Do You Remember? How Caregivers Question Their Spouses Who Have Alzheimer’s Disease and the Impact on Communication

Abstract

This study examined the types of questions caregivers use and their outcomes when conversing with their spouse with Alzheimer's disease (AD). Of particular interest was caregivers' use of yes-no and open-ended questions and the demands they make on the memory of the person with AD. It was hypothesized that communication between caregivers and their spouses would be more successful when caregivers used yes-no rather than open-ended questions; however, it was also predicted that a more positive communication outcome would occur when caregivers used open-ended questions that requested information from semantic rather than episodic memory. Eighteen caregivers and their spouses diagnosed with AD were audiotaped while they conversed for approximately 10 min on a topic of their choosing. The conversations were transcribed and coded according to the occurrence of questions, the type of question (yes-no, choice, or open-ended), the type of memory required to respond to a question (semantic or episodic), and the outcome of a response to a question (communication breakdown). The results indicated that caregivers used yes-no and open-ended questions to a similar extent, whereas episodic questions were used almost twice as frequently as semantic questions. Communication was more successful when caregivers used yes-no compared with open-ended questions and when questions placed demands on semantic rather than episodic memory. The findings from this study suggest that caregivers can reduce communication problems by avoiding the use of questions that depend on episodic memory. In addition, while yes-no questions were associated with more favorable outcomes than open-ended questions, the latter do not need to be avoided if they refer to information that draws only on semantic memory.