The discourse of self in dementia

Abstract

The preservation of self-identity in dementia is dependent upon internal (cognitive) and external (social) conditions. This study investigates the integrity of self (internal) and personae (external) in dementia as indexed by the verbal and nonverbal behaviours of dementia residents and their caregivers in a special care unit. Videotaped observations of spontaneous nursing staff-resident interactions were collected over a three-day period. The recordings were transcribed and subjected to detailed discourse analysis. Our analyses focused on several indexicals of self and personae including personal pronouns, proper nouns, interpersonal conflicts, and discursive positioning. The findings revealed that both self and personae are susceptible to decline in dementia. However, the results also provide evidence that even in severe dementia self and personae can be indexed in a variety of ways. We discuss the important role that caregivers can have in reinforcing self and personae in dementia.