Analysis of conversational features between individuals with dementia and their communication partners in natural conversation

Abstract

The study was conducted to identify the conversational features between the individuals with dementia (ID) and their communication partner (CP) during natural conversation (NC). Fifteen NC samples between IDs and CPs and 15 NC samples between age and gender matched healthy adults were audio recorded and transcribed verbatim. The data were analyzed based on two checklists of Discourse Impairing Conversational Features (DICF) and Discourse Building Conversational Features (DBCF). A self-administered questionnaire was used to identify perspectives of CPs on difficulties when communicating with IDs. Mixed method explanatory design, including descriptive and inferential statistics analysis using statistical package for the social sciences (SPSS version 22) software and qualitative thematic analysis was used. Absence of topic maintenance in IDs (n=6), inability to engage in extended discourse in IDs (n=6), and absence of repairing skills in IDs (n=6) were more frequently observed DICFs in IDs. The most frequently observed and helpful DBCF used by CPs was trying to figure out the meaning (n=12). A Mann-Whitney U test showed significant differences in the use of DICFs (Mann-Whitney U=30.500, Z=-3.449, p=0.001) and DBCFs (Mann-Whitney U=35.500, Z=-3.213, p=0.001) between the two groups. Perspectives of CPs on the communication difficulties faced with IDs were analyzed based on five primary themes; the knowledge of dementia, difficulties faced by CPs when communicating with IDs, strategies used by CPs to overcome communication difficulties, and successful communication strategies used by CPs and IDs. The findings provide an understanding of the communication difficulties faced by CPs due to the language and attention difficulties of IDs. Importantly it identifies the successful strategies used by IDs; asking for clarifications, short questions and attention and by CPs; recognition, validation, negotiation, facilitation, and asking short questions by providing useful information to the speech and language therapists to maintain their quality of life within resource limited clinical settings.