Living with dementia is generally associated with terms such as loss, confusion, and dependency; not development, agency and collaboration. Contributing to a growing body of research that acknowledges the remaining abilities of people living with dementia, and how they cope with challenges in their everyday lives, this thesis concerns a topic habitually framed by negative presumptions, namely learning. 

The risk of developing dementia increases with advancing age, and with an aging population the number of people living with dementia is expected to rise. Dementia is a complex condition that can have various underlying causes; it includes numerous diagnoses and is commonly characterized by a decline in cognitive and communicative functions. Due to its clinical connotations, people living with dementia often face negative assumptions about how they are, and what they can or cannot do. Alongside prevailing metaphors such as a return to childhood or empty shells, people living with dementia have been depicted as passive and disengaged communicators, incapable of initiating social action and asserting agency, who struggle to maintain attention in interactions. 

The aim of this thesis is to study novel learning in everyday activities for people living with dementia, taking the use of tablet computers as a case in point. Learning is approached from an interactionist perspective, where it is understood as a social and situated process, and conceptualized as changing participation in joint activities. The data used in this thesis comprises a collection of 50 video recordings where a person living with dementia, who has no previous experience of using touchscreen technologies, is using a tablet computer together with either a caregiver or another person living with dementia. The participants were asked to use the tablet computers according to their own interests, and did not receive any information regarding learning as an objective of their activities. Through four empirical studies, all using the methodological framework of multimodal conversation analysis, this thesis challenges the stereotypical belief that people living with dementia are incapable of novel learning. 

Study I shows how a woman living with dementia, over the course of six weeks, learns to perform the basic navigational steps needed to use an augmentative and alternative communication application. The analysis demonstrates how the participant's reliance on detailed information from her interlocutors gradually declined both during and across recordings. Study II highlights how people living with dementia position themselves as learners in unfamiliar joint activities. The results emphasize that the participants living with dementia publicly display their current understanding of the ongoing joint activities, introduce learning as a conversational topic, and are actively engaged in soliciting the information needed to partake. Study III shows how professional and family carers support the participants living with dementia in managing the tablet computers. The analysis reveals that the caregivers orient towards the doing of the participants with dementia, are attentive to their displayed understanding of the unfolding activities, and adapt any instructions with detailed multimodal cues if required. Study IV moves away from the dyadic constellations consisting of a person living with dementia together with a caregiver, and instead focuses on how people living with dementia manage the joint activities together with a peer. The results show that the participants treat the activities as collaborative endeavors, and orient towards the displayed competences of each other by offering or soliciting information when needed. 

Taken together, the findings from this thesis demonstrate that novel learning is possible for people living with dementia even without the use of structured interventions. The learning process is highly collaborative, and the participants actively support each other's conduct throughout the unfolding activities. Apart from possibilities for repeated participation in joint activities, procedural and agentive aspects of learning for people living with dementia are emphasized. 

A bourgeoning number of studies have demonstrated that people living with dementia are capable of participating in a wide range of everyday activities when supported by care professionals or family carers. However, little remains known about the situated practices used by carers to support people living with dementia as active co-participants in novel joint activities. Taking the use of tablet computers as an example, this study focuses on the interactional organization of instructions in joint activities involving people living with dementia, who have no previous experiences of touchscreen technologies, and their carers. The study is based on forty-one video recordings of ten dyads, each comprising a person living with dementia and a carer, as they are using tablet computers with applications suited to individual interests. Drawing on multimodal interaction analysis, we show how the carers continually foster the accomplishment of their interlocutors, and rarely take over responsibility for closing an ongoing joint project themselves. Our findings suggest that the carers' instructions, realized as verbal and embodied directives, function as a form of scaffolding practice that facilitates the coordination of visual perception and embodied conduct for the participants living with dementia.

Purpose: This study challenges the notion that people living with dementia are unable to achieve novel learning without focussed intervention techniques. The purpose of this study is to explore how a woman living with dementia (Alzheimer’s disease) learns to use a tablet computer with support from communicative partners.

