (talk) 04:46, 30 September 2014 (UTC)

Ak13sn, the first source is a research article - a primary source, not a secondary source. See the suggestions I made to your group member, above. --LynnMcCleary (talk) 17:17, 7 October 2014 (UTC)

Hello everyone! I apologize for posting my secondary sources late. I found my three sources a while ago but they were invalid since we are not allowed to use research articles, and some of the books I had were mostly about dementia and had very little information about Alzheimer’s disease and communication. Thus, here are my three secondary sources I found at the public library:

1) Hodgson, H. W. (1995). Alzheimer’s: finding the words. Minneapolis, MN: Chronimed.

This book discusses about communication guides to family members and caregivers who interacts with Alzheimer’s disease (AD) patients. Examples of discussion in this book are about miscommunication between AD patients and family caregivers, caregiver’s response, how scripts help caregivers and family members in finding words to express to AD patients, and how music therapy helps AD patients.

2) Communication: understanding and being understood. (1998). In C. R. Hellen (Ed.), Alzheimer’s diseases: activity- focused care (2nd ed., pp 67-80). Woburn, MA: Butterworth- Heinemann.

This is a whole chapter about communication from the book “Alzheimer’s Diseases: Activity- Focused Care”. This chapter discusses about ways on how caregivers communicate for them to be understood and to understand AD patients when communicating or exchanging information with AD patients.

3) Davidson, F. G. (1999). The alzheimer’s sourcebook for caregivers: a practical guide for getting through the day. Lincolnwood (Chicago), IL: Lowell House.

There is one particular chapter in this book that is about communication. I am not sure how to cite the chapter since it is not an edited book but written by a single author. The chapter is called “Alzheimer’s Communication-Following Clues” and it discusses about how caregivers misinterpret verbal communication from Alzheimer’s disease (AD) patients because of their symptoms such as repeating words or sentences when talking. Also, the chapter discusses about the problems in care facilities, such that the needs of AD patients are not almost being met and ignored. Moreover, the chapter talks about strategies for caregivers in communicating with AD patients and how caregivers should prepare when responding after listening to them.Klausa (talk) 00:04, 3 October 2014 (UTC)

Klausa, you would cite the book.LynnMcCleary (talk) 01:43, 9 October 2014 (UTC)

Professor advice re: summarizing and collaborating

Klausa, Ak13sn, Kl13ah123 , and Ek13ld, you have a lot of information. I know some of you are probably still looking for secondary source. Textbook chapters would be good.

I have some suggestions for you – to help you keep your work manageable and within the scope of this assignment. You have the potential to get overwhelmed. See the course page for information about your tasks due October 22. As you're summarizing relevant information from your sources, keep your focus on what you could add to the aging article about communication. You will come across irrelevant information. Don't let yourself get side tracked by it (if you want you can keep it in mind to make additional editing suggestions but keeping focused will help you keep the scope of this assignment reasonable). Thinking about the communication model we learned about the first week of class might help you focus and organize your information.

Your summaries should be between 250 and at most 400 words for each source. Try not to make them long. If there aren’t 250 words worth of information in your source, don't blather on to fill space. I am looking for summaries I can understand and that are logical and coherent. You'll need to really focus in on the heart of the relevant findings. You should be aiming to tell your group members what the key messages are in your sources and how you think the information fits or doesn't fit with the article (it's okay if you logically determine that it wouldn't add to the article). If there is repetition within your sources, you should note that. Each summary should have a citation that is acceptable for Wikipedia and that has the information needed for a reader to verify your interpretation by finding your source. Links that only work within the university aren’t user friendly for me or your group members. If there is information that you can’t paraphrase, indicate quotes with quotation marks and page numbers.

When you've got your summaries done, hopefully there will be some themes and repetition among your summaries. Your job then is to collaboratively decide on what deserves to be suggested as an edit for the article and craft summaries of what your group found that could be incorporated in the article. That might be citations for information that is already there or new information. Discuss why your new information is relevant to the article.

I can copy the alzheimer’s article over to your sandbox so you can practice editing before you make any suggestions to the editors of the article. If you want me to do that, let me know by email or by using my user name in a response to this post. As always, I'm available to guide you. LynnMcCleary (talk) 01:44, 9 October 2014 (UTC)

Source Summaries

I just want to clarify that I have changed all of my sources to secondary sources (Chapters from books) and that these summaries do not apply to the sources I posted above.

1. Canadian Modern Language Review The APA citation is: Wray, A. (2011). Formulaic Language as a Barrier to Effective Communication with People with Alzheimer's disease. Canadian Modern Language Review/La Revue Canadienne Des Langues Vivantes, 67(4), 429-458. doi:10.3138/cmlr.67.4.429

This article demonstrates a variety of approaches to communicate with those who have Alzheimer’s disease. It examines the use of different languages, word choices, and routines to further understanding and foster learning in individuals who have cognitive disorders and difficulty communicating. This article displays that each person with Alzheimer’s disease has unique and individual needs. Each client’s use of language is a valuable window into his or her unique thought process. This can be used to determine what type of communication strategies that the client will respond best to. The communication barrier that exists is not simply one sided. It is caused by the lack of understanding between the client and nurse, not simply the client’s inability to formulate thoughts or to understand thoughts. Therefore, both parties of this relationship must work together to facilitate understanding and foster learning. This can be done by utilizing formulaic language and testing the effectiveness of different routines and rituals. This article explains the value and importance of using formulaic language to aid clients who have Alzheimer’s. Formulaic language is used to begin breaking down the communication barriers between the Alzheimer’s disease clients and the nurses or other health care professionals. As health care professionals, we must realize that those individuals who have Alzheimer’s disease are not children. However, we must not overestimate their ability to communicate or underestimate their willingness to communicate their views. We must aid them in reaching their potential and use different strategies to find the strategy that best suits their needs.

The main theme of this source relates to a book called Cognitive Communication Disorders. They both discuss an overview of Alzheimer’s disease and overcoming communication barriers. Kl13ah123 (talk) 19:30, 16 October 2014 (UTC)

2. Cognitive Communication Disorders The APA citation is: Kimbarow, M. L. (2011). The Dementias: An overview of Alzheimer disease and related disorders. Cognitive communication disorders (pp. 169-218). San Diego: Plural Publishing Inc..

