Within the still-dominant medical discourse on dementia, disorders of language feature prominently among diagnostic criteria. In this view, changes in ability to produce or understand coherent speech are considered to be an inevitable result of neuropathology. Alternative psychosocial accounts of communicative challenges in dementia exists, but to date, little emphasis has been placed on people with dementia as social actors who create meaning and context from their social interactions. In this article we draw on Bakhtin's concepts of the carnivalesque, heteroglossia, polyphony and dialogism to analyse a series of interactions involving people with dementia in day and residential care environments. We argue that many of the communicative challenges faced by people with dementia arise from the social environments in which they find themselves, and that the utterances of people with dementia in the face of these social challenges show many of the hallmarks of cultural resistance identified by Bakhtin.
IntroductionTo be means to communicate dialogically. When dialogue ends, everything ends. Thus dialogue, by its very essence, cannot and must not come to an end.(Bakhtin 1984: 252) Connie: We all stuck together…if someone was frightened you' d all gather round and say 'Don't be frightened, it's over now. ' Peggy: I don't remember; there's a lot I don't remember now. Connie: I'll remember it for you. (Conversation between two women with dementia; Bryce et al. 2010: 76-77)This article has grown out of our experience of conducting, since 2009, audiovisual research in three care environments for people with dementia in the Northern UK. The first and second projects were carried out in different voluntary sector day centres, one of which catered exclusively for people with early-onset dementia (aged 65 and under) whilst the second also provided for people over 65, with many of those attending aged over 80. The third study was being undertaken in long-term, residential social care. The 10 participants in this final study ranged in age from 76 to 99 years of age, and many of them had relatively severe cognitive difficulties. All three studies took an immersive approach, which involved spending significant amounts of time in each care environment and getting to know the people who lived or spent their time there. One of the main outputs from the first study completed in 2010 (and referred to in this article as CE1, for 'Care Environment 1'), was a short film about the local city market, made with two women who had, at the outset of the study, a rather marginalised status within the day centre. The second project involved a number of people from Care Environment 2 (hereafter CE2) in the development of a short film to be used in practitioner education. In the final study, referred to below as CE3 (for 'Care Environment 3'), the participants were supported in the co-production of individual short films about subjects of personal interest to them.In the present article, we do not intend to describe these studies in detail, or to ...