Supporting individuals with dementia in conversation: The implications of overlapping talk

Background: Individuals with dementia experience difficulty participating in conversation due to cognitive and language deficits. Difficulty ‘taking the perspective of the other' in conversation has implications for appropriate turn taking, potentially resulting in overlapping talk. Frequent communication partners (FCPs) are often responsible for maintaining the structure and flow of conversation, yet are often unaware of how best to support their conversation partners with dementia, and exhibit varying levels of success in doing so.

Aim: Patterns of overlapping talk during interactional and transactional conversation between individuals with dementia and their FCPs were investigated.

Method: Three participants with dementia participated in two dyadic conversations: one with a FCP and one with a Speech Pathologist. Each FCP also conversed with a FCP without dementia. Per dyad, 10 minutes each of ‘casual' and ‘task-oriented' conversation were audio- and video-recorded. The recordings were later transcribed and analysed for patterns of overlapping talk, using Conversation Analysis.

Results: Conversations involving individuals with dementia were characterised by multiple instances of competitive overlapping talk. However, FCPs created opportunities for their partners with dementia to participate in the conversations by back channelling, permitting pauses and yielding their own turns when interrupted.

Conclusion: These findings have important clinical implications for the training of evidence-based conversational support strategies. Foremost, these findings have implications for the everyday communication of individuals with dementia by equipping FCPs with the knowledge of how best to create opportunities for participation in both interactional and transactional conversation.