Method: The study is based on video recordings and the theoretical framework of learning as changing participation in joint activities. Quantitative and qualitative focus is on changes in the interactional organization

over the course of six weeks in the activity of using an augmentative and alternative communication application.

Results: Over time, the participant living with dementia, relies less on the expertise and explicit instructions of her communicative partners when navigating the application, and more on the immediate feedback provided by the tablet computer.

Conclusions: The findings suggest that novel learning still is possible for people living with dementia, even without the implementation of focussed interventions. This study further emphasizes the procedural nature of learning for people living with dementia as the woman’s embodied actions were carried out in an increasingly more direct fashion.

Recent research has stressed the collaborative competences of people living with dementia, showing how they are capable of participating in a multitude of everyday activities when supported by cognitively healthy individuals. However, little is known about the collaborative work between different people living with dementia. Accordingly, this study aims to explore how people living with dementia, without the support of a cognitively healthy interlocutor, collaborate with other people living with dementia in an unfamiliar activity. The study is based on video recordings of three dyads, each comprising two individuals living with dementia, as they are using tablet computers with reminiscence and communication aiding applications. Drawing on multimodal interaction analysis, we show how the participants living with dementia treat the activities as joint endeavors and, when needed, engage in problem-solving sequences where they make their knowledge about how to progress within the activities publicly visible to their interlocutor. Our findings suggest that people living with dementia do collaborate with each other, and that the interactional labor between different people living with dementia is more symmetrical than what has been described in joint activities involving people living with dementia and cognitively healthy individuals.Previous article in issue

Purpose Language has been suggested to play a facilitating role for analogical reasoning tasks, especially for those with high complexity. This study aims to evaluate if differences in analogical reasoning ability between children with cochlear implants (CI) and children with typical hearing (TH) might be explained by differences in language ability. Methods The analogical reasoning ability (verbal; non-verbal; complex non-verbal: high relational integration demand) of children with CI (N = 15, mean age = 6;7) was compared to two groups of children with TH: age and language matched (TH-A+L, N = 23, mean age = 6;5), and age matched (TH-A, N = 23, mean age = 6;5). Results Children with CI were found to perform comparable to Group TH-A+L on non-verbal reasoning tasks but significantly more poorly on a verbal analogical reasoning task. Children with CI were found to perform significantly more poorly on both the non-verbal analogical reasoning task with high relational integration demand and on the verbal analogical reasoning task compared to Group TH-A. For the non-verbal analogical reasoning task with lower relational integration demand only a tendency for a difference between group CI and Group TH-A was found. Conclusions The results suggest that verbal strategies are influencing the performance on the non-verbal analogical reasoning tasks with a higher relational integration demand. The possible reasons for this are discussed. The verbal analogical reasoning task used in the current study partly measured lexical access. Differences between the children with CI and both groups of children with TH might therefore be explained by differences in expressive vocabulary skills.

Dementia is a source of growing concern globally, and often impacts on social and commu-nicative functioning. INdependent LIving Support Functions for the Elderly (IN LIFE) was aproject carried out within the European Commission Research and Innovation programmeHorizon 2020 that resulted in the development of two digital communication aids for rem-iniscence intervention for elderly people with dementia and their communication partners.The purpose of this intervention study was to investigate the effects on quality of life forpeople with dementia when using these aids. People with dementia (N = 118) and their for-mal care-givers (N = 187) and relatives (N = 9) were given the communication aids for a per-iod of 4–12 weeks. To assess a range of outcomes, questionnaires developed within theproject were used along with the EQ-5D (European Quality of Life – 5 Dimensions) andQoL-AD (Quality of Life in Alzheimer’s Disease) questionnaires. Quality of life improvedamong people with dementia when measured using EQ-5D ( p < 0.05). There was also a cor-relation between the impact on the participants’ health and wellbeing, the carers’ rating ofthe usefulness of the digital communication aids and the care-givers’ satisfaction with usingtechnology ( p < 0.05). These results indicate that digital communication aids may be usefulin social interaction where one partner has dementia.