The chapter of this book gives a brief overview of what Alzheimer’s disease affects inside of the aging body. It discusses topics such as cognitive deficits, memory deficits and language impairments in clients that suffer from Alzheimer’s disease. In order to understand why the communication barriers exist between nurses and clients who have Alzheimer’s disease, we must think about the effects of Alzheimer’s disease in terms of an impairment of an individual’s ability to think or express thought. The disease impairs cognitive functions far beyond what is typical of an aging person, and we must treat it this way. Due to the fact that memory retention is impaired in clients who have Alzheimer’s disease, nurses must take precautions to ensure that routines are followed everyday. We must inform the patient if a change is to be made and avoid new routes to locations. Clients often forget information that is told to them, so we must have patience and be prepared to explain information multiple times. In order to engage in discussion and establish a relationship of trust with clients who have Alzheimer’s, it is important to draw from their old childhood memories. When they begin to remember information, their oldest memories remain with them. Lastly, those with Alzheimer’s disease will have trouble reading, writing, and speaking. However, they may continue to have good social skills. It is important to use a variety of communication skills to interact with the clients, and determine which ones are most effective.

The main theme of this book was to give a brief overview of Alzheimer’s disease and to examine how they must be handled. This relates to the next book called Alzheimer’s disease: Caregiver practices, programs and community based strategies. Kl13ah123 (talk) 19:30, 16 October 2014 (UTC)

This is a great source and the information seems very detailed. The part about why communication barriers exist between nurses and clients is something that I definitely think we should incorporate into the wikipage. We just have to make sure we use the immediate relevant information though so that we don't get too broad and let the focus shift from communication to other aspects of Alzheimer's (i.e. cognitive deficits, how the disease affects aging body). But then again, we need the background information to understand the communication aspect. Hence, we should all discuss and agree on how brief and exactly how much background related information we need to incorporate into the page. Ak13sn (talk) 21:42, 22 October 2014 (UTC)

3. Alzheimer’s disease: Caregiver practices, programs and community based strategies. The APA citation for this is: Pfeiffer, E., Cairl, R., Middleton, L., Alexander, L., Kleine, E., & Elbare, J. (1989). Alzheimer's disease: caregiver practices, programs and community-based strategies. Tampa, Fla.: Suncoast Gerontology Center, University of South Florida.

This book talks about a variety of issues surrounding the caregivers of those who have Alzheimer’s. It discusses the problems and needs of caregivers, services for the caregiver and the client, and successful strategies when caring for those with Alzheimer’s disease. Caregiving is always a family affair. When a loved one suffers from Alzheimer’s disease, the entire family must support and nurture them. Those who have Alzheimer’s disease are not always cared for in institutions and are typically cared for by family members. The caregiver has a variety of different needs in order to successfully care for the client. This includes; knowledge about the disease, skills to take care of the client with the disease, emotional support and respite. Caregivers must not only have and be apply to apply knowledge concerning this disease, they must also be able to escape the burden of the role as caretaker from time to time. There are also a variety of groups to aid those who have Alzheimer’s disease, as well as the caregivers. These groups consist of family support groups, adult day care, at-home nurses, and institutional services. The family and other health care professionals must decide what will be most beneficial to the client. Lastly, there are a variety of strategies that can be utilized when interacting with individuals who have Alzheimer’s disease. There have been various trials conducted to determine what will be most beneficial to the clients. However, it was determined that each client is unique and benefits differently from each strategy. These strategies are further expressed and explained in this book. Kl13ah123 (talk) 19:30, 16 October 2014 (UTC)

Hi everyone! Here are my summaries from my 2 sources. I know that we are supposed to post our summaries from our 3 sources but one of the books I borrowed from the public library was reserved by someone and I have to wait this week to borrow it. I will post my summary from my third source as soon as possible this week.

Davidson, F. G. (1999). The alzheimer’s sourcebook for caregivers: a practical guide for getting through the day. Lincolnwood (Chicago), IL: Lowell House. The chapter in this book called “Alzheimer Communication-Following Clues” is about interpreting communication in Alzheimer’s disease, communication problems and how caregivers and family members can make a better understanding of good communication with patients diagnosed with Alzheimer’s disease by using several strategies. Obstacles that AD patients often experience when communicating include difficulties in building, rationalizing and expressing thoughts that leads them misinterpreting or mishearing what is said, and may struggle responding verbally. The obstacles that AD patients face in communication makes it difficult for caregivers to understand what the patient is trying to convey. It was mentioned that no word and action is meaningless, and therefore Alzheimer communication is no nonsense but has purposes. Language may be a struggle for AD patients and for caregiver’s interpretations but the way AD patients act is one alternative and significant way of conveying a message. Major communication problem in families and caregivers were discussed and examples were included such as using confrontation as communication, insisting and giving orders instead of suggesting, referring to absent objects, not telling anything to the patient as to they think may hurt them, ignoring their needs since it is hard to understand their language, and asking memory questions. Neglecting the needs of patients with AD by either ignoring or misinterpreting such communications with them can cause them to behave inappropriately to get what they want. Strategies that may help caregivers in communicating with AD patients include speaking on the same level with the person face-to face and speaking clear and simple sentences in a soft and kind voice to convey messages that can be easily absorbed. Since AD patients have difficulties remembering, the chapter discussed that memory questions should be avoided and that every interaction with the patients must involve the social skill of introducing yourself, regardless of how often you interact with them, to inform who you are. Acknowledging their emotional feelings and doing something about their needs are simple rules in communicating with AD patients to let them know that they are not alone. The chapter concluded that the basis of how caregivers and family members communicate with AD patients should be empathetic, understanding, receptivity, intuition and loving kindness.

As my second source, the book called “Alzheimer’s: finding the words” will discuss some similar aspects about communication in Alzheimer's disease as the first source.

