Aria Ghahrmani Project Prospectus SPM 499 14 October 2013 Care practices for Parkinsons patients tend to mainly,

if not only treat the cognitive or neuronal deficiencies caused by the disease. I will work with theories in embodied cognition to emphasize the need for attention to the agential role of the body in treatment of the disease. I am arguing for a view that sees the body in everyday skillful coping as first and foremost a mediating tool between the self and the world, where in Parkinsons patients, it breaks down and acts as a barrier. Important to this account will be the change in expressive capabilities as a result of this disruption. I want to show, due to the disturbance caused by Parkinsons; language comes to fill the mediating and expressive gap previously occupied by the body. I shall draw upon works in the phenomenological tradition of philosophy dealing with ideas of selfhood, world, dwelling, and home. This project will build on the embodied cognition thesis while promoting a mode of patient care that emphasizes the idea of bringing the patient home. An important aspect of home in this project will deal with the concept of being-with presented in the early writings of Martin Heidegger. Bringing the patient home will then be a return to a notion of being-with, with which the patient is familiar. Understanding the patients world, and learning to communicate appropriately with her will be seen as fundamental in home-guided, and embodied treatment. The paper will be organized into four sections, which are meant to build on each other, and are summarized below.

The project will begin with an initial overview of Parkinsons disease, and current care practices, which focus almost exclusively on the cognitive aspect of the disorder. Treatment is ministered in ways to only target the brain, and especially its receptivity to the neurotransmitter dopamine, while diagnosis depends almost entirely on the physical symptoms caused by the disease. I will provide a summary of current practices, and criticize them while making sure not to dismiss them as inessential. Instead, I will hint that patients would benefit from treatment in addition to the cognitive ones currently administered. I will then review literature in embodied cognition, and look at the ways in which it may be applied to care for patients suffering from dementia. A shift in focus toward the physical aspects of Parkinsons disease will make way for discussion of the relation between the self and the world, and the role of the body in mediating this relation.

A second section of the project will deal with the ways in which Parkinsons patients modes of communication are shaped by the changes in the body and new ways in which the world presents itself. Emphasis will be placed on the self-evident claim that the world shows up quite differently to patients suffering from a debilitating physical disorder, and the idea of world in the phenomenological tradition can help us understand the ways in which such patients come to occupy a different sort of domain than they did previously. A patient in a wheelchair does not encounter the world in the same ways she did when she had the ability to walk on two legs; the same sorts of activities dont afford her engagement, and this is an essential way in which we should

understand her engagement-with and being-in-the-world. As the patients world shows up as affording different activities, her mode of communication is likely to change, and since the bodys expressive capabilities have become limited, it becomes increasingly important to try to get a grip on the ways she might use verbal language to express herself. It should be expected that the patients verbal communication is out of the ordinary given the changes in her world, i.e the new ways in which the world is encountered.

A third section will deal with a review of the literature on dwelling, home, and house in the phenomenological tradition of philosophy. I will talk about dwelling and how it is relevant to our current project dealing with Parkinsons patients, noting that the self as dwelling in the primordial sense is not lost through the disorder, as most of the current literature and theories dealing with such patients suggest. Instead, the patient is always-already dwelling in the world of her concern; that she dwells does not change, and this is quite important in treatment practices, and in considering the self-hood of the patient. The notion of being-at-home will also build the ground for the final portion of the project that aims to find ways in which patients can be brought home. I will describe the phenomenon of being-at-home, as being-familiar, and having the appropriate skills and know-how, and how Parkinsons patients come to be away from home due to the disease. The third section will conclude that it is not a loss in dwelling that should be the topic of our concern, one that leads to conclusions about a gradual loss of self. But instead, it is

precisely this important maintaining of the self that leads to the ways in which the patient comes to feel not at home in her mode of always-already dwelling.

A final section will work to synthesize the above sections into a coherent project that uses the theory and findings from embodied cognition, how we can understand the manners of communication taken up by Parkinsons patients, and see all of that in light of the phenomena of dwelling and home to try to help the patients feel at home insofar as they may need caretakers to understand their comportment towards the world. Special attention should be paid to the role of verbal language. Insofar as the world shows up differently to the patient than it did before, the use of language should be understood as reflecting and expressing such change. I will talk about the phenomena of being-with, that is, human beings are always with other beings in the world, and their activity reflects this. An inability to communicate in the meaningful ways with which one was previously comfortable, strips away an important sense of being-with that makes up an important part of ones feeling at home. If the patient feels that she cannot communicate meaningfully with those around her, she necessarily does not feel at home in the ways she previously did. By rejecting notions of loss of self in the current understanding of the disease, stemmed from inattention to the primordial role of dwelling, and grounding the project in theories of embodied cognition and phenomenological interpretations of world, we can come to grips with the manner in which we should pay attention to the role of language in Parkinsons patients. We can then understand that an important step in bring the patient home, requires caretakers efforts in trying to understand the world of the

patient, her interactions, and the ways that we must be attentive to her use of language that should not be dismissed simply on the ground that it is unordinary. While improving care practices, this way of dealing with patients can be a meaningful way in which caretakers themselves can benefit from an originary way of experiencing the shared world.