9.4.1 Practices to Request Information

Three different kinds of request formats were used to get Trudy to identify persons in the photographs. The first two were most often produced in wh‑interrogative format: Who are they? and Who is that? The third practice, Find X, used a directive format to initiate a ‘seek and find’ activity. From the perspective of deontics, the other family members use these request formats to exercise control of the conversation, deciding on the topic (identifying a person) and speaker selection (Trudy is directed to answer).

9.4.2 Displaying Difficulty with Answering

Trudy most often displays difficulty with responding to the first pair part action produced by either the researcher or by someone from her closer social network (e.g., daughter or caregiver/nurse). In this section we explore in detail how these sequences are accomplished by showing (1) how Trudy displays downgraded epistemic access in her response (e.g., by guessing, remaining silent, disengaging from the activity); (2) how co-present interactants pursue a response from Trudy via hints (Nilsson, Reference Nilsson2017), encouragers and directives to get Trudy to focus attention on the photo; and (3) how co-present interactants account for or assess Trudy’s performance within post-sequences.

9.4.3 Assessments in Sequential Third Position

Following the question- or directive-response sequence, a member of Trudy’s social network has the opportunity to produce what may be termed a third position assessment (Schegloff, Reference Schegloff2007; see also Table 9.1 for exam questions). These are slots in which family members may account for or assess Trudy’s performance. In many of the extracts shown thus far, Trudy’s (second position) response was not correct. This resulted in a negative assessment of Trudy’s response in third position, such as the daughter’s ‘↓no its not me’ seen in Extract 4. This negative evaluation also has important sequential implications. Because Trudy has not yet got it right, the activity of identifying the person on the photo has not come to a close, but rather there is an implication that subsequent talk will orient to getting an eventual identification. Thus, as has been shown, the speakers mobilize various practices in the pursuit of a (correct) response, such as by offering hints, adding more granularity or even getting Trudy to (re-)engage and focus on the photo.

When Trudy provides a correct answer, however, different response types will occur in third position. This is shown in Extract 10.

Trudy’s correct identification of her daughter in line 32 is followed by Joanna’s positive assessment (‘exactly’) and confirmation (‘=that’s me:’), which gets further upgraded by the caregiver in line 34 with ‘super’ and ‘perfect’ (see also Webb, Chapter 15 this volume, and Jones, Chapter 12 this volume, for discussions of similar evaluative third position responses). According to Schegloff (Reference Schegloff2007), these expressions work as sequence closing thirds. As the name suggests, they close off the sequence, thereby licensing the start of a new sequence.

9.4.4 Certainty Displays

Trudy’s responses to first position wh‑interrogatives to identify a person in a photo or first position directives to ‘find X’ are often hesitant and designed as guesses. She also often disengages with the activity by looking away from the photo. There were instances, however, in which her responses displayed certainty, as in Extract 11.

At the beginning of this extract Joanna had provided Trudy with a hint to help her identify the person in the photo (‘that is my mother’). It can be recalled that Joanna is actually referring to Trudy (from an earlier period in her life). Although Trudy, in line 9, partially repeats the prior turn through mirroring, thus displaying some form of ‘reflection’, she does not go on to say that she herself is in the picture. Trudy may thus be conveying slight hesitancy or even incipient disagreement with her daughter. In line 10 Joanna repeats the request to identify using a wh‑interrogative, leading Trudy to again engage with the photo before looking back up towards Joanna. Trudy then responds with a declarative devoid of modal expressions displaying uncertainty (‘it’s not me’). In this way, she indicates who the person on the photo is not, thus contradicting her daughter. What this disagreement shows is that Trudy has indeed understood the daughter’s hint (‘my mother’ = ‘Trudy’), but also that Trudy is not always displaying uncertainty and can take up an upgraded epistemic stance even if her professed knowledge turns out to be incorrect. Nonetheless, her contradiction does expose other cognitive deficits, since it shows that she was not able to ‘recognize’ a younger version of herself.

Another example in which Trudy denies with certainty that a given person in the picture is not the one that she is looking for is shown in Extract 12.

In line 1 the nurse directs Trudy to identify Joanna’s husband using the ‘find X’ turn format. The photo shown to Trudy has many people in it and so might prove overly challenging for her. After Trudy has looked at the picture for over 10 seconds, the daughter then places a different picture in front of Trudy containing only one person, Joanna’s husband. The nurse then requests confirmation from Trudy (‘is that him), followed immediately by a wh‑interrogative from Joanna (‘who is that’). Thus, to respond affirmatively, Trudy needs either to confirm the prior question with ‘yes’ or state that it is Joanna’s husband. Instead, in line 5 Trudy makes a visible emotional display consisting of her pounding her fist on the person in the picture, followed by a brief outburst of laughter and, in line 8 produces a wh‑interrogative (‘who is it’). Trudy’s question serves as a repair initiator (Schegloff et al. Reference Schegloff, Jefferson and Sacks1977) because she is soliciting help in answering the question, but it also serves as implicit disagreement because it does not offer the preferred variant (confirmation or ‘the answer’) to the prior questions. In line 9, rather than provide the ‘repair’, the nurse repeats the question and then produces an attention-focus directive (‘look at him closely then tell us’), suggesting that Trudy’s inability in answering is due to her lack of attention and not a ‘faulty’ memory. As a response, however, Trudy makes a certain display of denying that it is Joanna’s husband and that she has no knowledge of or any relationship to this person (lines 11–12). While constructing her turn, Trudy also makes various emotional displays of anger or irritation by clenching her teeth and making a fist while looking at the (unknown) person in the photo. In lines 14–17, occurring off-camera, the caregiver and the daughter explain to the researcher that Trudy was able to easily recognize Joanna’s husband in the photo on the previous day.

9.4.5 Displaying Knowledge of Co-present Interlocutors

The activity of identifying and displaying knowledge of persons appeared to be different when comparing contexts of ‘looking at family photos’ to ‘everyday talk between co-present interlocutors’. Extract 13, which occurred towards the end of the research, shows an example of how Trudy is able to display unsolicited knowledge about personal life events that include her daughter.

