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

Elin Nilsson

doi:10.1177/14713012211059028

Abstract

The general approach to a life with dementia is negatively charged, and alternative views are rarely found in research or in media coverage. This case-study explores conversational practices for framing dementia in a more positive light, employed by a husband of a wife with dementia. Framing regards the structured experiences of dementia, drawing on Goffman’s ‘Frame Analysis’. Benefitting from conversation analysis, this article presents principal results of four conversational practices used by the spouse without dementia: mitigating trouble, normalising trouble, justifying trouble, and praising. The conclusions drawn are that the practices contribute to the challenging of the dominant negative framework of the dementia experience, as they facilitate talk which emphasises the wife with dementia’s positive progression and skills in managing the household chores. Despite a positive framing of dementia, this couple still embed their talk in the overall negative framework of loss and decreased cognitive competence. The visualisation of a positive framing could add to a broadened view of dementia, which in turn could contribute to greater well-being for those affected. However, the results may also imply a risk of one spouse’s conversational practices of normalising and mitigating trouble being dominant in interaction and thereby neglecting the other spouse’s experience of the situation.

Highlights

This study focuses on conversational practices employed by a husband of a wife with dementia for framing the dementia experience of everyday tasks in a positive light
The results indicate that the framing of dementia in a positive light is strengthened over time
The analysis has identified several conversational practices used by a husband without dementia to enable a ‘positive framing’ in talk of dementia-related experiences, as well as to include his wife with dementia in the talk

Summary

Introduction

This study focuses on conversational practices employed by a husband of a wife with dementia for framing the dementia experience of everyday tasks in a positive light. Receiving a chronic illness like a dementia diagnosis is often described as a dramatic turn of event in life leading to the experience of several present and potential future losses (Dupuis, 2002; Hellstrom & Taghizadeh Larsson, 2017; Moniz-Cook et al, 2006). As spouses diagnosed with dementia have an increase in symptoms, couples may experience a negative change in marital quality and equality as spouses (Molyneaux et al, 2011). How spouses within couples and families approach and talk about the dementia may have an impact on their experience of and management of everyday life over time (Roach et al, 2014) and may contribute to the general framing of the dementia experience

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Conclusion