Couples living with dementia managing conflicting knowledge claims

Abstract

This conversation analytic study investigates how couples manage conflicting knowledge claims when one of the persons has dementia (PWD). The data are video-recordings of 16 couples talking with a third party. The analysis focuses on the negotiation of epistemic rights, more precisely how partners initiate repair and correct claims made by the PWD on matters belonging to the latter’s epistemic domain. We identified three main practices for correcting the PWD: (1) correcting the statement, thereby claiming epistemic authority for oneself and denying it to the PWD, (2) inviting the PWD to self-correct, thereby attributing some epistemic authority to the PWD, and (3) disagreeing and providing reasons for one’s alternative claim, establishing a more symmetric epistemic gradient. The PWDs responses to the corrections displayed different degrees of acceptance, ranging from self-denigration to resistance and insistence.

Framing dementia experiences in a positive light: Conversational practices in one couple living with dementia

“…In relationships, this type of epistemic trespassing may even display a couple's relationship as intimate rather than general (Bristol & Rossano, 2020;Landmark et al, 2021). Kari agrees with Mathias's questioning of her baking habits, and also adds a 'justifying account' for this (Svennevig & Landmark, 2019), 'because I find it boring' (line 44).…”

“…A conversational partner such as a spouse may increase the abilities of the person with dementia to participate socially and tell stories in a competent manner, through for instance narrative scaffolding and repair sequences (Hydén, 2018;Kindell et al, 2016;McCabe et al, 2018) but also through mitigated corrections (Landmark et al, 2021). Hydén (2018) argues that the telling of a story when having dementia may be more of a collaborative and interactive project than for people who do not have this condition.…”

“…Within families and couples, talking of how life is, and how it has changed and will change due to the dementia can therefore be described as a sensitive matter which requires careful attention and further knowledge (e.g. Landmark et al, 2021).…”

“…In talk of daily matters or knowledge regarding dementia, both spouses in a couple may have equal rights to the talking about something which only one of them actually has experienced (Landmark et al, 2021). Previous research drawing on audio-recordings has emphasised that the voices of persons with dementia are often neglected ( Österholm & Samuelsson, 2015).…”

Persuasion in practice: Managing diverging stances in needs assessment meetings with older couples living with dementia

“…As dementia affects both cognitive and linguistic abilities, the everyday life as well as future life of both partners in a relationship changes (Nilsson, 2022; Nilsson and Olaison, 2019). When living with dementia, partners may express diverging stances on factual matters (Landmark et al, 2021), but also on their shared and individual needs (Nilsson and Olaison, 2022). When partners express diverging stances on the provision of formal care and support, negotiations might be necessary in order to reach an agreement, and it may be challenging to prioritise the other person and find suitable solutions for both individuals and the couple (Tolhurst and Weicht, 2018).…”