Hodgson, H. W. (1995). Alzheimer’s: finding the words. Minneapolis, MN: Chronimed This book discusses the difficulty of communication between caregivers and Alzheimer’s disease (AD) patients and strategies that can be used by caregivers in Alzheimer’s communication. The book discussed about why caregivers and patients have difficulty communicating. Caregivers have partly difficulties talking to AD patients since the patients are less verbal and less aware leading the caregivers to guessing what the patient is thinking. Also, patients have difficulties talking to caregivers too such that caregivers do not have a clear understanding of the patients strengths. Furthermore, observation was concluded as a key for better communication, such that body language or gestures provide more information during communication. In the book, anger in caregivers was briefly discussed such that it is mostly observed in caregivers since their time is mostly given to patients with Alzheimer’s disease (AD). The caregiver’s anger reveals negative attitudes, such as impatience, and may cause them to have a gradually bad communication with patients, such as responding by speaking in a high pitch, irritated voice or not answering the patient. Sending negative messages such as not answering the patient could cause them to ineffectively communicate in the future. For caregivers, it is important for them to consider the way they send messages to patients such as being aware of their vocabulary or accent (e.g. using uncommon words), pitch (e.g. speaking in high pitch) and attitude (e.g. showing impatience) as these could create problems in Alzheimer’s communication. Furthermore, maintaining a cheerful attitude may be helpful for caregivers as they are not only sending a positive message to patients but giving remedy for their own dark times and preventing anger. Another aspect that caregivers should consider is eliminating background noises and making the patient comfortable (e.g. letting them sit or fully awaken when speaking to them) to allow them receive messages properly and preventing external and physiological noises. Since expressing thoughts become more complex for AD patients, waiting and valuing silence while the patient is trying to convey a message verbally is an indication for patients that the caregiver is paying a deep attention to them. Klausa (talk) 18:16, 20 October 2014 (UTC)

I like that the first source incorporates some reasons as to why clients with Alzheimer's disease have difficulty with communication. I also like that the second source describes the reasons nurses have difficulty communicating with those who have Alzheimer's disease. I agree that we should incorporate some of the difficulty's the caregivers have and the problems there experience in their life due to their care giver status (ex. depression, anger). I also agree that we should discuss that Alzheimer's patients should not be neglected or treated like children, simply because a care giver cannot understand them. Kl13ah123 (talk) 00:53, 21 October 2014 (UTC)

Here are my sources. I am also waiting on my third source, I shall post about it as soon as I have access to it.

1. This is a scholarly review article; APA Citation: Woodward, M. (2013). Aspects of communication in Alzheimer's disease: Clinical features and treatment options. International Psychogeriatrics, 25, 877-885.

In most patients, cognitive symptoms worsen overtime such as memory loss and language deficit. Loss of verbal fluency, decline in reading and writing skills, difficulty with comprehension and concentration are all symptoms that lead to trouble with initiating and maintaining conversations. These difficulties with communication cause frustration, and negatively impact maintenance of close relationships. In order for effective treatment to take place, it is essential to identify the communication deficits early in the disease course for better management, and provide necessary support at all stages. “Until now, studies of pharmacological treatment effects have tended to center on overall domain measures of cognition, function, behavior, and global outcome” (Woodward, p.879). Additionally, non pharmacological speech-language therapies and social programs should be explored as part of disease management. The focus of all treatments for AD should be to delay the decline in language and conversational ability. A study of dementia family caregivers found that communication issues predicted behavioral problems in patients with AD, which was a contributory factor for all forms of caregiver burden in terms of increasing demand and stress.

As I mentioned before, this article focuses on lack of proper communication associated with AD and investigates effective methods of treatment and explains how poor communication correlates to caregiver stress. This is a reoccurring theme in most of our sources. From this source, we can definitely use the detailed information on pharmacological treatment for the article. Ak13sn (talk) 21:55, 20 October 2014 (UTC)

2. APA Citation: London, J. L. (2009). Connecting the dots: Breakthroughs in communication as Alzheimer's advances. United States. New Harbinger Publications.

This book is basically a guide that is meant to help the reader better understand and communicate with a person with AD. In chapter 2, page 17, a list is provided on the type of attitude that enables the caregiver to continually treat the patient with AD as their loved one. This includes simple steps such as smiling, introducing yourself politely as many times as required, using an inviting tone, speaking slowly, using frequent gestures as you speak, etc. On page 18, there is another tool on empathizing with the patient. Informing oneself on the details of the patient’s life helps the caregiver carry on conversations and provides the caregiver with a better chance of comprehending what the patient is talking about with reduced levels of frustration. Moreover, on page 20, there is yet another tool providing tips on how to carry out a conversation. This includes acknowledging the patient by restating what they said, talking about past memories, and not expecting the patient to remember what either of you had said. Chapter 3 further explores communication when faced with challenges of hearing and visual distortion.

I think that the information from this book could really contribute to writing about how to communicate with AD patients in a more relational sense. For the lack of better words, the information would be more personal and in-depth as opposed to just providing general guidelines on how to interact with patients with AD. --Ak13sn (talk) 21:55, 20 October 2014 (UTC)

I agree that we should have a section about the deterioration of communication in client's with Alzheimer's disease and we should also focus on the ways we can prevent or work to aid this deterioration. I also liked that your second source provided tips and ways to facilitate communication with those who have difficulty communicating. It will also help others understand how to relate to the client a little bit more. Kl13ah123 (talk) 01:00, 21 October 2014 (UTC)

Hi Wiki friends! Sorry for the delay in posting. Here are my summaries for my 3 sources:

1. The APA citation for my first source is: Zarit, S., & Talley, R. (2013). Family Caregivers as Members of the Alzheimer’s Treatment Team. In Caregiving for Alzheimer's disease and related disorders: Research, practice, policy. New York: Springer. The chapter of this book that may be helpful to our project explain the responsibilities that the family has in order to take care of their loved one with Alzheimer’s disease. Family members are often the ones who have to make decisions for the patient. These decisions include when to seek help, what medications to use, etc. It is important for the family to stay calm during this time, as the patient will become confused. This chapter also demonstrates the fact that the family caregiver has the most experience with the patient, and must effectively communicate the patient’s needs to the physician/specialist that is helping the patient manage the disease. It is important for the family member’s to just be involved in the patient’s life, even if they cannot verbally communicate with you. It helps to relieve emotional stress of both the patient and the family members.

2. The APA citation for my next source is: Guidelines for care person-centred care of people with dementia living in care homes : Framework. (2011). Toronto, Ont.: Alzheimer Society of Canada. This e-book has a wide spectrum of information, however I was able to pull bits and pieces from a few chapters into one summary that I feel may be helpful. As the title suggests, the book puts stress on giving the Alzheimer’s patient “person-centred care.” This includes focusing on maintaining and making sure the patient stays as independent as possible and family members staying in touch with their relatives and continuing the bonds that they have. It is important to give the patient an environment that is calm and predictable. When communicating with the patient, it is also shown that they should not be asked lots of questions or given too many choices. This overwhelms the patient. On page 42, a guideline for communicating with persons was addressed: - Use simple words and short sentences in a gentle, calm tone of voice. - Avoid talking to the person with Alzheimer’s disease at a reduced cognitive level or discussing the person as if he or she was not there. - Minimize distractions and noise, such as the television or radio, to help the person focus on what you are saying. - Address the person by name, making sure you have his or her attention before speaking. - Allow time for the person to respond independently. Be careful not to interrupt. - If the person with Alzheimer’s disease is struggling to find a word or communicate a thought, gently try to provide the word he or she is looking for. Try to frame questions and instructions in a positive way. - Explain all procedures and activities in simple and straightforward terms to the person before performing them.

