Universität zu Köln

Stockleben, Lisa M. ORCID: 0000-0002-1727-6893 (2026). Between body and mind: diagnosing and caring for deaf people with dementia. PhD thesis, Universität zu Köln.

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Abstract

This dissertation explores the question of what is needed to provide better and urgently needed appropriate healthcare to deaf people with dementia. The current healthcare situation of deaf people in general is insufficient and presents with barriers to receive adequate care, with language barriers being the most robust cause. Dementia is one of the biggest health-related challenges and one of the most feared conditions of our time. In the common cognitivist worldview, the loss of reasoning and memory is closely connected to losing one’s identity and selfhood. In this framework, dementia is regarded as a threat for which no cure is currently available. An alternative framework is embodied cognition which acknowledges the central role of the body and the environment to shape the mind. In dementia, body-related implicit memory, proposed as body memory, is retained until late stages of dementia. While the explicit and conscious memory and reasoning diminishes, the person themself maintains selfhood. Therapeutic and care practices that include an embodied framework foster well-being and quality of life for people with dementia. This shift in perspective invites to reconsider dementia prevention, diagnostics, therapy, and care. Detecting dementia at an early stage, increases the options of treatment and support for the person with the diagnosis and their environment. Most Deaf communities do not have access to diagnostic tools that can detect dementia-related cognitive decline and are linguistically and culturally sensitive for deaf people who communicate in their local sign language. Study 1 presents the first sign-language based cognitive screening tool for deaf signers of German Sign Language (DGS). The novel screening tool, the KoDGS (Kognitionstest Deutsche Gebärdensprache) is based on a comprehensive cultural test adaption paradigm that was developed as part of the study. It was normed with 99 participants and showed reliable distinction between cognitively healthy individuals and individuals with a neurological history or an indicative life profile. In order to ensure reliability of the KoDGS test items and control for underlying mechanisms related to memory processing, the sign frequency and sign iconicity of the test items in DGS were investigated. Study 2, therefore, collected subjective rating data for the psycholinguistic measures of frequency and iconicity of more than 300 DGS signs. The data elaborated on the issue of reliability of these measures and cross-checked with existing subjective rating data, and objective measures from DGS corpus data. A large emphasis on collaborative work between deaf and hearing researchers is discussed to stimulate the methodological normative discourse in the field. 8 Study 3 presents the shift in perspective in dementia care contextualized for the deaf population. Acknowledging the embodied nature of deaf persons, therapeutic and care practices that include the embodied framework provide deaf persons with dementia with a sense of continuity. The results of all three studies are discussed in the context of bridging theory and practice. Aspects related to reducing current disparities in healthcare for deaf people, the impact of physical, social, and historical environments on deaf individuals (with dementia), and the importance of practitioner awareness are examined. Additionally, memory processes and potential future applications that incorporate the embodied framework into dementia care practices are proposed. This dissertation argues that appropriate therapeutic and care practices and assessment tools offer a step towards higher-quality, reliable, and culturally and linguistically sensitive healthcare for deaf people. Methodological aspects are reflected and the role of collaboration discussed. At the end of this dissertation, a phenomenological description of three scenes calls for action on the reviewed insufficient situation of deaf people, before concluding the pooled presented evidence.

Item Type:	Thesis (PhD thesis)
Creators:	Creators Email ORCID ORCID Put Code Stockleben, Lisa M. lisa.stockleben@uni-koeln.de https://orcid.org/0000-0002-1727-6893 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-803421
Date:	2026
Language:	English
Faculty:	Faculty of Human Sciences
Divisions:	Faculty of Human Sciences > Department Heilpädagogik und Rehabilitation
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language dementia English diagnostics English deaf English sign language English care English cognitive test English body memory English embodiment English old age English frequency English iconicity English
Date of oral exam:	20 March 2026
Referee:	Name Academic Title Mann, Wolfgang Prof. Dr. Perniss, Pamela Prof.'in Dr. Villwock, Agnes Prof'in Dr.
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/80342