In line 1 of this extract, the daughter Joanna is about to initiate another round of person identification by getting Trudy to focus on another photo (‘look at him’). At the same time, however, Trudy initiates a different move by verbalizing the second person pronoun ‘You::’ and non-vocally by touching her daughter’s leg. She then continues her turn in line 3 by stating or announcing some biographical information (‘are my first daughter’). Thus, in contrast to the other extracts examined so far, Trudy initiates a sequence and shows that she can be a cooperative and engaged participant in the interaction. By doing so, she also takes up primary epistemic rights and access (Heritage, Reference Heritage, Sidnell and Stivers2013). Following a confirming response from the daughter, Trudy continues to provide even more biographical information (‘you I made when I was eighteen years old’). The daughter’s response in line 7 confirms what Trudy has said, but it might also be doing additional work. Because Trudy would, by most accounts, have first-hand, primary knowledge of at what age she gave birth to her daughter, Joanna’s response of ‘exactly’, by emphasizing the ‘correctness’ of what Trudy said, treats this knowledge as contestable; that is, she could have gotten it wrong and this biographical knowledge may not necessarily (or no longer) be in Trudy’s epistemic domain. In line 10, Trudy begins a turn in which it appears that she will be launching another statement, thus taking up primary epistemic rights (‘you are my:’), but what follows instead are a series of exam questions or known answer questions (Levinson, Reference Levinson, Drew and Heritage1992; Schegloff, Reference Schegloff2007) in which Trudy’s knowledge about her personal social network is being tested. For example, the questions directed to Trudy – ‘what’s my name?’, ‘and what’s my boy’s name?’, ‘and does Hans already have a child’ and ‘and what’s ↑his name’ (lines 11, 17, 23, 31) – are obviously all known to Joanna, and her third position responses of ‘mm hm’ and ‘exactly’ reveal this. In line 28, after being asked if her grandchild Hans has a child, Trudy displays some uncertainty as to whether he has one or two. After it is confirmed that Hans has only one child, Joanna proceeds to ask Trudy to identify someone in a photograph (lines 31–32) and, following no response, provides a hint (‘is that Hans’). Trudy’s response is designed with some uncertainty (‘yes that’s possible that that’s Hans’), which is then confirmed by Joanna in line 37. Then, following Trudy’s nod of agreement in line 38, Joanna orients to Trudy’s uncertainty in being able to recognize or identify Hans (‘if you say so, right’).

It has often been noted that persons with frontotemporal dementia sometimes have difficulty in initiating sequences resulting in interlocutors doing most of the work to keep the interaction going (Mikesell, Reference Mikesell2009). What Trudy displayed at the beginning of Extract 13, however, is the ability to take conversational initiatives and to speak about pertinent aspects of her personal biography – perhaps triggered by the proceeding focused activity of getting her to identify family members in photographs. In doing so, she was also able to take up a position of epistemic authority, to reveal some parts of her epistemic domain. But even though the daughter did at first cooperate with Trudy’s initiatives, the conversation eventually reverted to a perhaps more typical conversational agenda in which Trudy is tested on what she knows, with the unfortunate result of often making clear where she is lacking in knowledge.

10.3.1 Epistemics in Analyses of Interaction Involving People with Dementia

In general, people are expected to have access to their own biography and to be able to account for their own past (Muntigl et al., Reference Muntigl, Hödl and Ransmayr2014; Pomerantz, Reference Pomerantz1980). Due to a declining ability to remember, this is not always the case for people with dementia. Issues related to epistemic rights and responsibilities have recently been investigated with a focus on interaction involving people with dementia in several studies (e.g. Black, Reference Black2011; Hamilton, Reference Hamilton2019; Hydén & Samuelsson, Reference Hydén and Samuelsson2019; Landmark et al., Reference Landmark, Nilsson, Ekström and Svennevig2021; Lindholm & Stevanovic, Reference Lindholm and Stevanovic2022; Muntigl et al., Reference Muntigl, Hödl and Ransmayr2014, Nilsson, Reference Nilsson2017; Nilsson & Olaison, Reference Nilsson and Olaison2019; Nilsson et al., Reference Nilsson, Ekström and Majlesi2018; Svennevig & Landmark, Reference Svennevig and Landmark2019; Williams et al., Reference Williams, Webb, Dowling and Gall2019).

Hamilton (Reference Hamilton2019) outlines a number of identified strategies a person with dementia uses to handle memory problems related to Type 1 knowables. When asked questions related to personal facts that proved difficult to recollect, the person with dementia used both fellow interlocutors and assistance from the material surrounding to be able to provide an answer. In these situations, it was noted that partners of the person with dementia sometimes contradict the answers given by the person with dementia and answer on their behalf (Hamilton, Reference Hamilton2019; see also Nilsson et al., Reference Nilsson, Ekström and Majlesi2018). How spouses initiate corrections and repairs related to the epistemic domain of the person with dementia is a specific focus in a study by Landmark et al. (Reference Landmark, Nilsson, Ekström and Svennevig2021). In this study, couples’ management of conflicting knowledge-claims and negotiation of epistemic rights was investigated. Three main practices for correcting the person with dementia were identified: for example, the partner without dementia claiming epistemic authority and denying the person with dementia’s authority; or inviting the person with dementia to self-correct, thereby attributing some epistemic authority to them. Instances of disagreement where the spouses provided reasons for their alternative claims and displayed a more symmetric epistemic gradient were also found. Nilsson et al. (Reference Nilsson, Ekström and Majlesi2018) also showed how spouses with dementia sometimes actively hand over epistemic primacy to their partners by assigning them to be their spokespersons regarding information that they would normally have been expected to know themselves.

Related to the aspects of social sensitivity of handling asymmetries of knowledge (Linell & Luckmann, Reference Linell, Luckmann, Marková and Foppa1991), Nilsson (Reference Nilsson2017) argues that the act of prompting, or ‘fishing’ for Type 1 knowables regarding a specific memory may have a face-threatening and counter-productive effect on the participation of a person with dementia in an ongoing interaction. Managing such a potential face threat due to the difficulty of recollecting, as Svennevig & Landmark (Reference Svennevig and Landmark2019) show, may be done through accounts or justifications. Likewise, focusing on a conversation between a person with dementia and her two relatives, Hydén & Samuelsson (Reference Hydén and Samuelsson2019) have also argued that the participants jointly work to avoid face threats and confrontation when disagreement occurs, not only on factual matters but also on more foundational questions, such as who could possibly be alive at a certain point in time; this is what the authors call ‘reality disjunctions’.

