1887
Dementia-compromised language conflict and aggression
  • ISSN 2213-1272
  • E-ISSN: 2213-1280
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Abstract

Differences in power are frequent in institutional care settings and provide contexts in which conflict can occur. In order to examine the power imbalance between residents and caregivers and the consequent potential for verbal conflict we first discuss the situations in which persons with dementia (PWD) find themselves within long-term residential care institutions and the interactions they commonly experience with those who care for them. We then examine strategies commonly used by conversational partners that either support or hinder the attempts by PWD to interact competently. The strategies may lead to cooperative conversations or verbal conflicts. They include caregiver marginalization as well as joking and teasing, both of which may serve to positively support PWD or can minimize conflict (Offord et al. 2006; Schnurr and Chan 201l) and can be initiated by both residents and caregivers. The final section contains case studies of interactions with two PWD, “Madge” and “Maureen”, to illustrate the minimization and the positive and negative use of joking and teasing in interactions with PWD. We conclude with a brief discussion with “Maureen” on joking and deliberate repression of conflict.

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2016-08-11
2019-09-20
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References

  1. Alberts, Jess , Yvonne Kellar-Guenther , and Steven Corman
    1996 “That’s not Funny: Understanding Recipients’ Responses to Teasing.” Western Journal of Communication60 (4): 337–357. doi: 10.1080/10570319609374553
    https://doi.org/10.1080/10570319609374553 [Google Scholar]
  2. Almor, Amit , Daniel Kempler , Maryellen MacDonald , Elaine Andersen , and Lorraine Tyler
    1999 “Why do Alzheimer Patients have Difficulty with Pronouns? Working Memory, Semantics, and Reference in Comprehension and Production in Alzheimer’s Disease.” Brain and Language67: 202–227. doi: 10.1006/brln.1999.2055
    https://doi.org/10.1006/brln.1999.2055 [Google Scholar]
  3. Backhaus, Peter
    2009 “Politeness in Institutional Elderly Care in Japan.” Journal of Politeness Research5: 53–71. doi: 10.1515/JPLR.2009.004
    https://doi.org/10.1515/JPLR.2009.004 [Google Scholar]
  4. Ball, Mary , Michael Lepore , Molly Perkins , Carole Hollingsworth , and Mark Sweatman
    2009 “‘They are the Reason I Come to Work’: The Meaning of Resident-Staff Relationships in Assisted Living.” Journal of Aging Studies23 (1): 37–47. doi: 10.1016/j.jaging.2007.09.006
    https://doi.org/10.1016/j.jaging.2007.09.006 [Google Scholar]
  5. Banerjee, Albert , Daly, Tamara , Armstrong, Pat , Szebehely, Marta , Armstrong, Hugh , Lafrance, Stirling
    2012 Structural violence in long-term, residential care for older people. Social Science & Medicine74: 390–398. doi: 10.1016/j.socscimed.2011.10.037
    https://doi.org/10.1016/j.socscimed.2011.10.037 [Google Scholar]
  6. Banerjee, Albert , Armstrong, Pat , Daly, Tamara , Armstrong, Hugh , Bradley, Susan
    2015 ”Careworkers don’t have a voice:” Epistemological violence in residential care for older people. Journal of Aging Studies33: 28–36. doi: 10.1016/j.jaging.2015.02.005
    https://doi.org/10.1016/j.jaging.2015.02.005 [Google Scholar]
  7. Beck Cornelia , Kathy Richards , Corinne Lambert , Rebecca Doan , Reid Landes , Ann Whall , Donna Algase , Ann Kolanowski , and Zachary Feldman
    2011 “Factors Associated with Problematic Vocalizations in Nursing Home Residents with dementia.” The Gerontologist51(3): 389–405. doi: 10.1093/geront/gnq129
    https://doi.org/10.1093/geront/gnq129 [Google Scholar]
  8. Berdes, Celia , and John Eckert
    2001 “Race Relations and Caregiving Relationships: A Qualitative Examination of Perspectives and Nurse’s Aides in Three Nursing Homes. Research on Aging23: 109–126. doi: 10.1177/0164027501231006
    https://doi.org/10.1177/0164027501231006 [Google Scholar]
  9. Boström, Anne-Marie , Janet Squires , Agnes Mitchell , Anne Sales , and Carole Estabrooks
    2012 “Workplace Aggression Experienced by Frontline Staff in Dementia Care.” Journal of Clinical Nursing21 (9-10): 1453–1465. doi: 10.1111/j.1365‑2702.2011.03924.x
    https://doi.org/10.1111/j.1365-2702.2011.03924.x [Google Scholar]
  10. Brown, Penelope , and Stephen Levinson
    1987Politeness: Some Universals in Language Usage. Cambridge: Cambridge University Press.
