Applying Systemic Functional Linguistics to

Conversations with Dementia: The Linguistic

Construction of Relationships between
Participants
Nicole Müller, D.Phil./ and Zaneta Mok, Ph.D.^

ABSTRACT

Social isolation in dementia is a growing concern as the

incidence and prevalence of dementing conditions is on the rise in
many societies. Positive social interactions, which foster the construction
and enactment of positive interpersonal relationships and therefore
positive discursive identities, make an important contribution to emo-
tional well-being. In this article, we investigate how two women diag-
nosed with dementia of the Alzheimer's type use language to relate to
each other and two visiting graduate students. We use Systemic Func-
tional Linguistics as an analytical framework, specifically investigating the
use of vocatives and naming, and conversational moves and exchanges.

KEYWORDS: Dementia, conversation, Systemic Functional

Linguistics, interpersonal relationships

Learning Outcomes: As a result of this activity, the reader will be able to (1) apply introductory familiarity with
basic notions of Systemic Functional Linguistics, sufficient to pursue further study in the field, and (2) explain the
role of language in the construction and enactment of interpersonal relations in dementia.

SYSTEMIC FUNCTIONAL language use: when "doing SFL," linguists first

LINGUISTICS
Systemic Functional Linguistics (SFL) is a
theory and toolkit of analytical procedures that
has become increasingly popular in the clinical
domain in the recent past. SFL is a theory of
and foremost analyze texts, that is, language
used by speakers in context. Halliday highlights
that SFL "presents language as a semogenic
(meaning-making) resource, one governed by
tendencies not rules, and whose categories (as is