In line with the abovementioned studies, Black (Reference Black2011) examined a conversation between a woman with dementia and her daughter, focusing on how the daughter challenges her mother’s statements and takes an epistemic stance as being more knowledgeable in relation to domains of knowledge ‘without explicit indication of sensitivity to the fact that the domains of knowledge in question would normally be considered more Sophia’s [the mother] than Lucy’s [the daughter]’ (pp. 84–85). Epistemic authority seems to be underlined through the use of a number of conversational techniques, including specific turn designs (see Muntigl & Hödl Chapter 9 this volume) and the emphasis of subjective experiences, which are sometimes acknowledged by the mother with dementia. Black argues that although the daughter in this way threatens the mother’s position as an equal participant in the conversation with the capability of knowing about her own life, the mother manages to participate in the conversation ‘without overt loss of face in the form of allowing herself to be corrected or contradicted about her own ability, experience, or knowledge’ (Black, Reference Black2011: 86).

In another study, Muntigl et al. (Reference Muntigl, Hödl and Ransmayr2014) analysed clinical interviews with patients with frontotemporal dementia, focusing on how patients position themselves regarding knowledge about their health. When asked about their condition, the patients would either deny being ill without necessarily accounting for their condition, or affirm being ill but display and elaborate on their epistemic stance with varied certainties with regard to direct knowledge and experience of their condition. That is, it is shown that disclaiming knowledge of any problem or claiming it with various degrees of awareness has effects on how people with dementia succeed in displaying themselves as competent social actors (Muntigl et al., Reference Muntigl, Hödl and Ransmayr2014).

10.5.1 Introducing the Story

In this first sequence, Karen is telling a story about some past events that involved both Mike and herself; they were both present and would both presumably have knowledge of these events from first-hand experience (see Pomerantz, Reference Pomerantz1980). In this way, this is an A–B event for Karen and Mike, and the knowledge domain should be a Type 1 knowable to both of them. As Karen tells the story, she creates a participation framework with the two interviewers as main recipients of the story. Karen’s telling about the past event comes as a response to a question posed directly to her about the deterioration of Mike’s condition as the interviewer poses the question using the second person singular pronoun ‘you’ (line 01) and a direct invitation to her to recount what had happened (line 03). She starts off a story rather straightforwardly, describing the events in which Mike is one of the main characters (from line 04 onwards). In her reference to Mike, she uses both his proper name (line 05) as well as a third person singular pronoun (lines 06, 08 and 09). This is a common way of telling a story for a third, unknowing, party when all involved participants have access to the information being told, and it is also a recurrent pattern in the interview material (Hydén & Nilsson, Reference Hydén and Nilsson2015; Nilsson et al., Reference Nilsson, Ekström and Majlesi2018). In line 10, however, it becomes apparent that Mike does not have access to this story. By posing a confirmation-seeking question, ‘°no:° was that so?’ (line 10), Mike takes an unknowing epistemic stance toward the events being talked about, although the event could be expected to be a Type 1 knowable for him, as he is the one who presumably has performed the described actions. In other words, the event seems like a B‑event to Mike, as evidently displayed in his question (line 10) (see Labov 1972: 124).

Mike’s positioning of himself as not knowing about, or perhaps even taking a disbelieving stance towards, these events (line 10) does not come with any account of why he does not recognize the story. Instead, he is posing his question without any extra interactional work, marking the event as something out of the ordinary by simply asking ‘°no:° was that so?’ (line 10), and thereby indicating a lack of recollection. Similarly, Karen’s response in line 11 is not in any way questioning why Mike does not remember what happened, and she does not hold him accountable for not knowing this. She simply responds to Mike by upholding the claim and elaborates with further details by referring to their son, as he was called over to his parents that evening (and could potentially corroborate the story) (lines 11–13; note the particle ‘ju’ in line 12, which is used in Swedish to show mutual knowledge or shared information; see Heinemann et al. (Reference Heinemann, Lindström, Steensig, Stivers, Mondada and Steensig2011)). By responding in this way and not treating Mike’s lack of recollection as surprising or noteworthy, Karen can be viewed as ratifying Mike’s diminished epistemic position. Karen’s focus on what happened and not on different experiences of the event seems to tally with other studies (e.g., Hydén & Samuelsson, Reference Hydén and Samuelsson2019; Svennevig & Landmark, Reference Svennevig and Landmark2019) that also describe instances of similar discrepancies in terms of shared memory or experience in interaction involving a person with dementia. As Karen continues with the story, the interviewer seems to become her main recipient, as shown by her gaze and orientation toward him (line 11), while she again positions Mike as a present third party by referring to him in the third person (line 13).

10.5.2 Changing Participation Framework

Soon after Mike has positioned himself as unknowing in relation to the events in Karen’s story, framing this as a B‑event to him, the participation framework for the telling also changes. As Karen continues the story, she now turns toward Mike, looks at him and directly tells him how she felt when he could not recognize her as his wife: ‘I was pretty sad then’ (Extract 2, line 19). A change of Mike’s participation between a ratified hearer, an addressed recipient and a character of the story (a third party present) in the telling (see e.g., Nilsson et al., Reference Nilsson, Ekström and Majlesi2018) can be observed throughout the whole sequence. Such a repeated shift between a second-party and a third-party positioning seems to highlight Mike’s interactional position within the epistemic constellation as unknowing. As will be shown, these changes in the participation framework and thus also the epistemic constellations are often accompanied and managed by embodied actions (see also Nilsson et al., Reference Nilsson, Ekström and Majlesi2018).

When Karen continues, there is a rather long sequence where she describes a specific evening when Mike did not recognize her. In the first part of the telling in Extract 1 (lines 1–16), Mike was positioned in Karen’s story as a third party present (Linell, Reference Linell2009; see also Nilsson et al. (Reference Nilsson, Ekström and Majlesi2018) for a discussion of such positioning in interaction involving people with dementia). In the continuation of the telling in Extract 2, at lines 17–19 when Karen talks about her feelings, she actually turns her gaze toward Mike and thereby includes him as an addressed recipient of her talk. This gives an interactional space to allow Mike to enter into the talk again by asking a question (line 21). Karen’s change of embodied orientation toward Mike, followed by the question, begins a sequence in which Mike seems to be included as a main addressee (lines 22–23). It is noteworthy that the question that Mike poses in response (‘what does Laurent say about that now then?’, line 21) heightens his position as someone who is not aware of his own life story and the consequence of his own actions. After Karen’s response (lines 22–23), the only reaction from Mike is an acknowledgement token ‘m:’ (line 25). He does not take any stance on his own involvement in the story. Following the lack of affiliation with the story by Mike, Karen then once more redirects her gaze away from Mike and towards the interviewer (line 27) and continues her story with the interviewer as her main addressee. This change in participation framework is seen not only in Karen’s bodily orientation, but also in the way she designs her story by providing an explanation of who Sara, the couple’s daughter, is (line 27), information that would be expected to be known by Mike but not the interviewers.

