The Dynamics of Dementia Communication

Abstract

Despite a plethora of good advice, it can be hard to sustain effective communicative behaviours when someone is living with a dementia. This book asks why that is. Part 1 explores how various dementia-causing diseases affect the linguistic, pragmatic (reasoning), and memory systems; how social perceptions and practices exacerbate the underlying biological problems; how people living with a dementia describe their experiences; and how dementia care currently addresses the challenges of communication. Part 2 asks why people communicate and what shapes how they communicate. The Communicative Impact model of communication is introduced and theoretically justified. It is argued that all communication is driven by people’s desire to make beneficial changes to their experiential world by getting the hearer to do, say, think, or feel something. Part 3 applies the model from part 2 to the range of considerations explored in part 1, helping readers see how and why communication is undermined and reshaped by the various biological, social, and emotional factors underlying the dementia experience. The model is used to shed light on how people living with a dementia are perceived and, as a result, treated, with particular attention to the acceptability of (well-intentioned) deception. The final chapter asks what needs to change if communication and well-being are to be optimized for people living with a dementia. In pursuit of truly person- and relationship-centred care, proposals for advanced skills in communication with a person living with a dementia are presented and explained, helping anchor the ubiquitous dos and don’ts in a deeper understanding of why interaction is difficult.

A feasibility study of the impact of a communication-skills course, ‘Empowered Conversations’, for care partners of people living with dementia

“…EC is able to target a range of needs (communication, connection, relationships and psychological health) due to its detailed underlying conceptual framework (the Communication Empowerment Framework) ( Morris et al, 2018a ). It draws on a detailed evidence-based theoretical and practical model of communication across dementia diagnoses, the Communicative Impact Model, which indicates that the adaptations required to respond to communication changes are similar across types of dementia diagnoses ( Wray, 2020 ). For example, language production and comprehension may change differently across dementia types, but adaptations are more similar, such as relying on a range of communication mediums and being curious about goals and needs ( Morris et al, 2018a ).…”

A qualitative evaluation of the impact of a Good Life Club on people living with dementia and care partners

“…The GLC offers members a way to promote social reserve (Wray, 2020). In that the GLC empowers individuals by offering a range of activities and allowing them to choose how they use them.…”

Epistemic responsibility - Labored, loosened, and lost: Staging Alzheimer's disease

“…Given that memory loss is the hallmark of Alzheimer's disease, conversation analysts and discourse analysts have employed an epistemic lens in analyzing talk by and with persons with the disease (see Hamilton, 2019;Hyden, 2018;Schrauf & Müller, 2014;Wray, 2020). This article extends such research in natural and naturalistic settings (Svennevig & Landmark, 2019;Williams et al, 2019) to the specific clinical-institutional setting of cognitive assessment.…”