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Multilingual Life in Dementia Care: Crossing Linguistic Boundaries and Cognitive Gap: Navigating Mutual Understanding
Linköping University, Department of Culture and Society, Division of Language, Culture and Interaction. Linköping University, Faculty of Arts and Sciences.
2023 (English)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Flerspråkigt liv inom demensvård : Överstiga språkliga gränser och kognitiv klyfta: Navigering mot ömsesidig förståelse (Swedish)
Abstract [en]

This dissertation presents empirical research in the field of multilingual communication in residential homes of people living with dementia.  

Prior research has emphasised the crucial function of a common language and culture between care workers and residents in such settings. It has been argued that a shared language is essential for fostering mutual understanding between care workers and residents with dementia. The absence of a common language can result in significant issues, such as creating misconceptions about the capabilities of multilingual residents, potentially preventing care workers from recognising the residents' communicative abilities. This can prevent residents with dementia from participating in social activities, leading to social isolation and negatively impact their well-being. This, in turn, increases costs for all parties involved, including residents, care workers, and residential homes.  

While the significance of a shared language for mutual understanding is undeniable, it's not always feasible to match care workers and residents linguistically and culturally in a multilingual society with diverse ethnic groups. This situation prompts questions about how to achieve mutual understanding in the absence of a shared language in residential homes. This dissertation investigates how care workers and residents from various linguistic and cultural backgrounds in dementia care achieve mutual understanding during task-oriented communication, despite the absence of a shared verbal language.  

Employing a micro-analytic perspective, this research delves deep into instances of multilingual communication within residential homes to uncover the function of linguistic features such as sound prolongation in task-oriented communication. Additionally, the study explores how forms of address contribute to achieving mutual understanding in dementia care when there's no shared verbal language in multilingual communication. These questions are addressed using data obtained through a combination of ethnography, video recordings, and interviews. The study involves participants, including residents from ethnic minorities displaying symptoms of dementia and care workers from diverse linguistic backgrounds.  

Conversation analysis is employed for transcribing and analysing interactions among participants, while thematic analysis is applied to the interview data. The results suggest that in the absence of a common verbal language, participants recycle each other's verbal and nonverbal actions to foster mutual understanding. This process relies heavily on the actions of care workers. The findings also underscore the importance of care workers’ knowledge of residents' life histories, including their preferred forms of address, as a valuable resource for establishing rapport with residents.  

In conclusion, this dissertation highlights that the effectiveness of specific linguistic resources in multilingual communication not only varies among individuals but is also contingent on the particular situations in which a resident is involved. 

Abstract [sv]

Denna avhandling presenterar empirisk forskning inom området flerspråkig kommunikation inom boenden för personer som lever med demens. Tidigare forskning har betonat den avgörande funktionen av ett gemensamt språk och kultur mellan vårdgivare och boende i sådana miljöer. Det har hävdats att ett delat språk är avgörande för att främja ömsesidig förståelse mellan vårdgivare och personer som lever med demens. Bristen på ett gemensamt språk kan resultera i betydande problem, såsom missuppfattningar om de flerspråkiga boendes förmågor, vilket potentiellt kan förhindra vårdpersonal från att erkänna de boendes kommunikativa förmågor. Detta kan hindra personer med demens från att delta i sociala aktiviteter, vilket leder till social isolering och negativ påverkan på deras välmående. Detta ökar i sin tur kostnaderna för alla inblandade parter, inklusive boende, vårdpersonal och äldreboende.

Även om betydelsen av ett gemensamt språk för ömsesidig förståelse är oomtvistlig, är det inte alltid genomförbart att matcha vårdgivare och boende lingvistiskt och kulturellt i ett mångkulturellt samhälle med olika etniska grupper. I en sådan situation uppstår frågor om hur man kan uppnå ömsesidig förståelse när det inte finns ett gemensamt språk inom boenden. Denna avhandling undersöker hur vårdgivare och boende med olika språkliga och kulturella bakgrunder inom demensvård uppnår ömsesidig förståelse under uppgiftsrelaterad kommunikation, trots avsaknaden av ett gemensamt verbalt språk.

Med hjälp av ett mikroanalytiskt perspektiv granskar denna forskning djupt in i exempel på flerspråkig kommunikation inom boenden för att avslöja funktionen av språkliga aspekter som ljudförlängning i uppgiftsrelaterad kommunikation. Dessutom utforskar studien hur olika former av tilltal bidrar till att uppnå ömsesidig förståelse inom demensvård när det inte finns något gemensamt verbalt språk i flerspråkig kommunikation. Dessa frågor behandlas med hjälp av data som samlats in genom en kombination av etnografi, videoinspelningar och intervjuer. Studien involverar deltagare, inklusive boende från etniska minoriteter som uppvisar symtom på demens och vårdgivare med olika språkliga bakgrunder.

Samtalsanalys används för transkribering och analys av interaktioner mellan deltagarna, medan tematisk analys tillämpas på intervjudata. Resultaten tyder på att när det saknas gemensamt verbalt språk, återanvänder deltagarna varandras verbala och icke-verbala beteenden för att uppnå ömsesidig förståelse. Denna process är starkt beroende av vårdgivarens åtgärder. Resultaten understryker också vikten av vårdgivarens kunskap om boendes livshistorier, inklusive deras föredragna former av tilltal, som en värdefull resurs för att etablera kontakt med boende.