    [Google Scholar]
  11. Code, Chris
    2011 “Nonfluent Aphasia and the Evolution of Proto-Language.” Journal of Neurolinguistics24: 136–144. doi: 10.1016/j.jneuroling.2009.12.007
    https://doi.org/10.1016/j.jneuroling.2009.12.007 [Google Scholar]
  12. Clark, Herbert H
    1985 “Language Use and Language Users.” InHandbook of Social Psychology, 3rd ed., edited by Gardner Lindzey , and Elliott Aronson , 179–231. New York: Harper and Row.
    [Google Scholar]
  13. Culpeper, Jonathan
    2011Impoliteness: Using Language to Cause Offence. Cambridge: Cambridge University Press. doi: 10.1017/CBO9780511975752
    https://doi.org/10.1017/CBO9780511975752 [Google Scholar]
  14. 2012 “Epilogue: (Im)politeness: Three Issues.” Journal of Pragmatics44: 1128–1133. doi: 10.1016/j.pragma.2012.05.011
    https://doi.org/10.1016/j.pragma.2012.05.011 [Google Scholar]
  15. Daly, Tamara , Banerjee, Albert , Armstrong, Pat , Armstrong, Hugh , Szebehely, Marta
    2011 Lifting the “Violence Veil”: Examining working conditions in long-term care facilities using iterative mixed methods. Canadian Journal of Aging/La Revue canadienne du vieillissement30: 271–284. doi: 10.1017/S07149808110006X
    https://doi.org/10.1017/S07149808110006X [Google Scholar]
  16. Davis, Boyd
    (ed.) 2005Alzheimer Talk, Text and Context: Enhancing Communication. New York: Palgrave. doi: 10.1057/9780230502024
    https://doi.org/10.1057/9780230502024 [Google Scholar]
  17. Davis, Boyd , and Margaret Maclagan
    2013 “Talking with Maureen: Extenders, and Formulaic Language in Small Stories and Canonical Narratives.” InDialogue and Dementia: Cognitive and Communicative Resources for Engagement, edited by Robert Schrauf , and Nicole Mueller , 87–120. New York: Psychology Press.
    [Google Scholar]
  18. Davis, Boyd , Margaret Maclagan , and Dena Shenk
    2014 “Exploring Communicative Interactions between Visitors and Assisted-living Residents with Dementia.” InRoutledge Handbook of Language and Health Communication, edited by Heidi Hamilton and Sylvia Chou , 344–361. NY: Routledge.
    [Google Scholar]
  19. Davis, Boyd , and Charlene Pope
    2010 “Institutionalized Ghosting: Policy Contexts and Language Use in Erasing the Person with Alzheimer’s.” Language Policy9: 29–44. doi: 10.1007/s10993‑009‑9153‑8
    https://doi.org/10.1007/s10993-009-9153-8 [Google Scholar]
  20. Davis, Boyd , and Mary Smith
    2011 “Dementia Care Communication in Residential Facilities: Intersections of Training and Research.” InCommunication in Elderly Care, edited by Peter Backhaus , 20–39. London: Continuum.
    [Google Scholar]
  21. De Bot, Kees , and Sinfree Makoni
    2005Language and Aging in Multilingual Contexts. Bristol: Multilingual Matters.
