Visualizing dementia and stigma: a scoping review of the literature

Abstract

Discursive choices are recognized by both academic and dementia communities as being central to the perpetuation (or challenging) of dementia-related stigma. Yet, the focus of the vast majority of research on the discursive dynamics of dementia stigma to date has been on the role of language only, effectively failing to regard the multimodal reality of discourse. The present study aims to address this gap by conducting a scoping review of the smaller, and relatively more recent, body of literature that has examined visual modes of communication. The authors ask the following questions: (1) What theories of stigma have informed or guided studies of visual representations of dementia and people with dementia? (2) What visual features of representations of dementia and people with dementia might contribute to and/or challenge dementia stigma? Using Scopus, PubMed, PsychInfo and Google Scholar, 10 papers published between January 2000 and July 2023 were selected and thematically synthesized. The authors found that most studies had limited or no engagement with specific stigma theories, although the general principle of establishing or challenging distance between an in-group (‘us’) and out-group (‘them’) informed many of the analyses. Visual features with the potential to contribute to stigma tended to impersonalize people with dementia through foregrounding visual markers of dementia (oftentimes emphasizing loss and/or the brain) and establishing symbolic distance between viewers/other represented participants and people with dementia. This distance could be achieved through visual framing techniques (regarding angle, gaze, colour, setting) which, for instance, could subtly position people with dementia as the ‘living dead’. There was much less focus on visual features with the potential to challenge stigma, which together emphasized social connection, transformation and taking the perspective of someone with dementia. Turning to reception, another potential aspect of challenging stigma was reinterpreting supposedly ‘stigmatizing’ images. In this article, these findings are interpreted in relation to the broader stigma literature and implications for future research and advocacy efforts are discussed.