‘Proto-conversation’ as a practice in late-stage dementia care

This study suggests that the concept of proto-conversation may be used to describe and understand communication with people with late-stage dementia who have lost their abilities to produce verbal language. In the study, a multimodal conversation analytic method is used to analyze sequences of interactions between professional caregivers in an elderly care home and people with late-stage dementia. The study shows how minimal actions (shift of gaze directions, vocalizations or bodily movements) not instantly recognizable as intentional, communicative conduct, may be recognized and treated as communicative contributions by engaging the person living with dementia in proto-conversations. In such interactional sequences, the caregivers do not only turn the contributions of persons with dementia into actions through their responses, but they also treat the persons as agentive actors and position them as partners in interaction.