    [Google Scholar]
  22. Dijkstra, Katinka , Michelle Bourgeois , Lou Burgio , and Rebecca Allen
    2002 “Effects of a Communication Intervention on the Discourse of Nursing Home Residents with Dementia and their Nursing Assistants.” Journal of Medical Speech-Language Pathology10 (2): 43–58.
    [Google Scholar]
  23. Drew, Paul , and John Heritage
    1992Talk at Work: Interaction in Institutional Settings. Cambridge: Cambridge University Press.
    [Google Scholar]
  24. Duchan, Judith , Madeline Maxwell , and Dana Kovarsky
    1999 “Introduction: Evaluating Competence in the Course of Everyday Interaction.” InConstructing (In)competence: Disabling Evaluations in Clinical and Social Interaction, edited by Dana Kovarsky , Judith Duchan , and Madeline Maxwell , 3–27. Mahwah, NJ: Lawrence Erlbaum.
    [Google Scholar]
  25. Frankel, Richard
    2002 “The (Socio)linguistic Turn in Physician-Patient Communication Research.” InLinguistics, Language, and the Professions, edited by James Alatis , Heidi Hamilton , and Ai-Hu Tan . Georgetown University Round Table 2000. Washington DC: Georgetown University Press.
    [Google Scholar]
  26. Galtung, Johan
    1969 “Violence, Peace, and Peace Research.” Journal of Peace Research, 6(3): 167–191. doi: 10.1177/002234336900600301
    https://doi.org/10.1177/002234336900600301 [Google Scholar]
  27. Gautier, Serge , Jeffrey Cummings , Clive Ballard , Henry Brodaty , George Grossberg , Philippe Robert , and Constantine Lyketsos
    2010 “Management of Behavioral Problems in Alzheimer’s Disease.” International Psychogeriatrics22 (3): 346–372. doi: 10.1017/S1041610209991505
    https://doi.org/10.1017/S1041610209991505 [Google Scholar]
  28. Goffman, Erving
    1955 “On Face-work: An Analysis of Ritual Elements of Social Interaction.” Psychiatry: Journal for the Study of Interpersonal Processes18(3): 213–231.
    [Google Scholar]
  29. Goodwin, Charles
    1996 Review, Talk at Work: Interaction in Institutional Settings. Language in Society25 (4): 616–620. doi: 10.1017/S0047404500020844
    https://doi.org/10.1017/S0047404500020844 [Google Scholar]
  30. Graham, Sage
    2009 “Hospitalk: Politeness and Hierarchical Structures in Interdisciplinary Discharge Rounds.” Journal of Politeness Research5 (1): 11–31. doi: 10.1515/JPLR.2009.002
    https://doi.org/10.1515/JPLR.2009.002 [Google Scholar]
  31. Grainger, Karen
    2004 “Communication and the Institutionalized Elderly.” InHandbook of Communication and Aging Research, 2nd ed., edited by Jon F. Nussbaum , and Justine Coupland , 479- 497. Mahwah and London: Laurence Erlbaum Associates.
    [Google Scholar]
  32. Grice, Herbert P
    1975 “Logic and Conversation.” InSyntax and Semantics 3: Speech Acts, edited by Paul Cole , and Jerry L. Morgan , 41–58. New York: Academic Press.
    [Google Scholar]
  33. Gubrium, Jaber
    1997Living and Dying at Murray Manor (Extended edition). Charlottesville: University of Virginia Press.
    [Google Scholar]
  34. Hall, Kira , and Mary Bucholtz
    2013 “Epilogue: Facing Identity.” Journal of Politeness Research9 (1): 123–132. doi: 10.1515/pr‑2013‑0006
    https://doi.org/10.1515/pr-2013-0006 [Google Scholar]
  35. Hamilton, Heidi
    2008 Narrative as snapshot. Narrative Inquiry18: 53–82. doi: 10.1075/ni.18.1.04ham
    https://doi.org/10.1075/ni.18.1.04ham [Google Scholar]
  36. Haugh, Michael
    2010 “Jocular Mockery, (Dis)affiliation, and Face. Journal of Pragmatics42: 2106–2119. doi: 10.1016/j.pragma.2009.12.018
    https://doi.org/10.1016/j.pragma.2009.12.018 [Google Scholar]
  37. 2013 “Im/politeness, Social Practice and the Participation Order.” Journal of Pragmatics58: 52–72. doi: 10.1016/j.pragma.2013.07.003
    https://doi.org/10.1016/j.pragma.2013.07.003 [Google Scholar]
  38. Hymes, Dell
    1966 “Two Types of Linguistic Relativity.” InSociolinguistics, edited by William Bright , 114–158. The Hague: Mouton.
