Navigating Bilingual Conversations in Dementia: Exploring the Intersection of Code- Choice, Co-construction, and Repetition Across Two Languages

It is well established that meaningful social interaction is vital for individuals living with dementia to maintain selfhood, identity, and well-being (e.g. Hamilton 2019, Wray 2020). While studies on monolingual discourse in dementia have grown significantly, with a focus on person-centered perspectives, the intersection of bilingualism in homebound care has been largely overlooked (but see e.g. Svennevig and Hamilton, 2021; Schneider 2022). Despite some attention given to bilingual institutionalized care (Karl 2021), insights into bilingual homebound care practices are limited. Understanding the linguistic dynamics of homebound care is essential for grasping the changing communicational needs of bilingual individuals with dementia and discerning potential differences from monolingual speakers.

Thus, this qualitative multi-case study delves into the intricate linguistic patterns and communicative dynamics exhibited in conversations involving individuals living with dementia of the Alzheimer’s type (DAT). Drawing on a dataset comprising interviews with ten Spanish-English bilingual participants at different stages of DAT and their primary care partner, the study sheds light on the nuanced code-choices within this context. Applying the ethno-social approach, which integrates elements of conversation analysis and ethnography of communication, the study investigates the link between code-choice and turn-taking patterns as well as speaker direction in their individual narrative interviews. The results show that while some care partners actively co-construct narratives, others direct their speech predominantly towards the person with DAT. Conversational strategies employed by individuals with DAT to seek support showcase varied approaches across different speakers. Furthermore, the analysis indicates that bilingual competencies persist even in individuals with severe DAT symptoms, evident in retained bilingual formulaic sequences such as salutations.

This study contributes insights into the linguistic behaviors of individuals living with DAT drawing on their English-Spanish repertoire, providing a foundation for future research on bilingual conversational data within the context of dementia.

References

Hamilton, H.E. (2019). Language, dementia and meaning making. Cham: Palgrave Macmillan.

Karl, K. B. (2021). Mehrsprachige Pflegebedürftige in deutschen Pflegeheimen und das Projekt UnVergessen: Studierende an der Schnittstelle von Forschung und Gesellschaft. Springer Nature.

Schneider, C. (2022). ‘Te hablo en ingles?‘ Code choice negotiation in caregiving with bilinguals who are living with Alzheimer’s. In Boyd H. Davis & Margret Maclagan (Eds.), Dementia Caregiving East and West: Issues of Communication (pp. 54-69). Newcastle Upon Tyne: Cambridge Scholars Publishing. The Dynamics of Dementia Communication. New York: Oxford University Press.

Svennevig, J., & Hamilton, H. E. (2021). Fostering Storytelling by Persons with Dementia in Multiparty Conversation. Multilingualism across the Lifespan, 169-189.

Wray, A. (2020). The Dynamics of Dementia Communication. New York: Oxford University Press