In the continuation of Karen’s telling, Mike is again positioned as a present third party by the use of his proper name (lines 28, 41 and 43) as well as the third person singular masculine pronoun (lines 30, 31). In line 47, however, Karen again changes the way she designs her story and addresses Mike by using a second person singular pronoun you (du in Swedish) when describing what happened and tells him what he said, something of which he shows no recollection. In this passage the interviewers are not included as addressed recipients of the story, but participate rather as ratified overhearers, or perhaps unaddressed recipients (Goffman, Reference Goffman1981), as Karen, in lines 46–51, tells a story about Mike that is designed with Mike as the addressed recipient. This way of designing the telling puts Mike in the spotlight as an unknowing party in the story of which he is the main character and of which he should presumably have first-hand knowledge.

In line 52 there is a new change in the participation framework, starting when Karen removes her hand from Mike’s hand (see Nilsson et al., Reference Nilsson, Ekström and Majlesi2018: 782–784) followed by a 2.2‑second silence. When Karen continues, she is once again referring to Mike, using his proper name (line 52). This can be seen as a change in the primary recipiency of her story. Nevertheless, Mike provides an acknowledgement of Karen’s story by saying ‘(jaså) (0.4) hm’ (‘oh really’; line 54) and thereby continues to claim a position as recipient of her story. As previously shown in research (e.g., Lindholm, Reference Lindholm2016: 835), the Swedish token ‘jaså’ signals ‘accepting the previous turn as news’, indicating receiving new and somewhat surprising information (see Heritage, Reference Heritage, Maxwell Atkinson and Heritage1984; Wilkinson & Kitzinger, Reference Wilkinson and Kitzinger2006). Mike’s ‘jaså’-prefaced turn can also be understood in the same way, that is conveying elements of surprise at the previous turn, which highlights that Karen’s telling is news to him (see, for example, third-turn receipts in Heritage, Reference Heritage and van Dijk1985). This tallies with the analysis that Mike has taken a position of an unknowing party throughout all episodes of talk despite his co-presence in the course of events and first-hand experience of them. With ‘jaså’, it seems that Mike has taken an unknowing stance toward Type 1 knowables, something that we analyse in more detail in Section 10.5.3.

In sum, the extracts of the interaction have so far shown how the interactional positionings (or participatory status in Goffman’s terms) of the person with dementia fluctuate between an addressed recipient of the story and the third person character in the story. The constant change of the participation framework goes hand in hand with the interactional positioning of the person with dementia vis-à-vis the knowable and also the management of him being cast as a character in a story in which he does not remember his involvement. The analysis has also shown how Karen uses embodied resources to manage the social sensitivity of telling this story by directing her gaze and body toward different recipients and also by using ‘touch’ in handling the third-party positioning of Mike in the interaction (see also Nilsson et al. (Reference Nilsson, Ekström and Majlesi2018) for details of the use of embodiment in the management of the speaking on behalf of a person with dementia).

10.5.3 Unknowing Stance towards Type 1 Knowables

As mentioned previously, a person is usually considered knowledgeable and accountable regarding their own experiences as well as their own private health (Heritage, Reference Heritage2012; Muntigl et al., Reference Muntigl, Hödl and Ransmayr2014; Stivers et al., Reference Stivers, Mondada, Steensig, Stivers, Mondada and Steensig2011). In the previous part of the extract, despite some signs revealing his unknowing position in the telling (e.g., lines 10, 20, 46), Mike has not explicitly stated that he does not know the story or does not have access to the information or the experiences Karen publicly shares with the interviewers. In the following part, Mike is clearly taking a downgraded epistemic position to Type 1 knowables and at the same time positions Karen as having primary access to information regarding his life and health condition.

While these episodes of Mike not recognizing his wife used to be rather common (line 55), Karen states that for the last two-three weeks ‘it has been better’ (lines 58–59), possibly an attempt to tone down the regularity of the problem. This seems to be taken as an opportunity for Mike to take part in the story once more, seeking information and also confirmation about his own behaviour, which has so far been under question throughout the telling. From line 58 onwards, Mike turns to Karen and keeps his gaze towards her while Karen states that Mike’s condition in the past two or three weeks has not been as previously described as it has been ‘better’ (even if perhaps still not good). This description is followed by Mike’s upgrading Karen’s gloss of being ‘better’ to being ‘normal’ when he directly asks whether his own condition has ‘been normal’ (line 62). By asking this question, Mike takes an epistemic, unknowing stance regarding aspects related to his own biography: he is turning to his wife for information about how he has been and has behaved during the past week (line 62). In response, Karen confirms that ‘it has been normal’, thereby confirming Mike’s upgrading of the description of his own condition from ‘better’ to ‘normal’ (lines 63–64). She verifies this description by adding that, lately, Mike has not had the previously described problems. Notably in her response, Karen is not marking Mike’s question as extraordinary or noteworthy. Instead, she responds straightforwardly and without any extra interactional work. Moreover, by turning to Mike, she also changes the participation framework once more by directly addressing Mike with a second person pronoun, making him a primary addressed recipient of this turn. Directly addressing Mike and highlighting his lack of awareness of his own health and condition (even though it belongs to his knowledge domain) heightens Mike’s positioning as an unknowing party, although Karen does not topicalize Mike’s lack of knowledge as a problem and does not make him directly accountable for showing a lack of knowledge of his own past and health (see Hydén & Samuelsson, Reference Hydén and Samuelsson2019; Svennevig & Landmark, Reference Svennevig and Landmark2019).