    [Google Scholar]
  39. Isaksson, Ult , Ulla Graneheim , Sture Åstrom , and Stig Karlsson
    2011 “Resident Behaviour in Dementia Care: Characteristics of Residents and Management of Violent Situations.” Aging and Mental Health, 15 (5): 573–579. doi: 10.1080/13607863.2011.556600
    https://doi.org/10.1080/13607863.2011.556600 [Google Scholar]
  40. Jay, Timothy , and Kristin Janschewitz
    2008 “The Pragmatics of Swearing.” Journal of Politeness Research4: 267–288. doi: 10.1515/JPLR.2008.013
    https://doi.org/10.1515/JPLR.2008.013 [Google Scholar]
  41. Johnson, Carrie
    2009 “Bad Blood: Doctor-Nurse Behavior Problems Impact Patient Care.” Physician Executive Journal November/December, https://www.ache.org/policy/doctornursebehavior.pdf
    [Google Scholar]
  42. Kakavá, Christina
    2005 “Discourse and Conflict.” InThe Handbook of Discourse Analysis, edited by Deborah Schiffrin , Deborah Tannen , and Heidi E. Hamilton , 650–670. Oxford: Blackwell. doi: 10.1002/9780470753460.ch34
    https://doi.org/10.1002/9780470753460.ch34 [Google Scholar]
  43. Keltner, Dacher , Lisa Capps , Ann Kring , Randall Young , and Erin Heerey
    2001 “Just Teasing: A Conceptual Analysis and Empirical Review.” Psychological Bulletin127: 229–248. doi: 10.1037/0033‑2909.127.2.229
    https://doi.org/10.1037/0033-2909.127.2.229 [Google Scholar]
  44. Lachs, Mark , Tony Rosen , Jeanne A. Teresi , Joseph P. Eimicke , Mildred Ramirez , Stephanie Silver , and Karl Pillemer
    2012 “Verbal and Physical Aggression Directed at Nursing Home Staff by Residents.” Journal of General and Internal Medicine28 (5): 660–667. doi: 10.1007/s11606‑012‑2284‑1
    https://doi.org/10.1007/s11606-012-2284-1 [Google Scholar]
  45. Lane, Heather Patricia , Sue-Anne McLachlan , and Jennifer Philip
    2013 “The War against Dementia: Are We Battle Weary Yet?” Age and Ageing42 (3): 281–283. doi: 10.1093/ageing/aft011
    https://doi.org/10.1093/ageing/aft011 [Google Scholar]
  46. Laplante, Debi , and Nalini Ambady
    2003 “On How Things Are Said: Voice Tone, Voice Intensity, Verbal Content, and Perceptions of Politeness.” Journal of Language and Social Psychology22: 434–441. doi: 10.1177/0261927X03258084
    https://doi.org/10.1177/0261927X03258084 [Google Scholar]
  47. Leech, Geoffrey
    1983Principles of Pragmatics. London: Longman,
    [Google Scholar]
  48. Locher, Miriam , and Richard Watts
    2005 “Politeness Theory and Relational Work.” Journal of Politeness Research1: 9–33. doi: 10.1515/jplr.2005.1.1.9
    https://doi.org/10.1515/jplr.2005.1.1.9 [Google Scholar]
  49. Lyketsos, Constantine , Cynthia Steele , Elizabeth Galik , Adam Rosenblatt , Martin Steinberg , Andrew Warren , and Jennie-Marie Sheppard
    1999 “Physical Aggression in Dementia Patients and its Relationship to Depression.” American Journal of Psychiatry156: 66–71. doi: 10.1176/ajp.156.1.66
    https://doi.org/10.1176/ajp.156.1.66 [Google Scholar]
  50. Maclagan, Margaret , and Annabel Grant
    2011 “Care of People with Alzheimer’s Disease in New Zealand: Supporting the Telling of Life Stories.” InCommunication in Elderly Care, edited by Peter Backhaus , 62–89. London: Continuum.