'Department of Communicative Disorders, University of
Louisiana at Lafayette, Lafayette, Louisiana; ^La Trobe
University, Melbourne, Australia.
Address for correspondence and reprint requests:
Nicole Müller, D.Phil., Department of Communicative
Disorders, University of Louisiana at Lafayette, P.O.
Box 43170, Lafayette, LA 70504 (e-mail: nmueller@
louisiana.edu).
Discourse Across Disorders: Acquired Neurogenic Con-
ditions; Guest Editor, Elizabeth Armstrong, Ph.D.
Semin Speech Lang 2012;33:5-15. Copyright © 2012
by Thieme Medical Publishers, Inc., 333 Seventh Avenue,
New York, NY 10001, USA. Tel: +1(212) 584-4662.
DOL http://dx.doi.org/10.105S/s-0031-1301159.
ISSN 0734-0478.
'
SEMINARS IN SPEECH AND LANGUAGE/VOLUME 33, NUMBER 1 2012
typical of semiotic systems) are 'fuzzy' rather
than determinate. It is formulated in terms of
strengths, rather than of deficits or constraints:
what the speaker can do (and what the language
'can do')." SFL's orientation is social-interac-
tional and context-embedded. Linguistic re-
sources are conceptualized within the analytic
framework as networks of choices available to
language users at every level of language (pho-
nology, lexicogrammar, discourse-semantics).
These networks, or systems of choices, make
up one of the cornerstones of the SFL model.
Note, however, that linguistic choices are not
made consciously (although some levels of lin-
guistic choice are accessible to metalinguistic
awareness). The other denning concept of SFL
is function: the focus is on meaning-making,
that is, SFL is oriented toward language users
employing the resources at their disposal to
create meaning in context (as compared with a
context-free perspective aiming to uncover as-
pects of an underlying language capacity, or
underlying language deficits, for instance). Hal-
liday and Matthiessen'^ summarize the basic
functions, or metafancúons, of language as
follows: Language construes human experience;
in other words, humans use linguistic resources
to construct meaning from their experiences of
the world. This fijnction is referred to as the
ideational function (with two subcomponents,
experiential and logical), and relates to the Field
of information, or, what is talked about. Simul-
taneously, language use also enacts relationships
with others and the world around us; this
enacting ñinction is referred to as the inter-
personal function, relating to the Tenor of
human relationships. A third function is recog-
nized, the textual metafiinction (relating to the
Mode of discourse), which is considered as
enabling and facilitating the former two, inas-
much as they depend on the language user's
ability to create and structure text, to manage
information flow and continuity. The term
metafunction was adopted to "suggest that
function was an integral component within
the overall theory" of SFL, because "[ljanguage
is as it is because of the ñinctions in which it has
evolved in the human species"'^ Every instance
of language use simultaneously relates to Field,
Tenor, and Mode, in that it expresses informa-
tion and thereby construes human experience.
enacts a relationship to an addressee and the
world, and is tied into its linguistic context
(Mode). The categories Field (what is being
talked about). Tenor (relationship of the
speaker to the audience, and the message), and
Mode (the role of language in the discourse
situation) are often referred to as register vari-
ables? In the rest of this article, we shall focus
mainly on the interpersonal metafunction and
on how conversation participants with and
without dementia construct and enact interper-
sonal relationships.
A thorough introduction to SFL would be
far beyond the scope of this article. The current
standard reference work is HaUiday and Mat-
thiessen.^ Eggins wrote a briefer, and for the
beginner rather more user-friendly introduc-
tion. Eggins and Slade^ offer detailed guidance
on analyzing conversations using SFL tools;
Martin and White^. specifically deal with ap-
praisal systems. Togher and Ferguson edited a
special issue of Clinical Linguistics and Phonetics
on SFL, to which Armstrong contributed an
overview on an SFL perspective on language
disorder. A very thorough chapter-length in-
troduction to SFL in the speech-language
pathology context is provided by Ferguson
and Thompson.^ Armstrong and Mortensen
apply the analysis of conversational moves to
the everyday talk of persons with aphasia.
Data
In this article, we draw on a conversation be-
tween four participants (all names are pseudo-
nyms): Ms. Frances (F) was, at the time the
conversation was recorded, in her early 90s, an
African-American woman with a diagnosis of
dementia of the Alzheimer's type (DAT). She
also used a wheelchair for mobility. Ms. Beatrice.
(B) was in her late 70s, Caucasian, and also had a
diagnosis of DAT; she was able to walk inde-
pendently. Both women were somewhat hard of
hearing, but neither had a hearing aid. Ms.
Frances and Ms. Beatrice -were residents in a
nursing home in South Louisiana, and Ms.
Beatrice was in the habit of visiting Ms. Frances,
who could not leave her room unaided. Both Ms.
Frances and Ms. Beatrice were natives of South
Louisiana. Neither had had recent assessments
of dementia severity, and neither had ever
 APPLYING SYSTEMIC FUNCTIONAL LINGUISTICS TO DEMENTIA/MÜLLER, MOK
received any dementia-related intervention.
Participant observation revealed that in both
women, dementia had progressed to the point
where they did not retain factual information
about their visitors (names, places of origin,
marital status, for instance), despite repeatedly
