“Our Own Little Language”: Naming and the Social Construction Of Alzheimer's Disease

Social meanings and cultural definitions attached to illness, disability, and aging have a powerful influence on the development and operations of medical care as well as the social, behavioral, and therapeutic processes occurring within these settings. Specialized care environments designed to meet the needs of what some would argue is a dramatically increasing population worldwide, those with Alzheimer's disease, have been dominated by a medical model of care where treatment of disease has primacy over person. In contrast to the medical model, the Certified Nursing Assistants (CNAs) at Starrmount (pseudonym) Alzheimer's Unit have socially constructed an alternative to the medical model of care through what I argue is the use of language and a process of “naming and reframing.” In this “different world,” as the CNAs call the world of the Unit, the resident is depicted as a socially responsive actor with a surviving self that is to be treated with respect. Using a symbolic interactionist framework, this paper examines the CNAs' construction and use of a “language of openings”—that is, the language arising out of the lifeworld of the residents—as the counterpoint to the “language of limits” of the medical model. Spoken everywhere but nowhere inscribed as “official” knowledge, this “little language,” as the CNAs speak of it, is the fundamental medium for social interaction in the Alzheimer's Unit.