‘i like 88.’ ‘do you mean you like rice?’ intra- and intergenerational talk in a japanese...
TRANSCRIPT
‘I LIKE 88.’ ‘DO YOU MEAN YOU LIKE RICE?’
INTRA- AND INTERGENERATIONAL TALK IN A JAPANESE GERIATRIC HOSPITAL
TOSHI HAMAGUCHI, PH.D.
UNIVERSITY OF THE SACRED HEART, TOKYO
Social motivation of studying language and aging
Cultural influences on discourse of and with the elderly
Scholarly implications for further research
JAPAN: SUPER-AGING SOCIETY
Okinawa, the southernmost part of Japan, is one of the 5 “blue zones” in the world where people live the longest. (Dan Buettner, GSA 2011 plenary speaker)
http://www.bluezones.com/2011/09/5-rules-for-building-true-friendships/
OKINAWA: BLUE ZONE“Okinawa’s Ushi Okushima still gardening at age 109”
http://www.bluezones.com/live-longer/
OLDEST PERSON TO SCALE MT. EVEREST
Alpinist and professional skier Yuichiro Miura climbed Mt. Everest in May 2013 at the age of 80. This was his 3rd time to climb Mt. Everest (the 2nd time was only 5 years ago, when he was 75).
HOW OLD IS OLD?
(Finishing a phone conversation with a jeweler)
“It was Mr. Aida. He says he’s retiring at the end of this month. He’s still 82.”
JAPAN AS SUPER-AGING SOCIETY
Life expectancy (2012): Men 79.44 yrs old
Women 85.90 yrs old
In 2012, 30,740,000 people were over 65. This is about 1 in 4 people (24.1%) of total population. Moreover, 15% have dementia (4,620,000).
It is estimated that by 2025, 30.5% of the population will be over 65, and 25% will be over 75.
Centenarians reached at 51,376 people in 2012, of which 87.3% were women.
(Source: Asahi Shimbun June 1st, 2013, Ministry of Health, Labor, and Welfare)
POPULATION BY AGE: DECLINING BIRTHRATE & AGING GROWTH
0- 4
10-14
20-24
30-34
40-44
50-54
60-64
70-74
80-84
90-
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
53235639
59026001
66777272
83949535
842477037651
90619356
83426879
57914221
23231326
1,326,000
Roughly one in 4 is over 65.
(1000)
Statistics Japan
ELDERLY POPULATION GROWTH (1990-2012)
1990 2000 20120
1000
2000
3000
4000
5000
6000
85+80+75+70+
10,0
00
Ministry of Health, Labor and Welfare
CENTENARIANS IN JAPAN (1991-2010)
1991
1993
1995
1997
1999
2001
2003
2005
2007
2009
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
45,000
50,000
Women Men
Ministry of Health, Labor and Welfare
JAPAN AS “AGED” SOCIETY
WHO’s definition of ‘aging’ vs ‘aged’ society
65+ < →7% of population = ‘aging society’
65+< →14% of population = ‘aged society’
Japan: Aged society in 1994 (24 years after Japan had become an ‘aging’ society)
“In most Western countries this process takes 60-120 years” (Takeda et al. 2010: 10).
# OF PEOPLE WITH DEMENTIA
Dementia: 4,620,000 (15% of age over 65)
MCI: 4,000,000
40% of age over 85 suffer from some kind of dementia
DAT: 67.6%
CVD (Cerebral Vasucular Disorder): 19.5%
DLB (Dementia with Lewy Bodies): 4.3%
(Asahi Shimbun June 1st, 2013)
“Considerable disruption to patients’ daily lives, the burden to caregivers, and the long duration of the disease make dementia, especially Alzheimer’s disease (AD), the most malignant disease of our time.”