I think this is an excellent source that we could use for the page. I find the guideline provided to be extremely useful. A couple of the sources I found provided guidelines on communicating with AD patients as well. Some information might be repetitive, however, I think we can combine all of the sources to pick out common and most effective guidelines and use that for the page. Ak13sn (talk) 21:47, 22 October 2014 (UTC)

3. The APA citation for my final source is: Cohen, D., & Eisdorfer, C. (1986). The loss of self: A family resource for the care of Alzheimer's disease and related disorders. New York: Norton. This book states many information points that will be useful to our Wikipedia article. One of them is that it is important for family members not to forget that the patient has still has feelings, even if they cannot communicate them well. Although it is difficult, family members should stay calm and be patient with their loved one. This book also informs family members that despite the fact that the patient cannot effectively communicate, they still have needs for comfort, intimacy, and family involvement. An environment that is comforting and warm is a non-verbal way of helping the patient deal with the disease. Patients should also be included in conversations, even if they cannot verbally contribute. Ek13ld (talk) 21:01, 21 October 2014 (UTC)

I feel as though all of our sources give us a really strong foundation for the basis of what we can add to our wikipedia page. However, we should communicate with each other and discuss who will contribute what and to where. We can also take some time to discuss what other new pieces of knowledge we could add to the page that isn't just about communication. Kl13ah123 (talk) 04:49, 22 October 2014 (UTC)

Hello Wiksters, this is my third source.

APA citation: Hummert, M. L., & Nussbaum, J. F. (2001). Aging, Communication and Health: Linking Research and Practice for Successful Aging. London: Lawrence Erlbaum Associates, Publishers.

Chapters 7 and 10 in this book solely focus on communication and Alzheimer’s/dementia patients. Communication with people with severe dementia should be based on a consoling communication between carers and patients. Results from a past study that used an unstructured naturalistic method to identify emotions provided evidence that those with severe dementia do experience and communicate affect. For those with AD, nonverbal language is important as it is the main method of communication with others. It is important that caregivers are aware and sensitive to these nonverbal cues as they may aid in providing optimal care and reduce frustration. Aspects of nonverbal communication AD patients rely on include touch, facial expressions, and simple gestures. Researchers and clinicians affirm that enhanced communication in AD is best achieved within the framework of individual assessment based on real needs. In addition, caregivers learn to change their own behaviors or develop specific ways to adjust to the behaviors of the patient, which results in optimized communication interventions. In order to minimize communication related stress, caregivers must use strategies that target individual needs. The rest of the chapter contains tables that provide detailed strategies for effective communication.

Page 239: Language, cognition, and conversation strategies

Page 240: Speech and Non verbal strategies

Page 242: Communication Environment Strategies

Page 243: Strategies for Emotions, Interactive Style, Roles and Relationships and Perceptions and Attitudes

The information in these tables can be used along with the tools from the previous source, Connecting the dots: Breakthroughs in communication as Alzheimer's advances to create a section on how to best communicate with patients with Alzheimer’s. Ak13sn (talk) 21:20, 22 October 2014 (UTC)

After reading everyone's summaries, I can conclude that we've got a lot of information to use, however there is definitely a spot for everything. I think that we need to make a concrete decision on what sections we are going to add to the Alzheimer's page. I definitely think that we need a section that is solely called "Communicating with one with Alzheimer's," where we can add subsections such as what to do as the family member, caregiver, etc. What other sections could we add? Ek13ld (talk) 00:04, 23 October 2014 (UTC)

Hi Everyone! I apologize for posting my summary from my third source since I had to wait for the book's availability in the library. This is the APA citation of the book: Hellen, C. R. (1998). Alzheimer’s disease: activity-focused care (2nd ed.) . Woburn, MA: Butterworth-Heinemann.

This book has a specific chapter about communications regarding Alzheimer's disease and the title of the chapter is called "Communication: Understanding and Being Understood". First of all, the book uses the term "residents" to refer to persons with Alzheimer's diseases (AD) since the term "patient" is most likely preconceived as a negative term. The chapter begins with defining communication as an activity since it involves action and response. Thus, communication is caused by verbal and nonverbal responses. The requirements for caregiver's ability to understand the resident's communication involves careful listening, observation, time, and patience, and that messages must be responded by not only using words. Also, the chapter points out the objectives of the two types of responses in communication and some of these includes enabling self-expression of thoughts and needs and encourage understanding of others and the environment. A set of guidelines in communication were fully explained in the rest of the chapter and it is used for connecting with residents. The set of the guideline is abbreviated as "COMMUNICATIONS" (definitions of each word are clearly specified in the chapter) and it involves guidelines on verbal and nonverbal responses that can be used by caregivers. The language of touch was further discussed in the chapter and it elaborated touch as a component of communication and as a way of promoting resident’s positive quality of life (e.g. by patting on the shoulder, hugging or holding hands). However, the boundaries and location of touch must be considered since it can affect both resident and the caregiver. Caregivers must make an effort to connect with residents for them to be effective in communicating with residents and hold the resident in high regard and as a person of worth. Klausa (talk) 01:23, 26 October 2014 (UTC)

Summary Discussions

I have copied everyone's suggestions and comments in here from the "Summary Sources" Section so that it is easier for everyone to read them. --Klausa (talk) 04:07, 23 October 2014 (UTC)

Hodgson, H. W. (1995). Alzheimer’s: finding the words. Minneapolis, MN: Chronimed

I like that the first source incorporates some reasons as to why clients with Alzheimer's disease have difficulty with communication. I also like that the second source describes the reasons nurses have difficulty communicating with those who have Alzheimer's disease. I agree that we should incorporate some of the difficulty's the caregivers have and the problems there experience in their life due to their care giver status (ex. depression, anger). I also agree that we should discuss that Alzheimer's patients should not be neglected or treated like children, simply because a care giver cannot understand them. Kl13ah123 (talk) 00:53, 21 October 2014 (UTC)

Kimbarow, M. L. (2011). The Dementias: An overview of Alzheimer disease and related disorders. Cognitive communication disorders (pp. 169-218). San Diego: Plural Publishing Inc..

