Deixis and dementia: Insights from phenomenological philosophy

Abstract

This article provides an overview of the relevance of deixis in dementia from the perspective of phenomenological philosophy with an inter- and transdisciplinary scope. A key objective is to integrate existing approaches and develop hypotheses for future research. The paper seeks to explore the potential of deixis to enhance interaction and communication in the most common form of dementia, Alzheimer's disease. The paper prepares the ground for three sub-goals: (1) Developing a general taxonomy of deixis, differentiating between verbal deixis (e.g., pronouns), corporeal deixis (e.g., pointing gestures), and medial deixis (e.g., arrows). (2) Investigating the diagnostic, therapeutic and care applications of deixis in Alzheimer's disease in the face of the progressive loss of higher cognitive skills. (3) Pinpointing the desiderata emerging from the relation between deixis and dementia at both conceptual and empirical levels. This paper argues for viewing deixis not solely as a deficit-indicator but also as a resource-indicator. Deixis in dementia can serve on two interconnected yet distinct levels: one for diagnosis, and another for therapy and care. On the one hand, verbal indexicals have a deficit-indicating function for the loss of higher cognitive skills, such as language, orientation and memory. This function is relevant for linguistically shaped dementia diagnosis and a holistic interpretation of key symptoms. On the other hand, all three kinds of deixis, the verbal, the corporeal, and the medial, do have a resource-indicating function. The threefold deixis helps us to advance orientation, communication and interaction in both private and institutional living environments. For example, the corporeal deixis is an important communicative resource, which helps to navigate and maintain attention, intention, and emotion. Finally, the paper proposes an index-ability scale to identify personalized communication resources for individuals with dementia.