(Takeda et al. 2010: 11)
OBSERVATION
Geriatric hospital in the outskirts of Tokyo
Founded by a psychiatrist in 2005
240 beds
Full-time medical staff
MD (8), RN (71), Care Workers (96)
Pharmacologists (3), Radiologist (2), Lab technicians (1)
Occupational therapist (6), Physical therapist (4),
Speech therapist (1) , Clinical Psychologist (1)
Medical Social Workers (4)
TEA-TIME TALK
Thursday afternoon (3:00-3:30pm, during or immediately after afternoon snack)
At a lounge
Led by a female clinical psychologist (age 32)
• Participant observation
• Recorded sessions: August 2011 (4)
January 2012 (1)
March 2012 (1)
PARTICIPANTS
Total participants: 13
Average age: 89.7
All have Dementia/DAT
Dementia levels
• Mild (MMSE 23<): 1• Moderate (MMSE 15-23): 5• Severe (MMSE 15>): 7
• People with AD: 6
TV
KITCHEN
CW
RW
CW: Care workerRW: Recreation worker
ACTIVITY FORMAT OF TEA-TIME TALK
Clinical psychologist (CP) moderates the session.
1. CP’s opening by greetings
2. Date
3. Warm-up talk
4. Explanation of the topic (with handouts) 5. CP’s questions
6. Participants’ responses
There has been concerns about young people's manners lately. How did you acquire manners? Do you have anything to say to the young people?
TOPIC: “MANNERS”
OPENING
1. CP: dewa minasama
konnichiwa
2. All: konnichiwa
3. CP: sanji de gozaimasu
4. Mrs. Tamura: A sou
5. CP: hai e: kyou wa
desune dai 145
kaime no oshaberi
no kai de gozaimasu.
maishuu mokuyoubi
ni kochira ni ojama
shite
1. CP: OK, everybody, good
afternoon.
2. All: Good afternoon.
3. CP: It’s 3 o’clock.
4. Mrs.Tamura: Oh, is it?
5. CP: Yes, ah today is 145th
Tea-Time Talk. Every
Thursday, I come here
and
6. Mrs. Goto: A:
arigatou
gozaimasu
7. CP: Oshaberi no kai
wo okonatte
orimasu keredomo
itsumo no youni
hizuke no kakunin
kara itashimashou
ka
8. Mrs. Goto: a:so:ka
6. Mrs. Goto: Oh, thank
you very much.
7. CP: (we) do this Tea-Time
Talk. As usual, why
don’t we start with
checking today’s date?
8. Mrs. Goto: Oh, I see.
INTERACTIONAL FORMAT OF TEA-TIME TALK
1. CP gives a topic of the day.
2. CP asks a question (Q) to a participant and s/he answers (A).
3. CP immediately rephrases what the participant has just said (R).
4. CP has some agenda, but other topics come up and get developed (by the participants) on the course of the discussion.
INTERACTIONAL & INSTITUTIONAL POWER OF CP
• Control of the activity from opening to closing
• Control of each turn-at-talk by Q-A sequences
• Justification of facts (e.g., date)
• Repetition of participants’ utterances
• Display of authority by a lab coat
THREE-PART STRUCTURE IN INSTITUTIONAL DISCOURSE
• 1st utterance: Inquiry
• 2nd utterance: Response
• 3rd utterance: Elaboration/Feedback/Acknowledgement
IRE sequence
1. Teacher: What are the two bending [mirrors] called? … something that begins with C.
2. Sheila: Concave and convex.
3. Teacher: Good. OK.
(Wells 2007, cited in O’Connor et al. 2007: 280)
1st position (Inquiry) &3rd position (Evaluation)-Teacher’s knowledge and authority
THREE-PART STRUCTURE BY CP
1. CP: Kyou wa nanyoubi
deshou ka.
2. Mrs. Goto: Mokuyou bi.
3. CP: Arigatou gozaimasu.
1. CP: What day of the week
is it today?
2. Mrs. Goto: Thursday.
3. CP: Thank you very much.
CP’S REVOICINGTOPIC: MANNERS
1. CP: Sakura-sama, nanka okaasama kara nanka kou iwareta koto tte arimasuka?
2. Mrs. Sakura: tokuni nani iwareta tte oboe mo naindesu kedo
3. CP: hai
4. Mrs. Sakura: yappari mukasi wa otokonoko wa yuukan ni onnnanoko wa oshitoyaka ni tte iu funniki ga attan janai kashira ne?