When the story continues in line 77, Karen moves back to using Mike’s proper name, once again including the interviewers as the addressed recipients. Karen elaborates on her previous story and describes how Mike sometimes takes the car to go to look for her, even though she is in fact at home trying to convince Mike that she is his wife. Mike again explicitly acknowledges his lack of knowledge (and also evidently some confusion) about the events, and thus once more takes a downgraded epistemic position while positioning Karen as the knowing party in, what would expectedly be, their shared epistemic domain.

Karen’s description of these events is mainly designed with the interviewers as addressed recipients as she is repeatedly using a third person pronoun and a proper name to refer to Mike (lines 77, 78, 81) (however, observe that Karen’s gaze is also directed toward Mike in the climax of the story where Karen says that Mike did not ‘believe’” that she was at home, line 79). It is also one of the interviewers who provides some minimal feedback to this part of the story (line 84), showing that the interviewer positions herself as a main addressee responsible for responding to Karen’s telling. However, in line 88, after being described as a person who was ‘firm’ with his wife (‘and that has happened so- some times three four times’, line 86), Mike once again claims a position as recipient to the story by asking Karen for information about how the episodes ended, episodes where Mike himself is the main character. His contribution can be interpreted both as an attempt to bring the story to the end by asking what eventually happened: ‘have I found you then?’ (line 88), and also as an indication that he has not been following the message of the story and is having trouble understanding the logic of it. Mike would not have asked the question had he kept track of the telling in which Karen describes that she was, in fact, at home when he went looking for her. Whereas the issue so far has been how Mike is positioned or positions himself as an unknowing party in the story about his own past, this sequence does not seem to be just about accessing information. There is also a trouble in understanding what is being talked about.

Mike’s question, ‘have I found you then?’ (line 88), displaying his difficulty in keeping up with the logic of the story, is responded to by Karen with laughter (line 89). Even if Karen provides the information that Mike has requested, she simultaneously does interactional work that may diminish the potential discomfort associated with Mike’s problem of recalling the event, as well as his problem following the story. Responding to Mike, she makes him the addressed recipient by using the second person pronoun and accompanies her response (lines 89 and 92) with a smile (shown by the symbol @ in the transcript) and also laughter. Even if the laughter displays that Mike got the story wrong and that it is a laughable matter, the laughter also frames the trouble as something not too serious and may very well be a face-saving strategy adopted in a delicate situation (Saunders, Reference Saunders1998). Mike also joins in the laughter, which perhaps momentarily covers up the trouble at talk (using laughter to manage embarrassing situations has been studied in dementia, e.g., Lindholm (Reference Lindholm2008); see also laughter in talk with people with aphasia in Wilkinson, Reference Wilkinson2007).

As in previous excerpts, Mike does not frame his questions as extraordinary or unexpected. He poses his questions straightforwardly without any account for why he asks Karen for information about whether he found her or not. While not knowing about one’s own past is recurrently something that needs to be accounted for (Muntigl et al., Reference Muntigl, Hödl and Ransmayr2014; Pomerantz, Reference Pomerantz1980), this seems not to be the case here. Neither Mike nor Karen marks Mike’s downgraded epistemic stance to this Type 1 knowable as extraordinary or something for which Mike should be held accountable.

In what follows, one of the interviewers poses a direct question to Mike about the events Karen has talked about (line 96). This is followed by a 2.5‑second silence where Mike gazes towards the interviewer, moving his head from side to side, and Karen gazes towards Mike (line 88). As seen in lines 97–99, Mike does not answer the question as to whether he usually comes home. Instead, he turns to Karen, stating that this is something she knows better: ‘you know that better than me right’ (line 99). When taking the turn in line 101, Karen first addresses Mike, confirming to him that he does indeed usually come home. She uses the particle ‘ju’, which shows that she expects Mike to know this, even if he seems to be incognizant of it. By handing over the question to Karen, stating that this is in fact something she knows better, Mike relinquishes epistemic authority to his own biography and positions Karen as the more knowledgeable about what he did at the time in question.

11.2.1 Participants in Interaction

The central two participants were a woman (referred to as ‘Dana’), who was 88 years of age and living alone in her own home, and her primary caregiver (her son, referred to as ‘John’). The names of all participants have been anonymised. Following the initial meeting with the dyad, in which I received written consent to conduct my study, further conversational participants from the family and community agreed to take part (see Table 11.1). This provided the opportunity to gather a unique data set with the person with dementia in conversation with a wide range of conversational partners in a variety of settings. This data set was the basis for a larger project (Lindley, Reference Lindley2016, Reference Lindley and Stickle2020) on which this chapter builds. Ethical approval for this study was received from the University of York, St John: Reference: UC/3/9/12/LL.

11.2.2 Data

The data collected in this study are everyday conversations between a woman living with dementia, her family and members of the community. Conversations were recorded on an audio recording device. It was relatively simple to operate and was demonstrated to the participants, then left with them to record at their convenience. The device was small and portable, giving ample flexibility to the participants to carry it with them on trips or moving from room to room. I visited Dana at home periodically to exchange the memory card in the device, and each time I ensured that I had listened to the previous week’s recordings in order to familiarise myself with the content and to be aware of any problems with recording or issues with consent or confidentiality.

Since the aim of the data collection was to obtain, as near possible, natural conversations, it was explained to the participants that they could record any part of their daily life and interactions. I stressed that constant dialogue was not necessary and there was no need to do any special activities or discuss specific topics. The family recorded as they wished over a period of three months, resulting in a total of 15 hours of audio data. The recordings were transcribed following the conventions of conversation analysis (Jefferson, Reference Jefferson and Lerner2004). The full corpus of recordings included mealtimes, watching television, car journeys, a visit from the chiropodist and a recording of one of Dana’s weekly appointments at her hairdresser’s salon. Noticing sequences involving reminiscence and advice-giving, especially in multigenerational conversations, I analysed these with respect to epistemics. Sequences were carefully inspected, exploring how the person with dementia was able to display primary epistemic rights and access.

11.3.1 Advice-Giving as a Means to Demonstrate Competence

Giving advice to a co-participant in conversation is a way to position the advice-giver as holding greater authority on a subject than the advice recipient (Vehviläinen, Reference Vehviläinen2001). Extract 1 is taken from a dinnertime conversation between Dana and her son’s (George’s) family. Trudy is Dana’s daughter-in-law and Chloe and Barney are teenage grandchildren. Following a similar mealtime conversation a few days earlier, seemingly a point of confusion for Dana is the work/school habit of Chloe, who is 15. Dana frequently asks about Chloe’s occupation and is reminded that she is still at school but has a part-time job as a waitress.