This is a great source and the information seems very detailed. The part about why communication barriers exist between nurses and clients is something that I definitely think we should incorporate into the wikipage. We just have to make sure we use the immediate relevant information though so that we don't get too broad and let the focus shift from communication to other aspects of Alzheimer's (i.e. cognitive deficits, how the disease affects aging body). But then again, we need the background information to understand the communication aspect. Hence, we should all discuss and agree on how brief and exactly how much background related information we need to incorporate into the page. Ak13sn (talk) 21:42, 22 October 2014 (UTC)

Guidelines for care person-centred care of people with dementia living in care homes : Framework. (2011). Toronto, Ont.: Alzheimer Society of Canada.

I think this is an excellent source that we could use for the page. I find the guideline provided to be extremely useful. A couple of the sources I found provided guidelines on communicating with AD patients as well. Some information might be repetitive, however, I think we can combine all of the sources to pick out common and most effective guidelines and use that for the page. Ak13sn (talk) 21:47, 22 October 2014 (UTC)

London, J. L. (2009). Connecting the dots: Breakthroughs in communication as Alzheimer's advances. United States. New Harbinger Publications.

I agree that we should have a section about the deterioration of communication in client's with Alzheimer's disease and we should also focus on the ways we can prevent or work to aid this deterioration. I also liked that your second source provided tips and ways to facilitate communication with those who have difficulty communicating. It will also help others understand how to relate to the client a little bit more. Kl13ah123 (talk) 01:00, 21 October 2014 (UTC)

Hummert, M. L., & Nussbaum, J. F. (2001). Aging, Communication and Health: Linking Research and Practice for Successful Aging. London: Lawrence Erlbaum Associates, Publishers.

I like this source as it has many varieties of information about strategies in Alzheimer's communication. Also, I think this is a great source to use for adding an information about the significance of nonverbal communication in our topic since most of our summaries have discussed that the ability of AD patients to verbally communicate is more complex than nonveral communication. Putting an information about nonverbal communication in our topic will be informative as if we will not be mostly discussing aspects of verbal communication in Alzheimer's Disease.

Other Suggestions

I feel as though all of our sources give us a really strong foundation for the basis of what we can add to our wikipedia page. However, we should communicate with each other and discuss who will contribute what and to where. We can also take some time to discuss what other new pieces of knowledge we could add to the page that isn't just about communication. Kl13ah123 (talk) 04:49, 22 October 2014 (UTC)

After reading everyone's summaries, I can conclude that we've got a lot of information to use, however there is definitely a spot for everything. I think that we need to make a concrete decision on what sections we are going to add to the Alzheimer's page. I definitely think that we need a section that is solely called "Communicating with one with Alzheimer's," where we can add subsections such as what to do as the family member, caregiver, etc. What other sections could we add?

Ek13ld (talk) 00:04, 23 October 2014 (UTC) — Preceding unsigned comment added by Km14dv (talk • contribs)

I think that we should add a section about common effective strategies or guides in communicating with patients with Alzheimer's disease. I have noticed that most of our summaries discussed some common strategies and guidlines (e.g. speaking slowly, not asking a lot of questions, avoiding noises and etc.) that could help caregivers and family members to communicate well with AD patients and I think that we should gather those information from all the sources we have in common and integrate them. Klausa (talk) 04:07, 23 October 2014 (UTC)

Discussion about where to go from here

Hey Wiki friends! After reading our sources, I think it's a good idea to add a section called Communication to the article. We can try and organize our ideas into the following subsections: -Miscommunication problems/barriers -Non-verbal communication techniques -Verbal communication techniques -Cognitive disorders and its effect on communication

My suggestion is to look at your source summaries and see where you can pull information that goes under each of these sections. Maybe we can try and do this by Sunday so we can collect all of our separate information and form proper paragraphs. Let me know what you think. :) Ek13ld (talk) 18:00, 30 October 2014 (UTC)

This is a great idea, I'll put up the subsections in bold below so everyone can just add their information under whichever one. Ak13sn (talk) 18:39, 2 November 2014 (UTC)

Miscommunication Problems/Barriers

Recognizing the decline in language and functional communication can extend patient independence, and postpone/avoid irritation and associated behavioral concerns. Impeding the decline in conversational capability could potentially allow patients to preserve social skills and contribute to their personal relationships for longer period of time. Some investigations indicate that non-pharmacological approaches such as speech-language therapies and social programs could help decrease communication barriers (Woodward, 2013). Ak13sn (talk) 19:26, 2 November 2014 (UTC)

Often, there are problems with miscommunication among the family and the physician. It is important to remember that the family caregivers are the people who know most about the patient, and are there to help make choices about what medications to use, when to seek help, and so on. (Zarit & Talley, 2013). Ek13ld (talk) — Preceding undated comment added 22:10, 2 November 2014 (UTC)

Often times, clients with Alzheimer's disease find it very difficult to communicate with others or understand what others are attempting to communicate. Individuals must use a variety of techniques to improve understanding and foster learning. These techniques include using precise and the exact same wording each time directions are given and following an unchanging daily schedule. By utilizing the exact wording each time a direction is giving, the helps clients understand the meaning and makes it easier for them to perform the given task. It is also important to inform the client and the client's family about each decision that is made so communication may be facilitated (Wray, 2011). Kl13ah123 (talk) 03:17, 3 November 2014 (UTC)

Non-verbal Communication Techniques

Sometimes it is difficult to directly communicate with an AD patient verbally. Especially with older patients as they have trouble understanding certain words, keeping track of the entire conversation, and remembering key points. Therefore, using the right techniques of non-verbal communication is essential. Below is a list of non-verbal techniques to use when communicating with an AD patient.