Recent studies have demonstrated that people living with dementia, contrary to common believes, are capable of novel learning without structured interventions. Opportunities for learning throughout an individuals lifespan have been acknowledged as important factors in facilitating social participation and promoting wellbeing. However, little is still known about the situated practices used in the learning process for people living with dementia. This study aims to explore how people living with dementia in Swedish residential care facilities position, perceive, and assert, themselves as learners in a novel activity. The study is based on video recordings of eight people living with dementia, who for the first time use tablet computers as a social activity on a one-to-one basis with their formal caregivers. Through interaction analysis, we show how the participants living with dementia use the engagement displays of requests, accounts, formulations and metacomments to make their active undertaking in the ongoing activity public to their communication partner. Our findings suggest that people living with dementia might still perceive themselves as individuals capable of novel learning and that they are active and engaged agents in this process.

The purpose of the study is to explore when and how technology becomes a topic in interactions involving people with dementia and their carers. Three dyads of older women with dementia and their carers participated in the study. The dyads interacted in the home environments of the persons with dementia using tablet computers and two web-based applications with generic pictures, videos, and music files (CIRCA) and personalized pictures and films (CIRCUS). The data included twenty-one video-recorded interactions. Topical episode analysis and transcripts of interaction were used to analyze and exemplify when and how technology was talked about in the dyads. The dyads were engaged in exploring the tablets, and six common ways of making technology a topic of conversation were identified: talk about tech problems, commenting actions, expressing uncertainty in navigation, instructing and explaining, expressing surprise, and talk about technical development. The dyads explored the tablets in ways that were reflected in the content of their conversations. If people with dementia and their carers should benefit from todays technology, such as there is evidence for the interactions examined in this study, their homes and daily environments must be equipped with sufficient internet access and technical support.

This presentation focuses on recycling of stories in conversations involving people with dementia. In dementia, communicative ability gradually deteriorates as the disease progresses typically leading to profound decline of communicative skills in the late stage. Of all of the domains affected by dementia diseases, communication is one of the areas where people with dementia and their caregivers experience most challenges. A significant characteristic for persons with dementia is a tendency to tell the same stories over and over (e.g. Hydén et al., 2013). While the significance conversational partners have on the organization of stories told by people with dementia are highly recognized (e.g. Hydén, et al., 2013; Hydén, 2011), how conversational partners to people with dementia orient toward recycling of stories are still in need of further investigation. In previous research, the phenomenon of recycling stories is mainly credited to the person with dementia. In our present study, we would like to propose another parallel point of view in which caregivers also tend to recycle stories repetitively in conversation with persons with dementia. We argue that recycling of stories in interaction involving people with dementia is a highly collaborative activity, and sometimes even initiated by conversational partners to people with dementia. In this presentation, we focus on how recycling of stories are sequentially organized is ordinary interaction between people with dementia and professional caregivers. The data consist of video recordings of 4 dyads (one person diagnosed with dementia and a professional caregiver in each dyad) totaling approximately 2,5 hours of recordings. In the analyses, we have focused specifically on how the telling of recycled stories is initiated in conversation, and what kind of feedback such stories receive. Our analyses show that recycled stories told by persons with dementia receive strong interactional support from conversational partners by, for example, the use of responses signaling newness and surprise (cf. Hydén et al., 2013). Conversational partners are also actively involved in the telling of recycled stories by, for example, asking guiding questions expanding the stories and use prompting techniques in cases where the person with dementia seem to have difficulties telling the whole story. In our analyses, we have also seen examples where conversational partners to people with dementia not only support the telling of recycled stories, but actually initiate such stories by instructing the person with dementia to talk about a specific topic.