eliciting this information during fortnightly
visits over the course of a year. Mary and Rose
were graduate students in speech-language
pathology at the time, and doing fieldwork
with the first author of this article. Mary had
grown up in South Louisiana; Rose had come
to Louisiana from China about a year previ-
ously. The setting for the conversation is Ms.
Frances' room in the nursing home; a few
minutes into the conversation, Ms. Beatrice
comes to visit. The conversation was tape-
recorded with the approval of the participants,
the nursing home management, and the Uni-
versity of Louisiana at Lafayette Institutional
Review Board.
Interpersonal Relationships
WHO'S DOING THE TALKING?
A simple first step, according to Eggins,'' in
teasing out dimensions of Tenor is to consider
who produces what proportion of the talk in
any given situation. Table 1 summarizes some
quantitative aspects of the conversation. Ms.
Frances contributes most of the talk, in terms
of numbers of words and turns produced,
followed by Ms. Beatrice, Mary, and Rose, in
descending order. In terms of mean length of
turn, the output produced by the two elderly
ladies and Mary is very comparable, whereas
Rose's turns are on average considerably
shorter. She also produces the largest propor-
Table 1 A Simple Quantification of the
Participants' Contributions
F B M R
Turns 169 108 107
Words 1124 958 568
Different words 269 284 199
M LU (words/turn) 6,6 8,87 5,3
1-word utterances 54 26 32
F, Ms, Frances; B, Ms, Beatrice; M, Mary; R, Rose, MLU,
mean length of utterance in words per turn.
tion of single-word utterances. The two resi-
dents on whose home ground the conversation
takes place are the most active talkers, whereas
Rose stays somewhat in the background, and
Mary appears, according to this first glance at
the conversation, to be better integrated into
the interaction. We shall refer to quantitative
aspects of speech function use later in this
article.
VOCATIVES AND NAMING EACH OTHER: "MS.,"
"SUGAR," "HONEY," "MY LITTLE MAMAN"
In this section, we take a brief look at how
participants express attitudes toward each
other. Speakers express varying degrees of fa-
miliarity, solidarity, and intimacy to each other,
and this is achieved largely through the use of
lexical choices.'' We shall look at how partic-
ipants address each other (vocatives), and how
in particular one participant, Ms. Beatrice,
expresses her attitude toward Ms. Frances by
using a specific label.
Mary and Rose invariably address Ms.
Frances and Ms. Beatrice by using the title
"Ms." plus first name. In the regional culture
(the southern United States, specifically. South
Louisiana), this is considered an appropriate
form used chiefly by younger participants to
address older ones: it signals more familiarity
than title plus last name ("Ms. Boudreaux," for
instance), but more respect than the first name
only would convey. The title "Ms." is appro-
priately used irrespective of the addressee's
marital status.
Ms. Frances uses two vocatives, "honey"
and "sugar," as, in examples la and lb (the
transcript conventions used are those of Sys-
tematic Analysis of Language Transcripts
[SALT],^° with some minor editing for read-
abihty).
(la)
833 F where you from honey?
834 R I/'m from overseas.
835 R China,
87 (lb)
229 617 F I/'m an old lady sugar.
85 618 ;:08
2,6 619 F {light chuckle} I am {quiet, slow] 57.
58
Ms. Frances uses both "honey" and "sugar"
as vocatives for all three participants in this
SEMINARS IN SPEECH AND LANGUAGE/VOLUME 33, NUMBER 1 2012
conversation, but most often when addressing
the two students. She doesn't use these terms
to secure the addressee's attention; rather, they
signal affiliation and friendliness. However,
the speaker also gently expresses a status
differential in that it would not, in the local
culture, be appropriate for the students to use
these terms, but for the older woman to
address the students in this way is perfectly
acceptable. It is safe to assume that Ms.
Frances is drawing on long-established habits
of language use; however, her use of these
terms of endearment also speaks to the inter-
actionally functional preservation of such hab-
its in dementia, in that they help to create and
sustain the interpersonal dynamic of the con-
versation.
Ms. Beatrice enters Ms. Frances' room,
stating, "I have come to see my little maman"
(line 86). In the formerly francophone culture of
South Louisiana, the French maman is used in.
English as a loanword to denote grandma rather
than mom. Following Mary's somewhat amused
question "Why do you call her that?" (line 91),
Ms. Beatrice proceeds to explain her reasons:
(2)
92 B (because she) she/'s so good to me [M, F
chuckle}.
93 B that/'s why I call her my little maman {M,
F chuckle).
95;:02
96 B I think her name is F.
97 M < m h m > .
98 R <yea>.
99 F < that/'s> right.
100 F you know my name [chuckles}.
101 B now I call her my little maman.
102 F that/'s right.
103 B she/'s the first one that come see about
me when I got in here.
104 B I was crying.
105 ;:02
106 B you know.
107 B I felt so alone.
108 R mhm.
109 B X she come:02 cover my feet.
110 B she say "do/n't cry."
111 B "do/n't cry, things gonna get better" {M,
R chuckle}.
112 B they did.
113 F {LV} it did get better huh?
Ms. Beatrice's use of "my little maman" is
somewhat incongruent with established usage,
but she makes it clear that she uses maman
metaphorically to capture the relationship she
perceives herself to have with Ms. Frances. By
using the verbal process call, she establishes that
she doesn't confuse Ms. Frances with her own
