Limited communicative resources due to dementia-related memory problems can be consequential for opportunities to claim epistemic rights and initiate and pursue communicative projects for persons living with dementia. This conversation analytic case study of a video-recorded homecare visit between Koki and his homecare nurse focuses on an extended negotiation concerning a factual disagreement related to a practical problem. The study explores how Koki manages to mobilize remaining communicative resources for initiating and pursuing a topical agenda, as well as how the caregiver recognizes and supports these initiatives. The analysis describes how a person with dementia manages to influence the course of action and, in collaboration with the interlocutor, succeeds in achieving two interrelated projects, one being within an epistemic domain and the other within a deontic domain. Koki’s persistent use of first actions, with repeated and upgraded knowledge claims, as well as embodied and verbal displays of a practical problem, contributes to influencing both the topical agenda and action agenda. The analysis shows how an attentive interlocutor may collaborate in identifying a practical problem and finding a solution to it, and thereby assist the person with dementia in taking control over his everyday life despite limited communicative resources.

In this introductory chapter, we provide a brief overview of some of the main topics related to dementia communication research that are addressed by the different chapters in this edited volume: Dementia and Diagnostics, Dementia and Conversational Strategies, Dementia and Epistemics, and Communicative Challenges in Everyday Social Life. One of the central aims of this volume is to shed more light on how persons with dementia accomplish relevant goals in interaction and also how changes in an individual’s discursive abilities may impact how conversationalists negotiate a world in common and continue to build their social relationships. All contributions for this edited volume draw on the methods of Conversation Analysis (CA), an approach to social interaction that provides a detailed view of the moment-by-moment accomplishment of social life. By exploring interactional practices through the lens of CA, this volume seeks to explore interactions involving people with dementia in a variety of contexts (everyday and institutional), pointing to both the interactional difficulties that often arise, but also the creativity and collaboration within these interactional encounters. A summary of each of the volume’s chapters is also provided.

This chapter explores how differing expectations and experiences manifest in diagnostic interactions in the memory clinic. We do this by microanalysing communication in dementia diagnosis feedback meetings, focusing on instances of misalignment between doctors and the person living with dementia. We examine three videos from a dataset of 101 recordings from two areas in the UK, collected as part of the ShareD study. We present different interactional contexts where the person receiving a dementia diagnosis choose to align or misalign with the doctors’ interactional projects of diagnosis delivery, prescribing medication and recommending support. Examination of these instances suggests that misalignment between the assessment of symptoms may, at least in part, reflect interactional facework in the face of dementia as a challenge to self-identity.

Singing may be a relative strength for people with dementia, yet little is known of how individuals leverage it as a communicative resource in everyday interaction. This study analyzes how Dan, a man living with vascular dementia, modifies lyrics based on prior talk and the physical environment during interactions with his wife, Morgan. Using Conversation Analysis, I describe the emergent structure of his singing and what it accomplishes. Dan uses singing to do a range of interactional jobs (such as complimenting, complaining, and requesting), and his lyrics are susceptible to evaluation based on their construction and relevance to previous talk. Both participants treat his singing as humorous and creative wordplay, but the laughability of his singing is contingent on how he modifies the formulaic lyrics based on the current discursive context. Thus, singing is a way in which Dan situationally constructs himself as a funny, clever, and sociable person. Dan’s singing also indirectly indexes his close relationship with Morgan by assuming her shared musical knowledge. This analysis contributes to the study of identity construction by people with dementia, the understanding of how people adapt to changes in cognition, and the study of the structure and function of singing in everyday interaction.

In this chapter we use conversation analysis to analyse the use of tag questions by co-participants of people with dementia. Tag questions can function as a ‘current speaker selects next’ technique. They also prefer, and hence put interactional pressure on, the next speaker to produce a response that aligns with the tag-formatted turn. We examine three classes of co-participant-produced tag-formatted actions and analyse how their use is recipient-designed for people with dementia. Tag-formatted assertions and assessments present information that the person with dementia has already been told or might be expected to know, while simultaneously acknowledging that this information is, or should be, within the recipient’s epistemic domain. By eliciting agreement, they co-opt the person with dementia into the co-construction of this topical talk. Tag-formatted challenges are produced in response to an inappropriate turn by the person with dementia and, as well as challenging/complaining about that turn, act to elicit from the person with dementia an acknowledgement of its inappropriacy. We then show how tag questions are used to induce verbal acquiescence to a suggested activity. We discuss how these tag questions encroach into the person with dementia’s territories of knowledge, power and interactional competence, highlighting asymmetries between the person with dementia and the co-participant in these domains.

