Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-21T22:35:20.522Z Has data issue: false hasContentIssue false
  • English
  • Français

Orally positioning persons with dementia in assessment meetings

Published online by Cambridge University Press:  29 October 2013

JOHANNES H. ÖSTERHOLM  and
CHRISTINA SAMUELSSON
JOHANNES H. ÖSTERHOLM*
Affiliation:
Division of Health and Society and Center for Dementia Research, Department of Medical and Health Sciences, Linköping University, Sweden.
CHRISTINA SAMUELSSON
Affiliation:
Division of Speech and Language Pathology and Center for Dementia Research, Department of Clinical and Experimental Medicine, Linköping University, Sweden.
*
Address for correspondence:Johannes H. Österholm, Division of Health and Society and Center for Dementia Research (CEDER), Department of Medical and Health Sciences (IMH), Faculty of Arts and Science, Linköping University, 581 83 Linköping, Sweden. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

In this paper we study if and how persons with dementia are orally positioned by others, and how they position themselves while participating in assessment meetings held in order to discuss access to supportive services. We analysed five assessment meetings where two older persons (one diagnosed with dementia and one without a dementia diagnosis) participated to investigate whether the person with dementia is positioned differently than the other old person. Interactional phenomena used to position the person with dementia were identified by interactional analysis. We identified six phenomena that positioned the person with dementia as an individual with less interactional competence than the other participants: ignoring the person with dementia; voicing the feelings, capacity or opinion of the person with dementia; posing questions implying lack of competence; others' use of diagnosis; self-(re)positioning; and elderspeak. Persons with dementia are often orally positioned as less competent, indicating that they suffer further from discrimination than other older persons. We suggest that this has an impact on the participation of people with dementia in negotiations regarding their future care. The results indicate that social workers should be made aware that negative positioning exists and how it may affect the ability of people with dementia to contribute to discussions about their everyday life. Social workers should be encouraged to find strategies to reduce negative positioning in interaction.