The overall sequence in Extract 1 is delivered as advice to Chloe but is simultaneously a reminiscence for Dana about her own time working as a waitress. Dana’s reminiscence sequence bears similarities to storytelling since the reminiscence is ‘locally occasioned’ (Jefferson, Reference Jefferson and Schenkein1978: 220) and topically coherent as it follows news of Chloe’s waitressing job. Hydén et al., (Reference Hydén, Plejert, Samuelsson and Örulv2013) observed that storytelling in family conversations can be fulfilling for a person with dementia, supporting the identity of the teller. After a shaky start, Dana displays her epistemic authority as she draws on her many decades working as a waitress to offer advice to Chloe. There are four co-participants in this conversation: Chloe is the chief recipient and Trudy and Barney intermittently participate in this interaction or continue their own two-party conversation simultaneously. Such intermittent schism in multi-party talk is systematically achieved without impeding the ongoing conversation (Sacks et al., Reference Sacks, Schegloff and Jefferson1974), and although Dana seems to be directing the advice to Chloe, Trudy also maintains a supporting role in this conversation.

A common language characteristic of people with dementia (Hamilton, Reference Hamilton1994, Reference Hamilton2019; Orange, Reference Orange, Lee Hummert and Nussbaum2001) is circumlocution, a means of delivering meaning indirectly in order to overcome problems with lexical access. Dana’s use of circumlocution can be seen to cause difficulties in conversation on occasion. Further analysis of Extract 1, in which Dana is having a mealtime conversation with her daughter-in-law and two teenage grandchildren, demonstrates potential problems associated with circumlocution. In the opening to this extract when Dana was reminded that Chloe is still at school and has a weekend job as a waitress, Trudy seems to attempt to deflect the topic when she utters a ‘laughable’ followed by laugh particles in line 12 and Chloe joins her mother by producing laugh particles in overlap. Glenn (Reference Glenn1989: 136) describes ‘laughables’ as ‘those items in reference to which people laugh’. Dana, however, does not laugh but utters further serious talk. At lines 17–18, Dana goes on to expand on her earlier question saying ‘are you learning how to say hello and bye bye’, which I have classified as circumlocution. This problematic turn is treated as a laughable by each of Dana’s co-participants: see their laughter in lines 19 and 20.

Laughter itself does not directly relate to coded linguistic meaning, but the sequential environment in which it occurs reveals the affiliative or non-affiliative characteristics of the sequence (Glenn, Reference Glenn2003; Jefferson, Reference Jefferson and Psathas1979). Glenn (Reference Glenn, ten Have and Psathas1995, Reference Glenn2003) distinguished between the practices of laughing at and laughing with co-participants. An interlocutor producing a first laugh at their co-participant’s troubles or producing an antagonistic laughable towards an interlocutor would be said to be laughing at. The ‘butt’ of the laughter (Glenn, Reference Glenn2003: 64) can then join the laughter and attempt affiliation or decline and continue with serious talk.

Dana’s interlocutors laugh together (lines 19–27) but Dana continues with serious on-topic talk. The laughter produced by Dana’s co-participants has the characteristics of ‘laughing at’ since the first laugh, in response to Dana’s circumlocution, was produced by Trudy and overlapped by laugh particles from Barney (line 20). An extension of the laughable was then produced by Chloe in lines 22–23, delivered with smile-voice and turn-final laughter. This sequence seems to be face-threatening (Goffman, Reference Goffman and Goffman1967 [1955]) to Dana and undermines her epistemic authority. Dana’s continuing with on-topic serious talk without any hint of laughter or smiling voice suggests that she has not aligned with the laughable nature of the topic and has treated the laughter as at her expense.

At line 25 Dana addresses Chloe directly ‘ah yeah but then and then you have to be able to say to a customer’; the use of you in this utterance appears to be both directed at Chloe, as recipient, and be a general use of you (Sacks Reference Sacks1992) as in waitresses in general. Indeed, Dana is not advising that Chloe says ‘can I get you something else’, but that she should be able to make such an offer. By being able to do this, she could fulfil the complex dual role of a waitress in serving her customers and increasing sales on behalf of her employer. Dana now has Chloe’s attention, as can be seen from the minimal response in line 30. The delivery of Chloe’s utterance has the quality of a smile-voice, denoted by the £ symbol, which appears to be following laughter from Chloe and Barney earlier in the sequence, which may well have been as a result of Dana’s circumlocution.

Following a one-second pause (line 31), Dana initiates a more detailed advice sequence. This is prefaced, in lines 32–34, by setting up a scenario in which the customers are ‘playing about’ and ‘don’t know what they’re talking about’. Dana aligns with Chloe by saying ‘you know’, which sets apart the waitresses (Dana and Chloe) from the customers, who are in need of guidance. Chloe acknowledges this scenario with a minimal token in line 33, which projects that Dana can continue with the advice sequence (Goodwin, Reference Goodwin1986; Schegloff, Reference Schegloff and Tannen1981). This time Dana delivers the advice by directing Chloe with ‘you say’ and then performing a courteous offer to the customer (lines 36–38): ‘would you like me to get something else for you’. The performance quality of this utterance can be heard in a switch in register, towards Standard English rather than the Northern Irish accent that Dana regularly uses in family conversation. In addition, Dana has now performed the same offer as in line 29 but with the more formal lexical structure ‘would you like me to get’ rather than ‘can I get’. This performative delivery sets the scene in Dana’s demonstration (Clark & Gerrig, Reference Clark and Gerrig1990; Hydén & Örulv, Reference Hydén and Örulv2009) as she enacts (Kindell et al., Reference Kindell, Sage, Keady and Wilkinson2013) her part as a professional waitress.

Trudy now re-enters the conversation (line 39). Trudy uses the same formulation as before (lines 15–16) ‘it’s all good […] isn’t it’, but this time she refers to ‘good learning’, which was adumbrated at the start of the sequence with talk about school and Dana’s question ‘are you learning anything’. Although this chapter is not primarily concerned with repetition (a common characteristic of conversations with persons with dementia), it is interesting to note that repeated formulations and ideas are being produced by Trudy, a participant with no known cognitive impairment. Repetition is common in interaction among participants with shared histories (Norrick, Reference Norrick1997) and can be found regularly across the entire data set, in particular in talk about food, service and working life. Non-impaired interlocutors contribute to, and are coerced into producing, repetition in conversation as familiar topics arise.