Chapter 2 delves into the intricate interactional dynamics of administering cognitive assessments, with a focus on the Addenbrooke’s Cognitive Examination-III (ACE-III). The chapter critically examines the standardisation challenges faced by clinicians in specialised memory assessment services, highlighting the nuanced reasons for non-standardized practices. While cognitive assessments play a pivotal role in diagnosing cognitive impairments, the study questions the assumed standardization of the testing process. Drawing on Conversation Analysis (CA), the authors analyse 40 video-recordings of the ACE-III being administered in clinical practice to reveal variations from standardized procedures. The chapter expands on earlier findings to show how clinicians employ recipient-design strategies during the assessment. It introduces new analyses of practitioner utterances in the third turn, suggesting deviations could be associated with practitioners’ working diagnoses. The chapter contends that non-standard administration is a nuanced response to the interactional and social challenges inherent in cognitive assessments. It argues that clinicians navigate a delicate balance between adhering to standardized procedures and tailoring interactions to individual patient needs, highlighting the complex interplay between clinical demands and recipient design. Ultimately, the chapter emphasizes the importance of understanding the social nature of cognitive assessments and provides insights into the valuable reasons for non-standardized practices in clinical settings.

This chapter uses conversation analysis to investigate how different quiz formats facilitate or impede participation in group quizzes for people living with dementia. Quizzes are an important way to prompt social interaction and engage people living with dementia. However, their reliance on memory and cognition can present difficulties for staff and players alike. Despite quizzes being based on a question–answer format, the way they are enacted can vary in the following ways: question formulation and type; the type of appropriate answer (i.e., is there one, or more than one, possible correct answer?); the social structure of the quiz (Is the quiz played in teams or individually? Do players self-select to answer or do so in a mediated turn allocation format?); the way the players are spatially organised. All these variations impact the degree to which players can engage with the activity and with one another. Through the examination of different types of quiz format, this chapter outlines and make recommendations for quiz structures which facilitate high participation and uptake, and low threats to face. Data are taken from a corpus of ten quizzes recorded in four different group settings in England.

Chapter 12 explores the relationship between cognition and interaction. The longitudinal study, spanning over two years, utilises Conversation Analysis (CA) to investigate the cognitive and interactional abilities of a person with Alzheimer’s disease, ‘May’, through 70 audio recordings of telephone conversations with family members. The chapter acknowledges a close relationship between language and cognition by examining how memory and memory loss are displayed in verbal conduct over time. Furthermore, the chapter sets out to challenge the deficit-focused perspective pervasive in dementia literature, showcasing how May employs sophisticated communicative strategies and transacts routinised practices of interaction even with more advancing dementia. The findings suggest a nuanced understanding of cognitive abilities in dementia, questioning the binary framework of competence versus incompetence in analysing complex cognitive issues and interactional events. The findings contribute to understanding the complexities of Alzheimer’s disease, emphasising the need for tailored communication strategies to enhance the quality of interactions for individuals and their family’s facing dementia. The chapter underscores the significance of using interaction as a window to cognition, offering insights into the degenerative consequences of Alzheimer’s and paving the way for a more nuanced understanding of cognitive decline in the context of family communication.

For this chapter, we examine everyday interactions involving a person diagnosed with behavioral variant frontotemporal dementia (bvFTD; pseudonym Trudy). Drawing on the methods of conversation analysis, our specific research focus is placed on how knowledge is solicited, displayed and resisted in contexts of viewing family photos. Our data are taken from video recordings of Trudy at home in the presence of family, caregivers and two researchers. We found that looking at family photos comprised three different activities, each aiming to elicit a response from Trudy: ’Who are they?’; ’Who is that?’; ’Find X!’. Epistemic stances taken up by the participants were found to index Trudy’s ‘reduced’ epistemic domain with respect to her ability in recognizing family members in photos. On the other hand, it was also found that she was able to take up a position of epistemic authority when asserting who is not in the picture. To conclude, although Trudy was at times able to take up a position of epistemic authority to reveal her biographical knowledge, the conversational agenda mainly involved testing Trudy on what she knew, with the unfortunate result being that it was often made clear where she was lacking in knowledge.