-Use slow and conscious movements; sudden ones may appear to be threatening (Hummert & Nussbaum, 2001)

-Make eye contact on the same physical plane and position yourself to be face-to-face with the individual (London, 2009)

-Making eye contact with Alzheimer's patients is recommended by health professionals and it increases caregiver's chances of getting messages across the patient(Davidson, 1999).Klausa (talk) 21:12, 2 November 2014 (UTC)

-Use hand gestures to go along with what you say (London, 2009)

-Touch the individual lightly on the hand to regain attention and to comfort but not until your presence is known by the patient (Hummert, 2001)

-AD patients need to be gently brought back into the here and now because they often spend periods of time in altered consciousness (Davidson, 1999)Klausa (talk) 21:12, 2 November 2014 (UTC)

Try to avoid and be aware of body language that indicate rejection, restlessness, and lack of dedication such as crossing arms and legs, hasty movements i.e. foot and hand tapping, constantly checking the time, and turning away or breaking eye contact when the patient is speaking (Hummert & Nussbaum, 2001). Ak13sn (talk) 18:43, 2 November 2014 (UTC)

Even if you are unable to verbally communicate with an AD patient, it is important to continue to be involved in his/her life. Simply being around him/her is therapeutic, and it will help relieve emotional stress of the patient and the family member (Zarit & Talley, 2013). Ek13ld (talk) 22:23, 2 November 2014 (UTC)

It is important to create an environment that is calm and predictable for the AD patient. Minimizing noise and other distractions are helpful in doing so. This will also allow the patient to focus on what you are saying. Stress should also be placed on giving the patient "person-centred care", which includes helping the patient maintain a life that is as independent as possible. (Alzheimer's Society of Canada, 2011). Ek13ld (talk) 22:39, 2 November 2014 (UTC)

As the disease progresses, language becomes a struggle for AD patients and for caregiver's interpretation and understanding. However, observing the patient's actions when they are trying to convey a message verbally will help caregivers to receive the message. When language gradually becomes impaired, action is left as the only thing to interpret what they are trying to convey and it becomes a symbolic portrayal of their truth (Davidson, 1999).Klausa (talk) 01:58, 3 November 2014 (UTC)

Since AD patients lose their sense of direction, it is important to include directional signals in conversations to reassure them, help them get their bearings and let them know what to expect (Hodgson, 1995). Klausa (talk) 01:58, 3 November 2014 (UTC)

It is very important to convey a sense of warmth and understanding towards clients who have Alzheimer's disease. These clients are often confused and require much more attention, repetition, and care. This can be frustrating to the health care professionals or family members. However, it is important to demonstrate patience and work through any difficulties that the patient might have, due to the fact that clients with this disease do not understand why others project frustration towards them. Families must demonstrate supportive behaviour and be prepared to demonstrate warmth and love at all times (Pfeiffer et al., 1989). Kl13ah123 (talk) 04:19, 3 November 2014 (UTC)

Verbal Communication Techniques

Assessing a the person with Alzheimer's disease's hearing and vision is an important consideration in promoting good verbal communication (Hellen, 1998)Klausa (talk) 21:12, 2 November 2014 (UTC)

When communicating with an AD patient, there are many verbal techniques one can use to ensure the patient is understanding to the best of his/her ability. A calm tone of voice that uses simple and short sentences is effective. It is also important not to ask too many questions or give the patient too many choices as this will overwhelm him/her. When asking questions, allow the patient to respond independently and be patient with this response. If he/she is struggling with a word, calmly suggest a word they might be looking for. One should also address the patient by name, and avoid talking to them as if they are a child (Alzheimer's Society of Canada, 2011). Ek13ld (talk) 23:39, 2 November 2014 (UTC)

It is important to consider voice pitch when communicating with AD patients because changing the pitch of a word can alter its meaning completely. Communicating with AD patients in a high pitch voice may indicate a false praise or sarcasm for the patient and it is best to avoid ending sentences on a higher pitch. However, lower pitch is more suitable when communicating with AD patients because it is considered to be a sign of the caregiver's sincerity (Hodgson, 1995).Klausa (talk) 01:58, 3 November 2014 (UTC)

Formulaic language is an effective technique where the health professional utilizes specific words to foster learning and make communication more effective in patients. It is also important for the client's family and their health professionals to inform the client of every decision and action being made. Although it is also important not to overwhelm the client with possibilities (Wray, 2011). Kl13ah123 (talk) 04:19, 3 November 2014 (UTC)

Cognitive Disorders and its Effect on Communication

The cognitive effects of AD extend beyond memory loss to a deficit in overall functional communication. The declines in communication skills negatively influence their day-to-day life, affecting their ability to converse, socialize, and sustain relationships, thus triggering behavioral and psychological problems. Caregiver strain is also increased due to poor/lack of communication (Woodward, 2013). Ak13sn (talk) 19:12, 2 November 2014 (UTC)

Alzheimer's disease is an impairment of an individuals ability to think or express thought. It impairs cognitive function beyond what is typical for an elderly person. This causes memory loss and an inability to communicate (Kimbarow, 2011). Kl13ah123 (talk) 04:19, 3 November 2014 (UTC)

Extra Information(s)

This is not a subsection that will be posted in the article page but I just thought that the information below that I got from my sources are relevant and I couldn't think of which subsection should I add these information into. Klausa (talk) 21:12, 2 November 2014 (UTC)

-Empathetic understanding, receptivity, intuition and loving kindness should be the basis of all our communication in Alzheimer's Diseases Klausa (talk) 21:12, 2 November 2014 (UTC)

(Davidson, 1999)

-Both resident and caregiver's tone of voice and body language become primary transmitters of language and understanding (Hellen, 1998)Klausa (talk) 23:47, 2 November 2014 (UTC)

--This could be added to verbal. Ek13ld (talk) 18:45, 4 November 2014 (UTC)

I'm also unsure as to where this point should go. Do any of you have any ideas?

-Although the patient cannot always effectively communicate, they still have needs for comfort, intimacy, and family involvement. Patients should be included in conversations, even if they are unable to verbally contribute. Ek13ld (talk) 23:45, 2 November 2014 (UTC)

--I'm going to add this part to the beginning of the section. Ek13ld (talk) 20:33, 4 November 2014 (UTC)

Editing the article

Ek13ld, Klausa, Ak13sn, Kl13ah123 I received this message of advice for you:

Please have your students familiarize themselves with WP:MEDMOS and WP:OWN#Featured articles; inexperienced editors will have a more pleasant experience on Wikipedia, and cause less work for established editors in cleaning up their work, if they are familiar with these basic guidelines.

and this message:

Please have your students familiarize themselves with WP:MEDMOS and consider discussing their edits on talk before moving them out of sandbox so other editors will not have to correct them. Also, please have them review WP:OWN#Featured articles; it is important to consult other editors when editing a featured article.