In lines 41–52, Dana continues with her advice. She demonstrates (Clark & Gerrig, Reference Clark and Gerrig1990) to Chloe how to deal with customers: ‘that’s very nice, we do that nice, we do that and it’s very nice’ and finally ‘it’s very popular’. These turns are again delivered with a Standard English accent. After having repeated the adjective ‘nice’ three times, it seems as though nothing new is forthcoming in this sequence, but then the final demonstration given by Dana, in line 52, is delivered with an almost triumphant Received Pronunciation ‘populah’, which is then acknowledged by both Chloe and Trudy. Chloe receipts these recommendations with a minimal token ‘mmm’, but Trudy validates the advice and Dana’s authority to deliver it (lines 54–55). Dana has achieved this sequence in conversation by displaying access to her autobiographical memories. It is delivered in an appropriate manner as advice to a novice waitress, and Dana has received recognition for her authority and expertise in this role.

Furthermore, Dana is ultimately validated as an expert when Trudy says ‘you’ve always been a waitress haven’t you’ (line 63). Although this turn is addressed to Dana, it is also designed for the other co-present participants to hear, which further upholds Dana’s authority and self-worth in this matter. What is particularly noticeable about the construction of Trudy’s turn is the present perfect continuous tense – have [always] been – which imbues Dana’s occupation with a sense of continuing professionalism. It is all too easy when speaking to an older person to design one’s turn with a sense of what had been. As De Beauvoir (Reference De Beauvoir1972: 294) observed in her study of old age, there is a feeling of being ‘flung from the active into the inactive category’. Trudy has validated, not only the sense of what Dana once was, but also her authority to advise Chloe in the here and now.

As Dana delivered her advice, Chloe showed her participation in the conversation with a minimal token ‘mmmmm’ (line 66), expressing her alignment with Dana’s continuation. The sequence ends abruptly as George completes his telephone call and has to leave urgently, taking Dana with him. Although Chloe’s lexical contribution to this sequence is minimal, her participation in the interaction has offered Dana an opportunity to advise, remember and be validated as a ‘usable participant’ (Goffman, Reference Goffman and Goffman1967) – and, indeed, an expert on her working life.

11.3.2 Shared Reminiscence: Claiming Knowledge

This section explores a sequence in which Dana responds to memories, reminiscences and assertions produced by interlocutors. Whereas Dana’s self-initiated reminiscence sequences are often fluent and assertive, reminiscence initiated by others is not treated by Dana with the same authority. She can, however, design her turns as sequentially relevant to come off as doing remembering.

During the reminiscence sequence in Extract 2, Dana’s is twice asked ‘do you remember?’ Caregivers and families are often advised not to use this phrase (Alzheimer’s Society, 2024) as it is thought to challenge a person with dementia, cause distress and have a negative effect on their self-esteem by exposing memory impairment. In Extract 2, as in other instances of this question found in the data, this is asked without any such difficulties arising. Dana can successfully use the interactional context to sustain her conversation; she is able to align with the projected preference of the question (Pomerantz, Reference Pomerantz, Maxwell Atkinson and Heritage1984) by affirming, or at the very least not disconfirming, that she remembers. Dana is thus ratified as a participant in the shared reminiscence.

In Extract 1 reminiscence sequences were explored that involved Dana’s autobiographical memories about her long career as a waitress. Sequences from Extract 1 were packaged as advice to Chloe, the young waitress, but all involved Dana’s primary access (Drew, Reference Drew, Markova and Foppa1991; Heritage, Reference Heritage2012a; Labov & Fanshel, Reference Labov and Fanshel1977; Pomerantz, Reference Pomerantz1980, Reference Pomerantz, Maxwell Atkinson and Heritage1984) to knowledge about her own experiences, told by her to others who have only secondary access to the stories. Extract 2 differs from the earlier example in that this is a reminiscence of shared experiences between George, Trudy and Dana; they each have equal epistemic authority (Heritage, Reference Heritage2012a, Reference Heritage2012b; Heritage & Raymond, Reference Heritage and Raymond2005; Stivers et al., Reference Stivers, Mondada, Steensig, Stivers, Mondada and Steensig2011) relating to a shared experience. Furthermore, this reminiscence sequence is initiated by a person other than Dana; she has not ‘found’ this memory for herself.

Just prior to the start of Extract 2, Dana asked the age of her granddaughter, Chloe. Trudy answered the question, telling Dana she is fifteen and followed up with an assessment of the intervening years having passed so quickly: ‘seems like five minutes ago’. This is the start of a reminiscence sequence initiated by Trudy, and she goes on to provide some details of the event: Dana ‘came to visit her in Castleford’ in line 2, ‘came to see me in hospital’ line 6 and ‘she [Chloe] had a shock of black hair’ in line 13. Dana aligns with Trudy’s telling with fitted contributions including ‘god bless us’ in line 5, ‘yeah’ in lines 7 and 14, and laughter throughout. At line 12, Dana utters the phrase ‘God love her’. By using the female pronoun, it seems that Dana is on track in terms of the referent of the conversation, that is Chloe. However, it may not be clear to Dana at this stage that they are speaking about the Chloe of fifteen years ago. There is no explicit mention of the baby or birth until lines 15 and 16 when George brings together the implicit facts given in the sequence so far and states ‘she had black hair when she was born didn’t she, Chloe’. Dana laughs (line 17) in overlap with George’s utterance. Following Trudy’s response ‘yeah’ in line 18, Dana also responds to George’s assertion by uttering the word ‘yeah’, which is delivered with a smile voice. This quality in Dana’s voice may be attributed to having just completed a stream of laughter, but it also appears to lend an element of grandmotherly nostalgia to the utterance.