This chapter extends on the previous one by investigating the validity of preexisting theories of intersubjectivity within psychology. Operationalizations of children’s intersubjectivity are applied to narrative vignettes used to exemplify alternative theories. This analysis demonstrates how each theorization illuminates some dimensions of interaction while excluding others. The vignettes are contrasted to show how the measurement of interactions determines the form of intersubjectivity observed. The conclusion argued for in this chapter is that although all theories depict some component of intersubjective behavior, a theory in line with the principles elaborated in the previous chapter is necessary.

This chapter offers a toolbox of Methods for Gesture Analysis (MGA). Developed in the context of research on emerging protolinguistic structures in cospeech gestures, the present version of MGA differs from earlier publications (Bressem, Ladewig, Müller 2013; Bressem 2013) in offering sets of tools for gesture analysis that adapt flexibly to different research questions. Essential starting points for MGA are an understanding of hand gestures as temporal forms embedded in a dynamically unfolding context and an understanding of context that itself varies with the adopted framework. The baseline for any chosen tool is a microanalysis that entails some account of the form of the gesture (as temporal form), i.e. ‘form analysis’,and some analysis of how a gesture, a sequence of gestures, a multimodal sequence is placed in a given temporally unfolding context-of-use, i.e. context-analysis. Macroanalyses of gesture dynamics are briefly introduced. MGA offers a toolbox with a flexible set of tools that encourages critical reflection on the insight that can be gained from analyzing gestures in multimodal communication and interaction.

Conversation Analysis (CA) is a major contributing discipline to the study of language use and social action in context. Originating in the discipline of sociology, it forms the basis for the burgeoning field of interactional linguistics. This chapter offers an overview of major themes in the field. Beginning with a brief discussion of the intellectual background of the field, the chapter sketches three distinctive levels of analysis: sequential organization, practices of turn construction, and the organization of these practices as sets of resources for dealing with recurrent problems in the social organization of interaction. Sections of the chapter deal with sequence organization, preference, turn design, the fitting of talk to specific contexts and recipients (recipient design), progressivity, multimodality, and interaction in the context of specific social institutions such as medicine, legal discourse, and news conferences.

This opening chapter first discusses the important position politeness research holds in pragmatics. Four areas of research are selected for the purpose: speech acts, discourse analysis, conversation analysis, and interaction on the Internet, with the overarching aim to show that politeness offers insights for how meaning is made and transmitted in each of these areas. The second part of the chapter is devoted to the discussion on the important role Chinese politeness plays in politeness research in general. Since the notion of Chinese face is a pillar of Brown and Levinson’s notion of face, an in-depth understanding of Chinese face and, subsequently, Chinese politeness, stands to benefit the understanding of Brown and Levinson’s thinking in their theory. In addition, research on Chinese face has been drawing an increasing amount of attention from scholars of politeness in recent decades, accumulating a literature the size of which few other languages can parallel and offering insights to the understanding of politeness that are unique and significant, a thorough exploration of Chinese politeness can inform the field about politeness theorizing.

The introduction provides a brief overview of the topic, outlining the status of English as a global language and pointing at the lack of research when it comes to patterns of conversational interaction in Englishes of the Outer and Expanding Circle. Language and culture are closely interrelated, yet existing research on English interactions has so far focused on only one small part of the English language complex – that of Inner Circle varieties such as British or American English. The chapter ends with an overview of the research questions that will be addressed in this study as well as a detailed outline of the book.

Classroom language ecologies are increasingly diverse as a result of mobility, migration, and information technology. In these spaces, interlocutors may draw upon shared linguistic and cultural resources but also bring in others. Prime examples are additional-language (AL) classrooms, where there is a shared target language, but where students may have different first languages from their classmates and teacher. In this chapter, we review empirical research on interaction in multilingual classrooms in approaches such as ethnography, translanguaging, and conversation analysis (CA), and discuss methods and findings in relation to the growing field of intercultural pragmatics (IP). Additionally, we offer an empirical illustration from video ethnography research in multilingual English AL classrooms in Sweden. With a CA approach, we demonstrate how a group of students participating in a vocabulary game manage an instance of diverging understandings of an English word. We show how, in resolving this interactional trouble, participants draw on the target language English and the societal/school language Swedish, and we discuss the observations in light of the IP concepts of salience and common ground. Finally, we argue that classroom studies detailing social actors’ language repertoires by using audiovisual data are essential in advancing our understanding of multilingual AL classrooms.