‘Alright my lovely’: the use of terms of endearment as a mitigation device in the care of people living with dementia in the acute hospital environment

Bridgstock, Lauren ORCID: https://orcid.org/0009-0004-0807-5477, Pilnick, Alison ORCID: https://orcid.org/0000-0003-0987-8760, Goldberg, Sarah and Harwood, Rowan H (2024) ‘Alright my lovely’: the use of terms of endearment as a mitigation device in the care of people living with dementia in the acute hospital environment. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine. ISSN 1363-4593

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Abstract

This paper examines how terms of endearment (ToE) are used as a mitigation device in interactions between staff and people living with dementia (PLWD) in the acute hospital environment. ToE are often discouraged in training for healthcare staff. However, this research demonstrates that they are still commonly used in practice. Using conversation analysis, video and audio data were examined to identify the interactional functions of ToE. Analysis showed that ToE play an important role in mitigating potentially face-threatening actions such as when patients are asked to repeat hard-to-interpret talk, or when patient agency is compromised through instruction sequences or having necessary healthcare tasks undertaken. The success of this mitigation is sensitive to the specific interactional circumstances, as well as the responsiveness of the HCP to the patient’s voiced concerns. These findings have implications for healthcare practice, training and wider care of PLWD.