Keywords

Swedenageismelderspeakinteractionmalignant positioningpatronising talkformal support
Type
Articles
Information
Ageing & Society , Volume 35 , Issue 2 , February 2015 , pp. 367 - 388
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andersson, L. 2008. Ålderism [Ageism]. Studentlitteratur, Lund, Sweden.Google Scholar
Bartlett, R. and O'Connor, D. 2010. Broadening the Dementia Debate: Towards Social Citizenship. Policy Press, Bristol, UK.Google Scholar
Broughton, M., Smith, E. R., Baker, R., Angwin, A. J., Pachana, N. A., Copland, D. A., Humphreys, M. S., Gallois, C., Byrne, G. J. and Chenery, H. J. 2011. Evaluation of a caregiver education program to support memory and communication in dementia: A controlled pretest-posttest study with nursing home staff. International Journal of Nursing Studies, 48, 11, 1436–44.Google Scholar
Butler, R. N. 1969. Age-ism: another form of bigotry. The Gerontologist, 9, 4, 243–6.Google Scholar
Caporael, L. 1981. The paralanguage of caregiving: baby talk to the institutionalized aged. Journal of Personality and Social Psychology, 40, 5, 876–84.Google Scholar
Caporael, L. and Culbertson, G. 1986. Verbal response modes of baby talk and other speech at institutions for the aged. Language and Communication, 6, 1/2, 99–112.Google Scholar
Caporael, L., Lukaszewski, M. and Culbertson, G. 1983. Secondary baby talk: judgments by institutionalized elderly and their caregivers. Journal of Personality and Social Psychology, 44, 4, 746–54.Google Scholar
Cohen, G. and Faulkner, D. 1986. Does ‘elderspeak’ work? The effect of intonation and stress on comprehension and recall of spoken discourse in old age. Language & Communication, 6, 1/2, 91–8.CrossRefGoogle Scholar
Davies, B. and Harre, R. 1990. Positioning – the discursive production of selves. Journal for the Theory of Social Behaviour, 20, 1, 43–63.Google Scholar
Goodwin, C. 2003. Conversation and Brain Damage. Oxford University Press, Oxford.CrossRefGoogle Scholar
Harré, R. and Van Langenhove, L. 1999. The dynamics of social episodes. In Harré, R. and van Langenhove, L. (eds), Positioning Theory. Blackwell Publishers, Oxford, 1–13.Google Scholar
Harwood, J. 2007. Understanding Communication and Aging. Sage, Newbury Park, California.Google Scholar
Hummert, M. L. and Mazloff, D. C. 2001. Older adults' responses to patronizing advice – balancing politeness and identity in context. Journal of Language and Social Psychology, 20, 1/2, 167–95.CrossRefGoogle Scholar
Hummert, M. L., Shaner, J. L., Garstka, T. A. and Henry, C. 1998. Communication with older adults – the influence of age stereotypes, context, and communicator age. Human Communication Research, 25, 1, 124–51.Google Scholar
Hutchby, I. and Wooffitt, R. 1997. Conversation Analysis. Blackwell, Oxford.Google Scholar
Hydén, L. C. 2000. Att samtala om socialbidrag [Talking about social benefits]. In Puide, A. (ed.), Socialbidrag i Forskning och Praktik [Social Benefits in Research and Practice]. Centrum för utvärdering av socialt arbete, Förlagshuset Gothia AB, Stockholm, 224–43.Google Scholar
Kemper, S. 1994. Elderspeak: speech accommodations to older adults. Aging and Cognition, 1, 1, 17–28.Google Scholar
Kemper, S., Finter-Urczyk, A., Ferrell, P., Harden, T. and Billington, C. 1998 a. Using elderspeak with older adults. Discourse Processes, 25, 1, 55–73.CrossRefGoogle Scholar
Kemper, S. and Harden, T. 1999. Experimentally disentangling what's beneficial about elderspeak from what's not. Psychology and Aging, 14, 4, 656–70.CrossRefGoogle ScholarPubMed
Kemper, S., Othick, M., Gerhing, H., Gubarchuk, J. and Billington, C. 1998 b. The effects of practicing speech accommodations to older adults. Applied Psycholinguistics, 19, 2, 175–92.CrossRefGoogle Scholar
Kitwood, T. 1990. The dialectics of dementia: with particular reference to Alzheimer's disease. Ageing & Society, 10, 2, 177–96.CrossRefGoogle Scholar
Kitwood, T. 1997. Dementia Reconsidered – The Person Comes First. Open University Press, Buckingham, UK.Google Scholar
Linell, P. 1990. De institutionaliserade samtalens elementära former: Om möten mellan professionella och lekmän [The institutionalised appraisals’ elementary forms: for meetings between professionals and laymen]. Forskning om Utbildning, 17, 4, 18–35.Google Scholar
Linell, P. and Gustavsson, L. 1987. Initiativ och Respons. Om dialogens Dynamik, Dominans och Koherens [Initiative and Response. About Dialogue Dynamics, Dominance and Coherence]. Tema Kommunikation, Linköping, Sweden.Google Scholar
Ministry of Health and Social Affairs 2001. Social Services Act, SFS 2001:453 Sweden. Available online at http://www.scribd.com/doc/32167396/Social-Services-Act-in-Sweden. [Accessed 24 June 2013].Google Scholar
Rousseaux, M., Sève, A., Vallet, M., Pasquier, F. and Mackowiak-Cordoliana, M. A. 2010. An analysis of communication in conversation in patients with dementia. Neuropsychologia, 48, 13, 3884–90.Google Scholar
Ryan, E. B. and Bourhis, R. Y. 1991. Evaluative perceptions of patronizing speech addressed to elders. Psychology and Aging, 6, 3, 442–50.Google Scholar
Sabat, S. R. 2006. Mind, meaning, and personhood in dementia: the effects of positioning. In Hughes, J. C., Louw, S. J. and Sabat, S. R. (eds), Dementia: Mind, Meaning, and the Person. Oxford University Press, Oxford, 287–302.Google Scholar
Sabat, S. R. 2008. A bio-psycho-social approach to dementia. In Downs, M. and Bowers, B. (eds), Excellence in Dementia Care. Research into Practice. Open University Press, Milton Keynes, UK, 70–84.Google Scholar
Sabat, S. R. and Harré, R. 1999. Positioning and the recovery of social identity. In Harré, R. and Van Langenhove, L. (eds), Positioning Theory. Blackwell Publishers, Oxford, 87–101.Google Scholar
Savundranayagam, M. Y., Ryan, E. B., Anas, A. P. and Orange, J. B. 2007. Communication and dementia: staff perceptions of conversational strategies. Clinical Gerontologist, 31, 2, 47–63.CrossRefGoogle Scholar
Van Langenhove, L. and Harré, R. 1999. Introducing positioning theory. In Harré, R. and Van Langenhove, L. (eds), Positioning Theory. Blackwell Publishers, Oxford, 14–31.Google Scholar
Williams, K. N., Herman, R., Gajewski, B. and Wilson, K. 2009. Elderspeak communication: impact on dementia care. American Journal of Alzheimer's Disease and Other Dementias, 24, 1, 11–20.CrossRefGoogle ScholarPubMed