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.

The aim of this chapter is to discuss the role of applied Conversation Analysis in the overarching area of dementia care for minority ethnic groups in Europe: people who often do not receive the same quality of dementia care as majority populations. Analysis of an episode from a video-recorded, interpreter-mediated dementia assessment and accounts from ethnographic interviews and informal conversations with stakeholders are used as a vehicle for discussing the role of applied CA to intervene in the problem of inequity in care for minority ethnic persons with dementia. Even when CA studies, for example on dementia, get published and researchers present numerous important implications for relevant stakeholders, the road towards actual application is often long and complex. This chapter builds on the international collaboration between CA scholars and different stakeholders conducted over a period extending for ten years, also resulting in an impact at a societal level in terms of recommendations not just within the scientific community but also at an international, political level.

In this chapter, we investigate how a couple where one of the spouses is diagnosed with dementia handle challenges in narrations of past shared events that arise when the spouse with dementia has limited access to these events. Partners of people diagnosed with dementia recurrently have to take into consideration that their spouse may not remember details in stories they tell, even though the person with dementia is a main participant in the events being retold. The design of such stories is complex as the interactants must keep track of both the content of the story and manage the potential sensitivity of telling a story that should already be known to both spouses. We show how the spouse without dementia (re)organizes the participation framework in resourceful ways and delicately deals with her spouse’s limited memory using a variety of face-saving practices. The analyses highlight how issues related to knowledge and dementia can benefit from using an interactional and distributed perspective. While access and rights to knowledge is usually divided between participants depending on the knowledge domain and the participants’ relation to the topic, in the case of a dementia disease a more flexible approach towards such divisions could be advantageous.

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.

Part of a wider study of family interaction, this chapter focuses on the interactional competence of a person living with dementia and some ways in which her independence is facilitated, and personhood validated, by her interlocutors. Drawing on a corpus of 15 hours of naturally occurring conversation, the study investigates the interactional practices of a woman diagnosed with dementia (Dana) in conversation with a variety of interlocutors including family caregivers, teenage grandchildren and community service providers. This chapter examines sequences of advice-giving, shared reminiscence and occasions of confusion. Dana first draws on a lifetime of expertise as a waitress to advise her granddaughter who has recently begun her first job; second, in a sequence of reminiscence, conversational partners describe a shared experience that Dana is able to assess and engage with despite potentially being unable to remember the details for herself; finally, the analysis shows how the actions of probing and testing can lead to interactional breakdown and confusion, but then note how Dana is able to recover from the situation by moving to a familiar topic and claiming epistemic authority.

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.

This chapter demonstrates how a community of professional caregivers changes its view of a mealtime situation as a result of a communication intervention involving video guidance. We use data from a Finnish communication intervention model called OIVA, in which caregivers film everyday interactions and discuss these scenarios with a trained OIVA guide. In the 90-minute session investigated in this chapter, the community analyzes the interaction in a video where a caregiver spoon-feeds a resident living with dementia. This chapter focuses on how the OIVA guide uses practices such as hypothetical questions and reformulations of previous contributions to redirect the work community’s focus towards the interaction between the caregiver and the resident in the video. It is argued that, during the video guidance session, the caregivers begin to view the task of feeding as a social event and an opportunity to communicate with the resident.

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 explores the challenges faced by individuals with dementia and their caregivers in communication. It focuses on the potential of personalized communication applications on tablet computers to support interactions. While various communication aids have proven valuable in addressing dementia-related communication issues, digital tools like tablet computers are relatively new in this context. The analysis centers on two key aspects of interaction: caregivers’ use of questions and the management of communication support devices. Results reveal that questioning individuals with dementia can be both challenging and rewarding. The chapter emphasizes the importance of awareness regarding potential issues with certain types of questions and the readiness to address difficulties in interaction. Regarding the management of digital applications, the study suggests that aligning with the associations of the person with dementia and being responsive to their contributions may enhance conversation development. The findings underscore the significance of prioritizing conversation over facts and being attuned to the person with dementia’s conversational trajectory to promote their active participation and engagement. Overall, understanding how the management of communication support influences outcomes may enhance the effectiveness of such tools in facilitating meaningful conversations with individuals with dementia.

In this introductory chapter, an invitation is provided to begin a journey into the intricacies of Black Caribbean immigrant literacies through the use of Black Panther and Black Panther: Wakanda Forever, as exceptional Black imaginaries already inscribed in the world. Through the adept depiction of racialization and transracialization steeped in the Black experience in the US as juxtaposed against the notion of Black immigrants as a ‘model minority,’ the necessity for examining race in relation to the languaging and semiotizing of Black Caribbean immigrants is outlined. Presenting a brief overview of the emerging global project focused on racialized language, this chapter lays the groundwork for the painting of a compelling portrait of the holistic literacies of Black Caribbean immigrant youth. By signaling the attention to an ultimate positioning of flourishing as a necessary imperative for and alternative to rethinking literacies based on ‘success,’ the chapter concludes with a focus on solidarity between Black Caribbean and other populations as a key impetus for this work.