    [Google Scholar]
  51. Marsden, Sharon , and Janet Holmes
    2014 “Talking to the Elderly in New Zealand Residential Care Settings.” Journal of Pragmatics64: 17–34. doi: 10.1016/j.pragma.2014.01.006
    https://doi.org/10.1016/j.pragma.2014.01.006 [Google Scholar]
  52. McLean, Athena
    2006The Person in Dementia: A Study of Nursing Home Care in the U.S. Toronto: Broadview Press.
    [Google Scholar]
  53. Mishler, Elliot
    1984The Discourse of Medicine: Dialectics of Medical Interviews. Norwood, NJ: Ablex Publishing Corporation.
    [Google Scholar]
  54. Mitchell, Gail , Sherry Dupuis , and Pia Kontos
    2013 “Dementia Discourse: From Imposed Suffering to Knowing Other-Wise.” Journal of Applied Hermeneutics, June 2013, Article 5, jah.journalhosting.ucalgary.ca/
    [Google Scholar]
  55. Norrick, Neal , and Alice Spitz
    2008 “Humor as a Resource for Mitigating Conflict in Interaction.” Journal of Pragmatics40: 1661–1686. doi: 10.1016/j.pragma.2007.12.001
    https://doi.org/10.1016/j.pragma.2007.12.001 [Google Scholar]
  56. Offord, Rosslyn , Gillian Hardy , Caroline Lamers , and Louise Bergin
    2006 “Teaching, Teasing, Flirting and Fighting.” Dementia5 (2): 167–195. doi: 10.1177/1471301206062248
    https://doi.org/10.1177/1471301206062248 [Google Scholar]
  57. Peel, Elizabeth
    2014 “‘The Living Death of Alzheimer’s’ Versus ‘Take a Walk to Keep Dementia at Bay’: Representations of Dementia in Print Media and Carer Discourse.” Sociology of Health and Illness36 (6): 885–901. doi: 10.1111/1467‑9566.12122
    https://doi.org/10.1111/1467-9566.12122 [Google Scholar]
  58. Persson, Tove , and David Wästerfors
    2009 “‘Such Trivial Matters:’ How Staff Account for Restrictions of Residents’ Influence in Nursing Homes.” Journal of Aging Studies23 (1): 1–11. doi: 10.1016/j.jaging.2007.09.005
    https://doi.org/10.1016/j.jaging.2007.09.005 [Google Scholar]
  59. Reeves, Scott , Kathleen Rice , Lesley Conn , Karen-Lee Miller , Chris Kenaszchuk , and Merrick Zwarenstein
    2009 “Interprofessional Interaction, Negotiation and Non-negotiation on General Internal Medicine Wards.” Journal of Interprofessional Care23 (6): 633–645. doi: 10.3109/13561820902886295
    https://doi.org/10.3109/13561820902886295 [Google Scholar]
  60. Rubin, Gerald , Rengarajan Balaji , and Robert Barcikowski
    2009 “Barriers to Nurse/nursing aide Communication: The Search for Collegiality in a Southeast Ohio Nursing Home.” Journal of Nursing Management17: 822–832. doi: 10.1111/j.1365‑2834.2008.00913.x
    https://doi.org/10.1111/j.1365-2834.2008.00913.x [Google Scholar]
  61. Ryvicker, Miriam
    2009 “Preservation of Self in the Nursing Home: Contradictory Practices within Two Models of Care.” Journal of Aging Studies23: 12–23. doi: 10.1016/j.jaging.2007.09.004
    https://doi.org/10.1016/j.jaging.2007.09.004 [Google Scholar]
  62. Sabat, Steven
    2008 “Positioning and Conflict Involving a Person with Dementia: A Case Study.” InGlobal Conflict Resolution through Positioning Theory, edited by Fathali Moghaddam , Rom Harré , and Naomi Lee , 81–93. New York: Springer. doi: 10.1007/978‑0‑387‑72112‑5_5
    https://doi.org/10.1007/978-0-387-72112-5_5 [Google Scholar]
  63. Schnurr, Stephanie , and Angela Chan
    2011 “When Laughter is not Enough. Responding to Teasing and Self-denigrating Humour at Work.”Journal of Pragmatics43: 20–35. doi: 10.1016/j.pragma.2010.09.001
    https://doi.org/10.1016/j.pragma.2010.09.001 [Google Scholar]
  64. Scollon, Ron , Suzanne Scollon , and Rodney Jones
    2012Intercultural Communication: A Discourse Approach. 3rd edn. NY: Wiley-Blackwell.
