Ethical and Practical Challenges of the Communication and Behavioral Manifestations of Primary Progressive Aphasia

Donna C. Tippett; Argye E. Hillis

doi:10.1055/s-0040-1710062

Seminars in Speech and Language, Table of Contents

Semin Speech Lang 2020; 41(03): 249-256
DOI: 10.1055/s-0040-1710062

Review Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Ethical and Practical Challenges of the Communication and Behavioral Manifestations of Primary Progressive Aphasia

Donna C. Tippett

¹Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland

²Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland

³Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland

,

Argye E. Hillis

¹Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland

²Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland

⁴Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, Maryland

› Author Affiliations

Abstract

The communication and behavioral manifestations of primary progressive aphasia (PPA) present ethical and practical challenges for individuals with this clinical syndrome as well as for individuals who are involved closely in their care. In this article, cases representing all three PPA variants (logopenic variant, nonfluent agrammatic, semantic variant) are presented to illustrate commonly encountered situations in which self-determination is at risk in decisions about housing, driving, social interactions, finances, and treatment interventions. Potential approaches, including patient/family education, implementation of safeguards, redirection to meaningful activities, and protections against vulnerability in treatment decisions, are described to preserve autonomy in patients with this neurodegenerative clinical syndrome.

Keywords

primary progressive aphasia - logopenic variant PPA - nonfluent agrammatic PPA - semantic variant PPA

Full Text

References

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