George and Trudy have, collaboratively, provided Dana with an assessable referent. They have described the baby ‘she had a shock of black hair’ and some of the events occurring at the time of her birth – ‘you came to visit her in Castleford’ and ‘you came to see me in hospital’ – but they have not, themselves, made an assessment of the baby’s characteristics. For example, they did not say she had lovely black hair. Chloe’s parents have ‘seeded the ground’ (Goodwin, Reference Goodwin, Glenn, LeBaron and Mandelbaum2003: 157) for Dana to make the first assessment, which she does in line 21: ‘God love her she was gorgeous’. As Pomerantz (Reference Pomerantz, Maxwell Atkinson and Heritage1984) noted, making assessments is related to rights of experiential access to an event or referent. In addition, Heritage and Raymond (Reference Heritage and Raymond2005) state that by uttering the first assessment, an interlocutor is claiming epistemic rights over the assessable. In this case, it has been put to Dana that she was present at the hospital and that she saw the baby. Dana has the right to assess, and by doing so, demonstrates that she has personal access to details of the event.

We cannot know whether Dana actually remembers this event for herself. Given that she is a fluent speaker and her talk is rich with description of events in her self-initiated reminiscence sequences, there seems to be a marked lack of detail in her contribution in this example. Positive assessments of babies, and grandchildren in particular, are culturally relevant and expectable owing to Dana’s status as a grandmother (Raymond & Heritage, Reference Raymond and Heritage2006). Comparable with Jones’ (Reference Jones2015: 564) concept of ‘answering without knowing’, it is possible that Dana cannot access this memory herself but is relying on the interactional context to design her assessment. Dana’s interlocutors have, incrementally, created an interactional environment in which Dana can share in a joint reminiscence sequence. Despite the taboo surrounding the phrase do you remember, when it is produced, in lines 2 and 13, it provides the sequentially relevant slot for Dana to affirm that she does remember. This question has not exposed Dana’s memory impairment or caused upset or interactional difficulties. On the contrary, by exploiting the subtle processes of ‘sequential implicativeness’ (Schegloff & Sacks, Reference Schegloff and Sacks1973: 296), Dana has demonstrated that she is a competent and authoritative participant in this reminiscence.

11.3.3 Resolving Interactional Problems Involving Confusion

In this section I inspect how Dana’s failing understanding leads to interactional breakdowns and the ways she and her co-participants manage to recover her authority. Firs, some background to Extract 3 is required. The Fortes referred to in the conversations are the family who became famous for a large, multinational chain of hotels and restaurants. The name ‘Forte’ is, therefore, retained so as to preserve the sense of what is being discussed and because the name is publicly known. For the same reason, some names of establishments in Belfast are retained, but all other names of people and private addresses are pseudonyms.

The uncertainty in this sequence arises from John questioning some details relating to Dana’s reminiscence (not shown) about working in the Café Grande in Belfast. Dana mentions her employers, the Finleys and the Fortes, and John is trying to understand the relationship between the two.

Lines 2–15 involve a sequence in which John is probing for information about the relationship of the two families, the Finleys and the Fortes. Dana does not seem to understand what he is asking or, perhaps, considers that the question has been satisfactorily answered. After a pause in line 10, Dana produces a turn ‘and uhm’ which suggests she is projecting a resumption of her earlier topic. Local (Reference Local and Couper-Kuhlen2004) showed that turn-initial ‘and uhm’ is a device to signal that the upcoming turn would not be sequentially relevant to the immediate prior, but a move to resume an earlier topic. Dana, however, does not complete the turn and John continues with his questioning about the Fortes and the Finleys, which leads to Dana becoming confused, as evidenced in line 21. Dana is consistent in the fact that the Finleys are parents of the Fortes, but what John wishes to clarify is how they came to have different names. Elsewhere in the data John and Dana discuss this problem: for example, John says: ‘Mr and Mrs Finley must have been Frank Forte’s inlaws’. While Dana repeatedly offers the same information, answering John’s questions with sequentially relevant and consistent facts, she does not seem to understand the complexities of the overall project that John is proposing, which is that the Finley’s son would, according to British custom, take the same surname as his parents.

John’s probing for information seems to result in Dana’s uncertainty. In line 15 John invites a collaborative completion (Lerner, Reference Lerner and Lerner2004) from Dana to try to elicit the information. Dana answers ‘Barney’ with intonation that has an abrupt quality, the start of the single word being of increased amplitude. This is followed by perturbations from Dana and in line 21 she actually states ‘you’re mixing me up now’, delivered with laugh particles and smile voice. The indication of laughter signals a light-hearted recognition of her incompetence (Haakana, Reference Haakana2010; Jefferson, Reference Jefferson, Atkinson and Heritage1984; Wilkinson, Reference Wilkinson2007) and John continues with a serious account of whom she may be referring to in line 24.

Further questioning from John on the matter does not elicit an answer. In lines 25, 29 and 35, Dana simply repeats parts of John’s prior turns. In line 36 John initiates a side-sequence (Jefferson, Reference Jefferson and Sudnow1972) to elaborate on the Forte question. He uses the phrase ‘you know’, which is a marker of knowledge management in conversation (Schiffrin, Reference Schiffrin1987). You know refers to knowledge which is either generally known or which is expectedly shared between the co-participants. John incrementally delivers the information about the Forte family, who are known in the hotels and motorways services businesses. After a pause of 1.8 seconds in line 40, he modifies his assumption that Dana should know about this and utters ‘no’, which seems to signify an abandonment of the side sequence. At line 43 Dana utters ‘I don’t know no’, confirming that she does not know about the Fortes’ chain of restaurants.

This is the point at which Dana achieves the transition from uncertainty back to authority. By clearly stating that she does not know, the sequence is closed and nothing further is added by John as a 1.5 second pause ensues. The subsequent turn is constructed with a turn-initial but, indicating a referential contrast (Schiffrin, Reference Schiffrin1987) between the referent that Dana does not know about (the Fortes dilemma) and that which she does know (the Café Grande). Dana’s turn in line 45 ‘I worked at the Café Grande’ is delivered with declarative syntax, claiming ownership of knowledge. Her lexical choice but simultaneously manages various features of the ongoing talk: (1) it connects her statement to the prior talk, showing that it is sequentially relevant, (2) it projects the contrast of the actions not knowing to knowing, (3) it signals the speaker’s pursuit of an earlier topic (Schiffrin, Reference Schiffrin1987) – a return to the topic last referenced in line 1. The latter feature is crucial for Dana, it seems, since she returns to talk about autobiographical events over which she has primary authority and can confidently hold the floor.