    [Google Scholar]
  65. Sidtis, Diana Van Lancker
    2006 “Where in the Brain is Non-literal Language?” Metaphor and Symbol21: 213–244. doi: 10.1207/s15327868ms2104_2
    https://doi.org/10.1207/s15327868ms2104_2 [Google Scholar]
  66. Sifianou, Maria
    2010 “Linguistic Politeness: Laying the Foundations.” InInterpersonal Pragmatics, edited by Miriam Locher and Sage Graham , 17–41. Berlin: de Gruyter.
    [Google Scholar]
  67. 2012 “Disagreements, Face and Politeness.” Journal of Pragmatics44: 1554–1564. doi: 10.1016/j.pragma.2012.03.009
    https://doi.org/10.1016/j.pragma.2012.03.009 [Google Scholar]
  68. Small, Jeff , and Julian Montoro-Rodriguez
    2006 “Conflict Resolution Styles: A Comparison of Assisted Living and Nursing Home Facilities.” Journal of Gerontological Nursing, 32 (1): 39–45. doi: 10.3928/0098‑9134‑20060101‑14
    https://doi.org/10.3928/0098-9134-20060101-14 [Google Scholar]
  69. Sprangers, Suzan , Dijkstra, Katinka , Romijin-Luijten, Anna
    2015 Communication skills training in a nursing home: Effects of a brief intervention on residents and nursing aides. Clinical Interventions in Aging, 10: 311–319.
    [Google Scholar]
  70. Stalnaker, Robert
    2002 “Common Ground.” Linguistics and Philosophy25: 701–721. doi: 10.1023/A:1020867916902
    https://doi.org/10.1023/A:1020867916902 [Google Scholar]
  71. Stone, Teresa , Margaret Macmillan , and Michael Hazleton
    2010 “Swearing: Its Prevalence in Healthcare Settings and Impact on Nursing Practice.” Journal of Psychiatric and Mental Health Nursing17: 528–534. doi: 10.1111/j.1365‑2850.2010.01554.x
    https://doi.org/10.1111/j.1365-2850.2010.01554.x [Google Scholar]
  72. Tannen, Deborah
    2013 “The Argument Culture: Agonism and the Common Good.” Daedalus, 142 (2): 177–184. doi: 10.1162/DAED_a_00211
    https://doi.org/10.1162/DAED_a_00211 [Google Scholar]
  73. Temple, Valerie , Steven Sabat , and Rolf Kroger
    1999 “Intact Use of Politeness in the Discourse of Alzheimer’s Sufferers.” Language and Communication19: 163–180. doi: 10.1016/S0271‑5309(98)00020‑2
    https://doi.org/10.1016/S0271-5309(98)00020-2 [Google Scholar]
  74. Williams, Kristine , Susan Kemper , and Mary Lee Hummert
    2009 “Improving Nursing Home Communication: An Intervention to Reduce Elderspeak.” The Gerontologist43 (2): 242–247. doi: 10.1093/geront/43.2.242
    https://doi.org/10.1093/geront/43.2.242 [Google Scholar]
  75. Zeilig, Hannah
    2014 “Dementia as a Cultural Metaphor.” The Gerontologist, 54 (2): 258–267. doi: 10.1093/geront/gns203
    https://doi.org/10.1093/geront/gns203 [Google Scholar]
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