Sammanfattningsvis framhäver denna avhandling att effektiviteten hos specifika språkliga resurser i flerspråkig kommunikation inte bara varierar mellan individer utan också är beroende av de specifika situationer där en boende är involverad.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2023. , p. 175
Series
Linköping Studies in Arts and Sciences, ISSN 0282-9800 ; 864Studies in Language and Culture, ISSN 1403-2570 ; 38
Keywords [en]
Dementia, Multilingualism, Communication
Keywords [sv]
Demens, Flerspråkighet, Kommunikation
National Category
Communication Studies
Identifiers
URN: urn:nbn:se:liu:diva-199189DOI: 10.3384/9789180754040ISBN: 9789180754033 (print)ISBN: 9789180754040 (electronic)OAI: oai:DiVA.org:liu-199189DiVA, id: diva2:1812024
Public defence
2023-12-15, KEY1, Key-building, Campus Valla, Linköping, 10:00 (English)
Opponent
Supervisors
Funder
Swedish Research Council, 2013-2020Available from: 2023-11-15 Created: 2023-11-15 Last updated: 2023-11-17Bibliographically approved
List of papers
1. Accommodation Practices in Multilingual Encounters in Swedish Residential Care
Open this publication in new window or tab >>Accommodation Practices in Multilingual Encounters in Swedish Residential Care
2017 (English)In: Multilingual Interaction and Dementia / [ed] Plejert, Charlotta; Lindholm, Camilla; Schrauf, Robert W., Bristol: Multilingual Matters , 2017, p. 148-174Chapter in book (Other academic)
Place, publisher, year, edition, pages
Bristol: Multilingual Matters, 2017
Series
Communication Disorders Across Languages
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-199188 (URN)10.21832/9781783097678-009 (DOI)9781783097678 (ISBN)9781783097661 (ISBN)
Available from: 2023-11-15 Created: 2023-11-15 Last updated: 2023-12-05Bibliographically approved
2. An interactional perspective on sound prolongation in multilingual encounters in residential care
Open this publication in new window or tab >>An interactional perspective on sound prolongation in multilingual encounters in residential care
2019 (English)In: Clinical Linguistics & Phonetics, ISSN 0269-9206, E-ISSN 1464-5076, Vol. 33, no 2, p. 1103-1124Article in journal (Refereed) Published
Abstract [en]

Elderspeak refers to adapting ones language to a perceived language decline of an older interlocutor. Earlier studies have explored different features of elderspeak; some of these studies attribute positive outcomes to using elderspeak that facilitates communication, but other studies consider elderspeak a negative way of communicating that should be avoided. The aim of this study is to investigate a largely unexplored feature of elderspeak, namely sound prolongation in a multilingual context. There are five participants in this study: three carers and two care recipients in a residential care unit. The carers and care recipients have limited access to a shared spoken language. The data consist of video- and audio recordings of interaction between the participants. The recordings have been transcribed and analysed in accordance with Conversation Analytical methodology. The analysis shows that the carers use sound prolongation as part of their interactional repertoire in order to manage situations of distress. We conclude that in some distressful situations carers use of sound prolongation may help mitigating the care recipients emotional concerns since the source of agitations has been addressed properly. In other situations, the use of sound prolongation may lead to an escalation in distress, if the source of agitation is not addressed adequately. Our results bring to the fore that an interactional practice, such as the use of sound prolongation in the context of expressed distress must be interpreted in relation to the complexity of each and every situation participants find themselves in, their level of understanding, and the task/activity at hand.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Sound prolongation; resistiveness to care; agitation; elderspeak; conversation analysis
National Category
Specific Languages
Identifiers
urn:nbn:se:liu:diva-159868 (URN)10.1080/02699206.2019.1584914 (DOI)000479994100001 ()31385544 (PubMedID)2-s2.0-85070825137 (Scopus ID)
Note

Funding Agencies|Stiftelsen Solstickan; Vetenskapsradet

Available from: 2019-08-27 Created: 2019-08-27 Last updated: 2023-11-15Bibliographically approved
3. Whats in a name? Address practices in Swedish residential care facilities
Open this publication in new window or tab >>Whats in a name? Address practices in Swedish residential care facilities
2022 (English)In: Journal of Aging Studies, ISSN 0890-4065, E-ISSN 1879-193X, Vol. 61, article id 101007Article in journal (Refereed) Published
Abstract [en]

Encountering residents living with dementia who come from diverse linguistic and cultural backgrounds is a common aspect of everyday life in residential care homes. These facilities may have systems of address that differ from those used in residents respective cultures of origin. Residents forms of address are elements of identity established in accordance with their life histories. The aim of this article is to investigate empirically the role of address forms for residents and care-providing staff in multilingual residential settings. The findings rely on observational and interactional data as well as interviews. The observational and interactional data includes 23 participants, consisting of five residents and 18 members of care-providing staff. The interviews consist of informal conversations and a corpus based on open-ended interviews with 21 staff members and five residents in two residential homes in Sweden. On the one hand, the findings indicate that addressing the residents with their first name is a prevalent address practice by the staff. They also displayed 20 additional types of address practices. On the other hand, these practices, which are chosen with the best of intentions, often seem to be inconsistent with the residents preferred address forms. These data lend support to the large body of gerontological literature arguing that sensitivity to the life histories of residents, here the established forms of address, is vital to sustaining their identity.

Place, publisher, year, edition, pages
ELSEVIER SCIENCE INC, 2022
Keywords
Name; Form of address; Identity; Dementia
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-192356 (URN)10.1016/j.jaging.2022.101007 (DOI)000933151900006 ()35654542 (PubMedID)
Note

Funding Agencies|Vetenskapsradet

Available from: 2023-03-16 Created: 2023-03-16 Last updated: 2023-11-15

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4041424344454643 of 78
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