In the present case study, a care encounter between an older multilingual (Farsi/Swedish/English) Persian woman and staff in an ordinary, Swedish residential home is investigated. The woman is perceived as suffering from dementia symptoms, but has not received any formal diagnosis of the disease. More specifically, the study focuses on how the woman's contributions in her mother tongue, Farsi, are responded to by a carer, who is also multilingual and speaks Swedish as a second language (L2), but has a very limited knowledge of Farsi. The data consists of recorded material from a mundane morning activity in the residential home, as the woman is undressed and prepared to go to the shower. The method employed is conversation analysis, and the study addresses the interactional outcome of this type of multilingual encounters, highlighting the way the establishment of mutual understanding is negatively affected by the fact that the participants do not or only to a limited extent share a common language. Analysis of the data shows that most of the woman's contributions in Farsi are responded to in L2-Swedish by the carer, primarily by means of seven different response practices: soothing talk, instrumental talk, minimal responses, explicit expressions of understanding, mitigating talk, questions, and appraisal. The findings are discussed in light of new demands on Swedish (and Western) care- and health care systems to adapt to the increasing number of multilingual, older people, who will become residents in care facilities and attend day centers within the coming years.

In the Scandinavian countries Sweden, Denmark, Norway, and Finland, the number of first generation migrants reaching an old age, who will be in need of age-related health-care, is rapidly increasing. This situation poses new demands on health-care facilities, such as memory clinics, where patients with memory problems and other dementia symptoms are referred for examination and evaluation. Very many elderly people with a foreign background require the assistance of an interpreter in their encounter with health-care facilities. The use of, and work by an interpreter is crucial in facilitating a smooth assessment. However, interpreters, clinicians, as well as patients and their companions, may be faced with many challenges during the evaluation procedure. The aim of this case-study is to highlight some of the challenges that occur in relation to a specific activity within the dementia evaluation, namely the test of cognitive functioning. Special attention will be paid to the phenomenon 'repair', i.e., participants' joint attempts to solve upcoming difficulties during the course of interaction. Results show that sources of trouble may be related to the lack of cultural, linguistic, and educational adaptation of the test to the patient, and to interpreter and clinician practises. Findings will be discussed in terms of test-validity, clinician and interpreter training, and the institutional goals and constraints of the dementia evaluation. The methodology Conversation Analysis has been used to conduct a highly detailed analysis of participants' practices and actions during the administration of the test.

Elderspeak refers to adapting one's 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 recipient's 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.

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