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Ingebrand, E. (2023). Dementia and learning: The use of tablet computers in joint activities. (Doctoral dissertation). Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Dementia and learning: The use of tablet computers in joint activities
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Demens och lärande : Användandet av surfplattor i gemensamma aktiviteter
Abstract [en]

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. 

Abstract [sv]

Att leva med demens förknippas vanligtvis med termer som förlust, förvirring och beroende; inte utveckling, agens och samarbete. En vanlig föreställning är att nytt lärande är ouppnåeligt för personer med demens. Genom att studera lärande, ansluter den här avhandlingen till ett växande forskningsfält som undersöker hur personer med demens nyttjar kvarvarande förmågor för att hantera de utmaningar som uppstår i vardagen. 

Risken att utveckla demens ökar med stigande ålder och med en åldrande befolkning förväntas antalet personer som lever med demens att öka. Demens är ett paraplybegrepp som innefattar en stor mängd sjukdomar som vanligtvis karaktäriseras av förändringar i kognitiva och kommunikativa förmågor. Demenssjukdomars kliniska konnotationer avspeglas inte sällan i allmänna uppfattningar om demens, och personer som lever med demens möter ofta negativa antaganden om hur de är och vad de kan eller inte kan göra. Utöver stereotypa beskrivningar som att gå i barndom eller vara ett tomt skal, finns det föreställningar om att personer med demens är oengagerade samtalspartners, oförmögna att initiera social handling, hävda agens eller upprätthålla fokus i interaktioner. 

Avhandlingens syfte är att undersöka nytt lärande i vardagen för personer som lever med demens, med användandet av surfplattor som huvudexempel. I avhandlingen undersöks lärande från ett interaktionsbaserat och situerat perspektiv, där lärande konceptualiseras som förändrat deltagande i en gemensam aktivitet. Den empiriska grunden består av 50 videoinspelningar där en person med demens, som saknar tidigare erfarenheter av tryckkänslig teknik, använder en surfplatta tillsammans med antingen en vårdgivare eller en annan person med demens. Deltagarna ombads att använda surfplattorna efter egna intressen och fick inga instruktioner gällande lärande som ett mål med sitt deltagande. Avhandlingen baseras på fyra artiklar, metodologiskt grundade i multimodal interaktionsanalys, och resultaten kontrasterar mot den stereotypa bilden av personer med demens som oförmögna till nytt lärande. 

Artikel I visar hur en kvinna med demens, över sex veckors tid, lär sig hur man utför de grundläggande stegen i en kommunikationsstödjande applikation. Analysen demonstrerar hur deltagaren gradvis blir mindre beroende av detaljerade instruktioner från sin samtalspartner. Artikel II framhäver hur personer med demens positionerar sig själva som lärande individer i nya aktiviteter. Resultaten visar att deltagarna med demens explicitgör sin situerade förståelse av de pågående aktiviteterna, introducerar lärande som ett samtalsämne och är aktivt engagerade i inhämtandet av den information som de behöver för att kunna delta. Artikel III visar hur vårdgivarna stöttar deltagarna med demens i handhavandet av surfplattorna. Analysen betonar att vårdgivarna orienterar mot deltagarnas görande i aktiviteterna, är uppmärksamma på deras uppvisade förståelse och anpassar sina instruktioner med detaljerade kroppsliga indikatorer vid behov. Artikel IV undersöker hur personer med demens hanterar aktiviteten tillsammans med andra personer med demens och utan stöd från kognitivt friska deltagare. Resultaten tydliggör hur deltagarna behandlar aktiviteterna som ett gemensamt projekt och uppvisar en medvetenhet kring varandras förmågor genom att såväl erbjuda som efterfråga information när aktiviteten stannar upp. 

Sammantaget visar avhandlingens resultat att nytt lärande är möjligt för personer som lever med demens, även utan strukturerade interventioner. Lärandeprocessen är starkt kollaborativ och deltagarna stöttar aktivt varandras bidrag genom aktiviteterna. Utöver möjligheter till upprepat deltagande i gemensamma aktiviteter, framhävs vikten av kroppsliga och agensbaserade aspekter för lärandet hos personer m

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2023. p. 92
Series
Linköping Studies in Arts and Sciences, ISSN 0282-9800 ; 850
Keywords
Dementia, Situated learning, Conversation analysis, Collaboration, Scaffolding, Demens, Situerat lärande, Samtalsanalys, Samarbete, Stöttande
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-193546 (URN)10.3384/9789180750714 (DOI)978-91-8075-070-7 (ISBN)978-91-8075-071-4 (ISBN)
Public defence
2023-06-09, K4, Kåkenhus, Campus Norrköping, 09:00 (English)
Opponent
Supervisors
Available from: 2023-05-04 Created: 2023-05-04 Last updated: 2023-05-04Bibliographically approved
Derbring, S., Barbos Nordström, M., Svenningsson, J.-A., Ekström, A., Ingebrand, E., Samuelsson, C., . . . Buchholz, M. (2023). Effects of a digital reminiscing intervention on people with dementia and their care-givers and relatives. Ageing & Society, 43(9), 1983-2000
Open this publication in new window or tab >>Effects of a digital reminiscing intervention on people with dementia and their care-givers and relatives
Show others...
2023 (English)In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 43, no 9, p. 1983-2000Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Cambridge, United Kingdom: Cambridge University Press, 2023
Keywords
dementia, communication, digital communication aids, reminiscence intervention, quality of life
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-182431 (URN)10.1017/s0144686x21001446 (DOI)000742544200001 ()2-s2.0-85119022010 (Scopus ID)
Note