LynnMcCleary (talk) 14:10, 5 November 2014 (UTC)

How to add to a featured article

@Kl13ah123, Ek13ld, Km14dv, and Ak13sn: I noticed that your proposed change to Alzheimer's disease was reverted. I wanted to drop by and explain why that was and try to work with you to restructure the section to allow your work to be added to that article eventually, since you've worked pretty hard on it and it does cover a hole in our current coverage. Adding to a featured article is hard, adding to one which also has to meet the medicine WikiProject's stringent sourcing guides is even harder, but it's not an insurmountable task. I'll try to outline below the changes I think you'll need to make to this draft to bring your work on to Wikipedia.

• First, I'd recommend deleting everything in the draft which isn't related to your section. If you take out everything but communication (Which is the only section you've changed) you'll be able to focus clearly on honing the content you have and not have to worry about anything else. Basically cut out everything but Communication and the references list. When you copy your content over you can just copy the sections, the references will automatically update.
• Second, remove everything that isn't about the subject expressly. Sentences like "Communication is a constant process between two or more individuals" can be removed, as can "In health care settings, miscommunication often occurs between the family and the physician, as well as the patient and the physician." While both are true, they are general statements and they are better left unsaid or explained via wikilinks to other articles like health communication.
• Third, the article on Alzheimer's disease is meant to serve as a general reference for the research, history and impact of the disease itself. While communicating with patients with Alzheimer’s disease is an important part of the disease itself, you want to refrain from offering advice on how to communicate. This includes best practices and pitfalls. There are a few reasons for this. First, wikipedia articles should (as a general rule) not contain "how to's" for the subject. On an article like bread we don't list a recipe for rye bread--while comparing that to best practicies for patient care seems crass they're functionally very close. Second, medical articles are read by a number of people who are caring for relatives with particular diseases and (sometimes, though few admit it) health care professionals, so the medicine wikiproject is especially focused on making sure that our articles on diseases don't include practical guides for treatment. Content with suggested techniques, pitfalls and other related guidance is very unlikely to remain on a featured article within the remit of WikiProject Medicine.
• Fourth, review the current article on Alzheimer's disease and look at how the text is formatted. Note that many important topics are "wikilinked" to their associated articles. This helps build the web between wikipedia articles but it also allows editors to concisely express concepts to a general audience without using (much) jargon. For instance, the phrase "Antipsychotic drugs are modestly useful in reducing aggression and psychosis in Alzheimer's disease with behavioural problems" can be terse and compact because an interested reader will click on the blue links to find out more without our having to explain or define those three terms in text. Those links are something wikipedia readers expect and your peers editing the Alzheimer's article will demand. You can also look at the article to see the style and tone that the remainder of the article adopts.
• Finally, you'll want to comb through your sources and make sure that you have the best sourcing available on the problem and that those sources are supplied with tools for editors to verify your work. You'll notice that many of the other sources in the articles have links to doi/pmid or ISBN numbers for journal articles and books respectively. That's not strictly required but it is something that the editors maintaining a featured article like Alzheimer's will expect. This also means that sources like "Guidelines for care person-centred care of people with dementia living in care homes" will probably need to be removed entirely (as will books like ISBN 0962207004).

Restructuring the section will require you to focus on the communicative impairments associated with the disease (support for which you'll want to find in literature reviews of the field or relatively well regarded recent studies on the matter) as well as the barriers created on the caregiver side. Since you are coming from a nursing background, you'll have a slightly different focus than the traditionally medicine focused editors--that doesn't mean your work on patient care has to be thrown out, it just needs to be reframed as a summary of the literature and have the components which represent best practices removed.

If you want help refactoring this section to try to get it into the article again, you can let me know on my talk page and I'll do my best to give you a hand. Adam (Wiki Ed) (talk) 23:37, 5 November 2014 (UTC)

Thank you Adam (Wiki Ed) LynnMcCleary (talk) 22:32, 6 November 2014 (UTC)

@Kl13ah123, Ek13ld, Km14dv, and Ak13sn: While I commend Adam (Wiki Ed) for taking the time to provide a good deal of helpful information, for many reasons, doing all of the above is unlikely to result in meaningful content additions to the article. HOWTO and off-topic information needs to be removed, but also, article structure for a broad overview article must be considered, and students should notice where communication aspects of AZ are already discussed within Wikipedia style guidelines for medical articles, and be aware of how it issues of how much weight to give to any one topic are decided on Wikipedia. Further discussion here; please review WP:MEDMOS for starters, as a separate communication section is not called for, and be aware of the multiple sections within an overview of AZ where communication is already discussed. SandyGeorgia (Talk) 22:19, 6 November 2014 (UTC)

The Section We Wanted to Add on to the Actual Page

@Kl13ah123, Ek13ld, Km14dv, and Ak13sn: I've removed the copy of what you wanted to edit from the talk page. I thought it might be confusing to have it both here and in the sandbox. I hope this is okay with you. I will add some direction for your classmates who will be giving you some feedback --LynnMcCleary (talk) 23:03, 6 November 2014 (UTC)

For classmates or other editors who would like to help the students with their editing, the sandbox (user page) has the edits that the group originally added to the Alzheimer page. Those edits were reverted. See the Alzheimer talk page and this section of the talk page for project medicine for information about the of the rationale for reverting the edits. There is also relevant information posted above on this talk page. LynnMcCleary (talk) 23:03, 6 November 2014 (UTC)

Professor advice for revising edits - and direction for student reviewers

@Kl13ah123, Ek13ld, Km14dv, and Ak13sn: I've sent you a Sakai email with some advice. I suggest that you read Adam (Wiki Ed)'s advice and take him up on his offer of more advice to help you figure out how to take the most important and most credibly sourced information you have to make a concise suggested edit. SandyGeorgia's advice to try to figure out where what you've learned fits with what is already integrated about communication is good advice. Your classmates Bm14pqKp13mn and Ls12ue will be helping give you advice on this as well. When you've figured this out, you can propose a change on the Alzheimer talk page and wait to see what other editors think. I can help you with the logistics of doing that if you want. You're almost finished with the assignment. I'm so pleased with everything you've learned about Wikipedia, communication, and Alzheimer's. This last step will really help you with your critical thinking and concise writing skills. It's a great opportunity for you and you're fortunate to have support from Wikipedia editors in this learning.LynnMcCleary (talk) 23:27, 6 November 2014 (UTC)