5. CP: hai, otokonoko wa yuukan ni yuukan ni
[writes yuukan on the board]
1. CP: Mrs. Sakura, do you have anything you were told by your mother?
2. Mrs. Sakura: I don’t remember being told anything in particular but
3. CP: Yes.
4. Mrs. Sakura: There was this ambience that boys should be brave, girls should be graceful, I think.
5. CP: OK. boys should be brave, boys should be brave, brave
[writes BRAVE on the board]
Mrs. Sakura: Mild, no AD
Inquiry
Response
Repetition of response utterance
“REVOICING” (O’CONNOR AND MICHAELS 1993, 2007)
Revoicing sequence in classroom
(1) Ms. Davies: Paulo, is 24 even or odd?
(2) Paulo: Well, if we could use 3, then it could go into that, but 3 is odd. So then if it was … but … 3 is even. I mean odd. So then if it’s odd, it’s not even.
(3) Ms. Davies: OK, so let me see if I understand. So you’re saying that 24 is an odd number?
(4) Paulo: Yeah, because 3 goes into it. Because 24 divided by 3 is 8.
(O’Connor et al. 2007: 279)
TEACHER’S REVOICING
“Whereas the IRE is a three-part move, ended by the teacher’s evaluation, the revoicing move is a four-part move, with the student having the ultimate interpretive clout, the right to agree or disagree with the teacher’s formulation” (281).
CP’S REPHRASING: Q-A-R SEQUENCE5. CP: hai, otokonoko wa
yuukan ni yuukan ni [writes yuukan on the board]
6. Mrs. Sakura: yuukan ni tte iuka
7. CP: otoko rashiku
8. Mrs. Sakura: Otoko rashiku ne? ima wa danjokinntou ni narimashita kara
9. CP: hai otokonoko wa otoko rashiku onnnanoko wa oshitoyaka ni onnanokoo rasihku toiu no wa warito iwarete kita koto nanja naika
10. Mrs. Sakura: Ee.
5. CP: OK. boys should be brave, boys should be brave, brave [writes BRAVE on the board]
6. Mrs. Sakura: Not brave but manly/masculine.
7. CP: Manly/masculine.
8. Mrs. Sakura: Manly, you know? Now there is gender equality so
9. CP: Yes so you’re saying, boys should be boyish, girls should be graceful and girlish, and this has been said quite often.
10. Mrs. Sakura: Yes.
CP’S REVOICING IN TEA-TIME TALK
• Maintaining participation framework in which CP has the overall control of the discourse.
• Facilitating elderly participants’ comprehension of the prior utterance by rephrasing word-for-word in a louder and clearer voice.
• Giving time for the participants with AD/Dementia to process information.
• Acknowledging and foregrounding the voice of the old, i.e., their knowledge and experiences.
CP’s interactional authority
vs.
Participants’ collective knowledge
ROLE SHIFTING : NEGOTIATION OF AUTHORITY
Rice polishing
1. CP: So nowadays, we have rice miller- rice milling
machines. But in the past uh, what was it, like this, in a
jar, in a jar,
2. Mrs. Goto (Goto): Oh, that’s right.
3. Mrs. Tamura (Tamura): Right, and there was rice bran
inside.
4. Goto: Yes, yes.
5. CP: And you put rice in it.
6. Goto: Uh-huh.
7. CP: And then you do tsuntsun (poking) with a stick like this
8. Goto: [Right, and the bran
9. Tamura: [Yes, (we) did it.
10. Goto: (It’s) a child’s job.
Mrs. Tamura: Severe, No ADMrs. Goto: Moderate, AD
11. CP: Is that so? Child’s job. It’s child’s helping (the mother)
12. Goto: [Chuckles]
13. CP: If you do that, would that remove bran?
14. Goto: It removes bran.
15. Tamura: That’s right.
16. CP: Did you do it, Mrs. Tamura?
17. Tamura: Yes, I did. So it’s not washing the rice, with rice /?/ poking
18. that thing.
19. CP: What is it?
20. Tamura: That thing.
21. CP: Bran?
22. Tamura: Bran, it was the same as that.
23. CP: Oh, Mrs. Kaede fell asleep.
24. RN: Why do you do tsuntsun?
25. Tamura: Because bran is removed. Isn’t that right?
26. Goto: Bran is removed. Then we make rice
27. bran paste out of it because we need bran.