Funding: The IN LIFE project was funded by the European Commission under the Horizon 2020 programme (grant agreement number 643442).

Available from: 2022-01-20 Created: 2022-01-20 Last updated: 2023-11-07Bibliographically approved
Ingebrand, E. (2022). Guiding novice tablet users living with dementia in managing iPads. In: : . Paper presented at 26th Nordic Congress of Gerontology, Odense, Denmark, June 8-10, 2022.
Open this publication in new window or tab >>Guiding novice tablet users living with dementia in managing iPads
2022 (English)Conference paper, Oral presentation only (Other academic)
National Category
Social Psychology
Identifiers
urn:nbn:se:liu:diva-185776 (URN)
Conference
26th Nordic Congress of Gerontology, Odense, Denmark, June 8-10, 2022
Available from: 2022-06-13 Created: 2022-06-13 Last updated: 2022-06-23Bibliographically approved
Ingebrand, E., Samuelsson, C. & Hydén, L.-C. (2022). People living with dementia collaborating in a joint activity. Learning, Culture and Social Interaction, 34, Article ID 100629.
Open this publication in new window or tab >>People living with dementia collaborating in a joint activity
2022 (English)In: Learning, Culture and Social Interaction, ISSN 2210-6561, E-ISSN 2210-657X, Vol. 34, article id 100629Article in journal (Refereed) Published
Abstract [en]

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

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Collaboration, Dementia, Peer learning, Scaffolding, ICT, Aging
National Category
Social Psychology
Identifiers
urn:nbn:se:liu:diva-184602 (URN)10.1016/j.lcsi.2022.100629 (DOI)000798787900004 ()
Available from: 2022-04-27 Created: 2022-04-27 Last updated: 2023-05-04Bibliographically approved
Socher, M., Ingebrand, E., Wass, M. & Lyxell, B. (2022). The relationship between reasoning and language ability: comparing children with cochlear implants and children with typical hearing. Logopedics, Phoniatrics, Vocology, 47(2), 73-83
Open this publication in new window or tab >>The relationship between reasoning and language ability: comparing children with cochlear implants and children with typical hearing
2022 (English)In: Logopedics, Phoniatrics, Vocology, ISSN 1401-5439, E-ISSN 1651-2022, Vol. 47, no 2, p. 73-83Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
Language comprehension; analogical reasoning; DHH; cochlear implant
National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:liu:diva-171529 (URN)10.1080/14015439.2020.1834613 (DOI)000585433700001 ()33150820 (PubMedID)2-s2.0-85095774442 (Scopus ID)
Note

Funding Agencies|European Union Seventh Framework Program (FP7/2007-2013) [FP7-607139]; Swedish Research Council for Health, Working Life and WelfareSwedish Research CouncilSwedish Research Council for Health Working Life & Welfare (Forte) [2013-01363]

Available from: 2020-11-20 Created: 2020-11-20 Last updated: 2023-05-02Bibliographically approved
Larsson, E., Ekström, A. & Samuelsson, C. (2018). Recycling narratives as a joint accomplishment in interaction with people with dementia. In: : . Paper presented at 5th International Conference on Conversation Analysis, Loughborough, July 11-15, 2018..
Open this publication in new window or tab >>Recycling narratives as a joint accomplishment in interaction with people with dementia
2018 (English)Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

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.

National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-150192 (URN)
Conference
5th International Conference on Conversation Analysis, Loughborough, July 11-15, 2018.
Available from: 2018-08-16 Created: 2018-08-16 Last updated: 2019-02-06
Ball, M., Isaksson, F., Larsson, E. & Müller, N. (2016). Dysarthria in Swedish. In: : . Paper presented at 16th ICPLA Meeting, Halifax, Canada, June 15-18 2016.
Open this publication in new window or tab >>Dysarthria in Swedish
2016 (English)Conference paper, Poster (with or without abstract) (Other academic)
Keywords
Dysarthria, Swedish
National Category
Other Health Sciences
Identifiers
urn:nbn:se:liu:diva-130339 (URN)
Conference
16th ICPLA Meeting, Halifax, Canada, June 15-18 2016
Available from: 2016-07-29 Created: 2016-07-29 Last updated: 2019-02-06Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-5449-8524

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