Learning from the Talk of Persons with Dementia: A Practical Guide to Interaction and Interactional Research

The edited book Learning from the Talk of Persons with Dementia: A Practical Guide to Interaction and Interactional Research seeks to provide practical guidance to whoever interacts with individuals experiencing dementia—clinicians, caregivers, and family members. It may also inform novice researchers who are considering employing methodologies this book offers. Gathering contributions from interdisciplinary perspectives (neurology, linguistics, sociology, ethnography, social anthropology, nursing, and clinical psychology), it explores how we might best navigate day-to-day interactions with persons experiencing dementia. These social-interactional studies, focusing on spoken language in the real world, aim to formulate how language mechanisms are employed in actual interaction and how language helps achieve actions.

The book consists of an introduction, 10 chapters, and a conclusion. Authors of each chapter have been encouraged to highlight learning objectives and provide various aids to assist readers in understanding dementia discourse, such as the contents of “Thinking Point” boxes and “Practical Highlights” boxes. A casual read of the book might lead to misunderstanding it as a detailed rulebook for successful conversation. However, it serves as a guide for how to be a good interlocutor. I interviewed a person with dementia in a care center for 4 months in China. Although some of my communication strategies are not demonstrated in the book, I am patient, engaged, and respect my interviewee’s dignity. Therefore, I think the general principles that emerged in the book, rather than detailed strategies, are worth putting into conversational practices. Besides, for novice researchers, it offers explicit examples of methods for future studies. As a family member of a person with dementia and a PhD candidate in linguistics and dementia discourse, I conducted the fieldwork about day-to-day communication with persons experiencing dementia. This book has truly satisfied my curiosity about language studies on dementia discourse and solved my difficulties in interacting with persons experiencing dementia. These perspectives informed this book review.

Part one in the book focuses on what the talk of persons with dementia can tell us. It brings out etiologies of dementia and their language effects, strategies for data collection in social-oriented research, and the necessity for using interactional data to understand dementia discourse better. Kohlenberg and Kohlenberg’s chapter (Chapter 2) demonstrates the individual etiologies of dementia, behavioral changes, and language changes that persons experiencing dementia may face. Davis and Pope’s chapter (Chapter 3) offers valuable suggestions on how to understand research purposes and what are research protocols in collecting naturalistic dementia discourse. It formulates the data collection protocols in interactional research. Müller’s chapter (Chapter 4) takes drawbacks of neuropsychological testing as the point of departure to bring out the background for the following chapters. These descriptions are valuable for those unfamiliar with the abilities of persons experiencing dementia to negotiate sense-making in real-life interaction.

Part two (7 chapters) focuses on actual interactions between individuals with dementia and their interlocutors. Davis and Maclagan (Chapter 5) describe the importance of little words (e.g., but and so) in enabling persons experiencing dementia to keep the interaction going and finds their places in conversation. The chapter advocates for being a careful and intentional listener. Stickle and Wanner (Chapter 6) concentrate on syntactic patterns of persons experiencing dementia. They argue that regarding the disjointed syntax of individuals with dementia as meaningful actions may allow persons experiencing dementia a window for better communication. They offer evidence of syntactic coordination of dementia discourse. With a focus on retained interactional competence of an individual with dementia, Lindley’s chapter (Chapter 7) demonstrates the healthy others’ conversation strategies of alignment, repair initiation, and correction for responding to disordered talk so that the healthy others choose their resources to facilitate a better conversation. Lindley demonstrates the functions of conversation analysis in facilitating the competence of persons experiencing dementia. Examining the discourse patterns in conversations between persons experiencing dementia and gallery visitors, Isaac and Hamilton (Chapter 8) demonstrate that objects of shared attention within daily conversations can be used to foster persons experiencing dementia to display their knowledge and nurture meaningful interaction. Isaac and Hamilton offer a new view of the functions of objects in facilitating better interactions. Smith’s chapter (Chapter 9) handles the troubles of persons experiencing dementia in assessment activities. These troubles impair their relationships with healthy others. Combining the interview approach with ethnography, Halpin and Richard (Chapter 10) argue for understanding dementia as a process across the life course and employing different communication strategies based on the progression of cognitive decline. They highlight the active role of family engagement in healthcare for persons experiencing dementia. Debunking the unclear boundary between the public and private space in residential centers, Jansson’s chapter (Chapter 11) explores how care staff and care center residents negotiate this ambiguous space in residential care facilities via fine-grained verbal and nonverbal interactional moves. The above three chapters combine ethnography with conversation analysis. Part two offers readers ample examples of social-interactional research based on different approaches and recommends general conversation principles. Each chapter’s methodological approach is determined by how authors contextualize the conversation, in degrees to which they rely on the environment and nonlanguage elements, and in degrees to which they generalize their findings to social patterns. Contributors stress being patient and expand the patience to offer persons with dementia ample time to respond, which resonates with my fieldwork introspection.

The last part summarizes general principles and provides research resources for better understanding dementia discourse. Stickle argues that meaningful interaction with persons experiencing dementia requires interlocutors’ patience, empathy, and engaged listening rather than corrections. It is important how interlocutors strive to be better conversation partners and how they embrace persons experiencing dementia as individuals. However, limitations in this book are research methods and geographic diversity. First, the book excludes narrative analysis of dementia discourse which explores the identity of persons experiencing dementia in self-narrative via caregivers’ scaffolding. Second, the chapters focus on conversational practices undertaken in the UK, the USA, Sweden, and Canada but exclude research in East Asia. Despite these small suggestions, there is no doubt that the book makes a significant contribution to facilitating our interaction with persons experiencing dementia. It promotes my awareness of how to achieve meaningful interaction with persons experiencing dementia in day-to-day conversation and conduct dementia discourse research. I would recommend it to caregivers, novice researchers, and anyone interested in dementia interaction.