1. CP: Did you make sake?
2. Goto: Oh yes, we made it quite often.
3. CP: Oh, really? Did you make it? Did you make sake?
4. Tamura: Yes.
5. Goto: Like amazake (sweet sake). Sake, no, adding bran to rice,
6. CP: Adding bran
7. Tamura: Right.
8. Goto: For Ohinasama (Girls’ Festival) 9. CP: Oh, you give it to the Ohinasama (dolls).
10. Goto: Yes.
11. CP: You made it by yourself.
12. Goto: My parents did.
13. CP: Oh, your parents did.
14. Goto: Yes.
15. CP: Oh, I see.
16. CP: How about miso (bean paste) or soy sauce?
17. Goto: Those things, we’d buy.
18. Tamura: Yes, we bought them.
19. CP: Have you made them?
20. Tamura: Well.
21. Goto: I don’t think so.
22. Tamura: Me, neither. May be in the past, (people made them), but when we became old enough to understand, I don’t think people made such things.
23. CP: OK, I see. So in your mothers’ or grandmothers’ generations, may be people were making miso or soy sauce at home, but
24. Goto: [Right, right.
25. Tamura: [Right, right.
26. CP: But in your generation, you bought them.
27. Tamura: That’s right.
28. Goto: Right [nods]
DEMENTIA/AD TALK: HUMOR
• Decline of humor comprehension in comparative studies with younger generations (e.g. Mak and Carpenter 2007).
• Humor and laughter for life enhancement for the eldery (e.g. Bethea 2001, Gladding and Martin 2010, Takeda et al. 2010)
• Humorous comments and laughter as self- and other-face-saving devices (Grainger 2004, Matsumoto 2009)
??Humor production of people with dementia/AD
HUMOR AND MEMORY1. CP: Hai Kyo:u wa nan-
nen no nan-gatsu nan-nichi deshou ka
2. Mrs.Tamura: [Heisei
3. Mrs. Goto: [Heisei 23nen no
4. CP: hai 23nen no
5. Goto: hachi gatsu
6. CP: hachi gatsu
7. Goto: ikutsu yatta kashira, nijuugonchi?
8. Workers: O: a: subarashii
9. Tamura: atari
1. CP: Yes. What day of what year is it today?
2. Mrs. Tamura: Heisei
3. Mrs. Goto: Heisei 23
4. CP: Yes, Heisei 23
5. Goto: August
6. CP: August
7. Goto: what day was it, 25th?
8. Workers: O:h, wow, great
9. Tamura: Bingo!
Mrs. Goto (Moderate, AD)
10. Goto: atari mashita?
11. CP: atari mashita
12. Tamura: ara sugoi
13. CP: nante tondemo nai
seikai desu
14. Goto: /?/detarame nano
datte kanjin no ne:
kyuuryou ga naimon
ne:
15. SW: a ha ha
16. Goto: a ha ha
17. Tamura: a:
10. Mrs. Goto: Did I get it right?
11. CP: (You) got it right.
12. Mrs. Tamura: Wow, great!
13. CP: Well, no, it was the
correct answer.
14. Goto: /?/ (I) made it up
because, (we) don’t have
the most important thing,
you know, the pay check.
15. SW: [laughs]
16. Mrs. Goto: [laughs]
17. Mrs. Tamura: Ahh
“RICE”Today is Rice Day. This year, buying futures or cornering of old rice have been in the news. Rice is a staple for Japanese. What memories about rice do you have?
“RICE” DAY: AUGUST (8) 18TH (10+8)
“Rice” “Eight” “Ten”
米 八 十
ALZHEIMER’S DISEASE: MEMORY DOES NOT LAST BUT HUMOR DOES NOT RUST
1. CP: Kaede-sama wa pan to
okome deshitara
dochira ga osuki esuka?
2. Mrs. Kaede: N: sou desu ne
watashi wa hachi-
juu-hachi no hou ga ii
desu
3. CP: hachi-juu-hachi no hou ga ii
[laughs] sore wa okome no
hou ga ii tteiu koto desu ka?