Students, for an example of how concise relevant information about communication can be integrated into a medical article, see these examples at the bottom of the the stroke talk page. LynnMcCleary (talk) 00:06, 7 November 2014 (UTC)

@Kp13mn, Ls12ue, and Bm14pq:, you're assigned to review the suggested edits. Your task is to help your classmates figure out what fits well with the Wikipedia and strong articles like this one (see the Five Pillars we learned about in the beginning of the course and the helpful comments of other editors above). Your classmates need to figure out what information is appropriate to make a small contribution. They're aiming for something that is like the information on communication that is already integrated into the article - but not replicating, duplicating, or unnecessarily lengthening what is already there. To help them, you need to read their suggested edits (in the sandbox) and read the Alzheimer article and figure out what logically fits and what would be essential in Wikipedia (recalling from what you learned about the Five Pillars that this is an encyclopedia, not a text book). You have a great opportunity here to learn a lot about Wikipedia editing and help make a meaningful contribution. Your classmates need meaningful, relevant, helpful feedback and advice.LynnMcCleary (talk) 23:27, 6 November 2014 (UTC)

Summary

After reviewing what your group wants to add to this page, I couldn't help but feel sorry for your group because you guys have a lot of very useful information that may never see the actual article due to the fact you got stuck with a featured article... Overall, I was impressed with what you guys came up with and it followed the Five Pillars of Wikipedia fairly well. However, in regards to the article being neutral, I'm not sure if patient is the right word to use in the communication context because it seems as if its directed towards health care professionals (which I can see why you wrote it like that because we are a nursing class). While communicating with a person with Alzheimer's does not make them a patient, they could be a friend, or family member as well. Maybe just generalizing patient as “person” or “individual” could help there. I'm not too sure if any information should really be cut from your information or not. However, if its possible to condense it, that could help! Hopefully that didn't come off rude! It was the only thing I could find on your article that I was a little unsure of, and I just want to help! Great work though guys! Bm14pq (talk) 00:59, 11 November 2014 (UTC)

Hi guys, i have been assigned to review your edits and give my feedback. Overall, i thought all of the edits were well written, and easy to follow. I also agree that the edits follow the Five Pillars to a certain degree. The only thing that i noticed that could be fixed was previously mentioned, which is the continuation of the term "patient" being used. I found that it was used almost every time when referring to an individual with the disease. Although this term would be used from our point of view as we are nursing students learning how to treat/care for individuals referred to as "patients" in the health system, it does not apply to everyone with the disease. I personally believe that using that term could possibly offend people as not everyone likes to be refereed to as a patient. Maybe using the terms "individual", or "person", as mentioned before, would be beneficial and allow the people reading the article to not view everyone as "patient" that has the disease, and rather just a person like everyone else. I do not think anything should be cut, as your sentences all flow, and do not seem repetitive. I think everyone did a great job, and I am also sorry that your edits may never be posted, that must be frustrating. But, once again, excellent work everyone! :) Kp13mn (talk) 21:07, 11 November 2014 (UTC)

Hey guys, very good job on your research since this we all know this was a tough project and I commend you work and contributions. I think the information you were trying to add is very relatable for most patients, however, from reading the comments Adam has made, I believe it is leading towards typical things that occur. Not every patient will respond the same way to the same treatment and it would be better to leave out any such ideas. The sentence in the verbal communication section regarding not talking to patients as if they are a child is a general statement and I feel that the featured article would not have it showing, so it is unnecessary. Overall, the research and information was well presented and formatted, however, there are many general sentences that can be removed for they tend to portray obvious characteristics. I liked how you included that pitch/tone of the communicator’s voice affects how the patient experiences the conversation, but I feel that not every patient would respond to the higher pitch in a negative way. Since patients vary in both progression of the disease and onset of the disease, generalizing the communication techniques does not always apply to the situations. Rephrasing sentences such as “do not ask too many questions or give the patient too many choices as this will overwhelm him/her” could be restructured to not generalize and make the assumption that this will occur in every case. Also, removing sentences that perceive a guideline for people reading the article to follow should also be removed such as the sentence “It is important to follow guidelines for improving a patient's non-verbal and verbal communication in order for him or her to have the highest cognitive ability possible for the circumstance.” This sentence is beneficial to readers; it just presents itself as a guarantee that if a reader follows a guideline for improving non-verbal and verbal communication, that the patient will be able to perform at a higher level. The intent was good, it just leads the reader to an assumption. I enjoyed reading your edits and I wish you the best in correcting and moving forward. I also agree with Bm14pq and Kp13mn in the use of the word patient, as not everyone experiencing AD would be considered a patient. Perhaps using a more neutral word, such as “person” would ensure a neutral basis. Best of luck to you all! Ls12ue (talk) 15:40, 12 November 2014 (UTC)

Hello everyone! Thank you very much for the feedback on our edits to the wikipedia article. We have changed our edits so that they would be more neutral, by changing the word patient to the word individual. We also attempted to follow the wikipedia style guide and 5 pillars more closely. Although we have made these changes to our edits, we will not be posting them on the Alzhiemer's disease article page. This feedback was very helpful when we made our edits to our original comments and you all gave us very useful feedback. Kl13ah123 (talk) 06:17, 23 November 2014 (UTC)

Followup

I have looked at this version of this project sandbox, and have to disagree with the poster above who asserts that "you guys have a lot of very useful information that may never see the actual article due to the fact you got stuck with a featured article". The problems with these proposed edits apply to any article: specifically that a large amount of the text goes off-topic for a broad overview article (on Wikipedia, we use wikilinks to link to relevant articles rather than covering the same territory in every article ... this article is not about communication, rather Alzheimer's, and communication concepts belong in their own article), and it contains anecdotal summaries that are not encyclopedic (see the first paragraph ... that is not encyclopedic writing style, although it is common for student term papers). I hope this content is not added to the article, as it isn't yet ready. Perhaps you all can find a few relevant sentences that can be incorporated into the content that is already there and that complies with our style guide for sections. SandyGeorgia (Talk) 16:51, 20 November 2014 (UTC)

Thank you SandyGeorgia. The students are working in their sandbox. If they decide that they would like to suggest any edits to an article, they will engage in discussion with editors on the article talkpage. --LynnMcCleary (talk) 20:53, 20 November 2014 (UTC)