ABS330 - Dialogue of hopes and desires: Joint exploration of possible selves and activities in dementia care

2.6 Dialogue and the co-construction of knowledge
20 minutes
Bakhtin’s theory of dialogue indicates that the human mind has a root in sociocultural communication and is constructed by the relationship between self and others (Wertsch, 1991). Although the significance of dialogue has been discussed in care settings (Leiman, 1998; Rober, 2005), little attention has been given to the dialogue between persons with dementia and the therapists, especially focussing on their voices as active responses to others in creating a sense of self and the therapist’s role as a co-author of their voices. To examine this point, the following questions were addressed: 1) What kinds of voices are created in care sessions? 2) How do persons with dementia position themselves with respect to the voices? 3) What kinds of professional skills and knowledge are used by therapists? The data were collected from interviews with one experienced occupational therapist and through observations of his care sessions with two female persons with Alzheimer’s disease (AD) in a Japanese nursing home for 25 days. Their interactions were described and qualitatively analysed. The result indicated that the therapist introduced multilevel voices towards the persons with AD, such as voices of the self, of actual others, and of imagined others. The persons with AD actively and emotionally responded to the voices, jointly created possible and positive selves, and could learn therapeutic activities that they were not capable of before the sessions. The therapist intentionally used the voices as a tool for therapeutic engagement to generate the persons’ desire for the therapy, others, and themselves.
Waseda University

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