4. Kaede: [smiles]
5. [laughter]
1. CP: Mrs. Kaede, which
one do you like better,
rice or bread?
2. Mrs. Kaede: Mm, well, I like
eighty-eight.
3. CP: You like eighty-eight
[laughs]. Do you
mean you like rice
better?
4. Kaede: [smiles]
5. [laughter]
Mrs. Kaede (severe, AD)
AD TALK
1. CP: sorekara minasama supootsu kansen yakyuu demo ma suiei demo sakkaa demo mini irashitakoto wa arimasuka?
2. Mrs. Kaede: Gozaimasuyo.
3. CP: gozaimasu? Nani wo mini ikimasita?
4. Kaede: sono: ano: kurasu ni ne ma ouchi ga oarini narukata wa ne sorede shite irashita kedo
5. CP: sorede site rasshatta kurasuno kurasuno
1. CP: so has everybody gone watch sports games? Baseball or soccer or, have you gone watching sports?
2. Mrs. Kaede: Yes, I have.
3. CP: You have? What did you go watch?
4. Kaede: well, uh, in the class, well, those who had the house, you know, they did it by that
5. CP: did it by that, for/of class. For/of class.
6. Kaede: hai
7. CP: hai otonani natte kara rikujo toka kakekko toka yakyuu toka ashi wo ohakobini nata koto wa arimasuka?
8. Kaede: yappari arimasu
9. CP: osuki desita?
10. Kaede: dousihitemo minasama nasaru kara kocchimo damatte wa iraremasen deshita ne
11. [laughter]
12. Kaede: kocho kocho kocho tte.
6. Kaede: Yes.
7. CP: Yes, after you were grown up, did you go watch track and field or sprint or baseball?
8. Kaede: Yes I did.
9. CP: Did you like it?
10. Kaede: By all means, because everybody would do it, I couldn’t keep quiet.
11. [laughter]
12. Kaede: Go kocho kocho kocho [tickling hand gesture]
DISCOURSE ANALYSIS OF PEOPLE WITH DEMENTIA/AD
• Some conversational features that require highly cognitive and highly communicative skills (e.g. turn-taking management, humor production in anticipation of its uptake by the recipients) may remain relatively unaffected by the disease.
• Close observation of naturally occurring discourse enables us to look at the data from multiple perspectives in order to find out (1) discourse behavior (abilities/inabilities) of the elderly, (2) interactional behavior (abilities/inabilities) of the younger conversational partners, (3) meaning of aging in a given culture.
REFERENCESBethea, Lisa Sparks. 2001. “The function of humor within the lives of older adults.” Communication
Quarterly, Winter 2001, 49 (1): 49-56.
Gladding, Samuel, T., and Beth Martin. 2010. “Creativity and self-esteem in later life.” Ed. Mary M.
Guindon. Self-esteem across the life span: Issues and interventions. New York: Routledge. 311-323.
Grainger, Karen. 2004. “Verbal play on the hospital ward: Solidarity and power?” Multilingua 23 (2004): 39-59.
Mak, Wingyun., and Brian D. Carpenter. 2007. “Humor comprehension in older adults.” Journal of the International
Neuropsychological Society 2007 (13): 606-614.
Matsumoto, Yoshiko.2009. “Dealing with life changes: Humour in painful self-disclosures by elderly Japanese
women.” Ageing and Society 29 (2009): 929-952.
O’Connor, Catherine., and Sara Michaels. 1993. Aligning academic task and participation status through revoicing:
Analysis of a classroom discourse strategy.” Anthropology and Education Quarterly (24): 318-335.
---. 2007. “When is dialogue ‘dialogic’?” Human Development 2007 (50): 275-285.
Takeda, Masatoshi., et al. 2010. “Laughter and humor as complementary and alternative medicines for dementia
patients.” BMC Complementary and Alternative Medicine 2010 (10:28).
Terasaki, Noriko., and Kota Takeda. 2013. “Elderly with dementia reaches 4620000.” Asahi Shimbun [morning
edition] June 1st, 2013.
Ministry of Health, Labor and Welfare
Statistics Japan