Epistemics and frontotemporal dementia

Abstract

We explore how patients with the behavioural variant of frontotemporal dementia (bvFTD) display different degrees of understanding when reporting on their experience of being ill. Using the methods of conversation analysis, we examine thevideo-recordings of bvFTD patients who had participated in clinical follow-up interviews with a doctor. Patient responses to the doctor’s questions were analyzed with respect to the action undertaken (i.e., confirmation vs. denial) and the epistemic stance (i.e., certainty vs. uncertainty) that was conveyed. We found that although patient denials of being ill were conveyed with certainty, these patients were unable to elaborate on their denials, thus generating an implication that they are not aware of their illness and its effects on their lives. By contrast, patients who confirmed being ill tended to produce expanded responses that either revealed the patient’s primary access to knowledge or the patient’s difficulty in understanding the doctor’s question.

Keywords

• conversation analysis
• dementia
• epistemic stance
• frontotemporal dementia
• medical discourse