grandmother, but conveys a title on her; and
she further establishes that she knows Ms.
Frances' real name (note, though, that she
qualifies the certainty of her assertion by using
the mental process and projection "I think").
She presents her use of this term of endearment
as grounded in her experience of loneliness and
sadness when coming "here," that is, the nursing
home, and of being consoled by Ms. Frances,
who looked after her. The explanation given is
entirely cogent and presented cohesively. It is
also impossible that it is entirely based on actual
experience: Ms. Frances is unable to leave her
room independently, so would not have been
able to "come see about" Ms. Beatrice or to
"come cover my feet." Thus, Ms. Beatrice has
established in her mind an experiential reality
that is not entirely founded upon fact; rather,
the presented-as-remembered reality is made to
fit and to express the friendship and gratitude
Ms. Beatrice feels for Ms. Frances. In the
absence of conflicting evidence (no one contra-
dicts her, and we may infer that she doesn't
remember any differently), this alternate reality
is discursively confirmed and accepted by her
conversation partners.
THE GIVE-AND-TAKE OF CONVERSATION:
CONSTRUCTING AND ENACTING
RELATIONSHiPS
Many studies have shown that casual conversa-
tion is a powerful site for doing "social work,"
and perhaps the most important site for the
construction and enactment of relationships
with others (see, e.g., Eggins and Slade'* for a
much more in-depth discussion). The SFL
framework for the analysis of speech functions
in conversation"''^'^ rests on the basic assump-
tion that "dialogue is a process of exchange"^^
in which either information or goods and
services are exchanged and in which speakers
adopt "roles associated with exchange rela-
tions: either giving or demanding."'' This
leads to a distinction between four basic
 APPLYING SYSTEMIC FUNCTIONAL LINGUISTICS TO DEMENTIA/MÜLLER, MOK
attend
E
atie
I— open
initiate
initi,
sustain —
react
Figure 1 System network diagram of speech function moves. Based on and abridged from components
in; Eggins S, Slade D. Analysing Casual Conversation. London, UK; Equinox; 2005.
speech functions, or moves, with which speak-
ers can initiate an exchange in dialogue,
namely making statements and offers (giving
information or goods/services, respectively),
asking questions (demanding information),
or making commands (demanding goods/
services). An opening move by one speaker
will constrain the choices available to a next
speaker, such that adopting a giving role in an
opening move sets up the expectation that the
responding move be one of accepting; by the
same token, an opening demand implies that
the next speaker adopt a giving role. Moves
relate to clauses by way of expression, or
realization: Clauses are grammatical units,
characterized by, in SFL terms, specific
mood structures (that is, configurations of
subject and verb group). Moves are considered
as units of discourse, expressed through
clauses. Although any one move type can be
expressed by more than one clause type, Halli-
day and Matthiessen'^ suggest that there are
unmarked associations of mood (clause) types
and categories such that the unmarked, or
congruent, realizations of statements, ques-
tions, commands, and offers are, respectively.
—
I— monitor
elaborate
prolong -\— extend
enhance
elaborate
'— append extend
enhance
engage
support register
reply
— respond ~ develop
confront disengage
— reply
support • track
• response
'— rejoin
confront - r ^ challenge
' response
declarative, interrogative, imperative, and
modulated interrogative mood types.
In this section, we shall look at conversa-
tional moves used by the participants in our
conversation, following the framework used by
Eggins and Slade.'*'' Fig. 1 diagrams move
choices available to speakers in a conversation,
in the form of a systeni network (note that in
Eggins and Slade's framework, there is an
additional level of subcategorization, or deli-
cacy, at the right-hand end of the system net-
work, which we have omitted from our
discussion because of space limitations). A
system network diagram is a tool to map
paradigmatic ordering in language, that is, a
set of alternatives available to a language user,
together with a condition of choice, or entry
point.
We are not going to comment in detail on
all move types used by the participants,, but
rather focus on some salient patterns. We shall
define and illustrate the move types as we
proceed, using an extract from the conversation
as raw material (see example 3). The move
labels in the right column correspond to those
in Fig. 1 and Table 2 (see below).
10 SEMINARS IN SPEECH AND LANGUAGE/VOLUME 33, NUMBER 1 2012
(3)
628 M do you have any brothers or sisters?
629 F (uh):02 yes.
628 F they live in L(city).
629 ;:02
630 F they're not around here.
631 ;:03
632 F well they were in L(city).
633 F but theyiOl travel a lot.
634 F I do/n't know where they are now they>
635;:17
637 F but I have a sister Margot:03 and two brothers.
637 ;:07
638 F they'll X. • Unintelligible
639 ; : n
640 F {louder} y'all from where?
641 M l/'m from O(city).
642 F O(city)?
643 M mhm.
644 F that/'s not too very far from here.
645 M mhm.
646 F uhhuh I used to go to O(city) often.
647 F I had a friend that lived:02 in O(city).
• In move analysis, the first distinction
drawn is between opening and sustaining
moves. Attending opening moves prepare the
ground for the following talk, by securing
another interactant's attention (by way of a
greeting, or a vocative, for instance, "hey
Sam"). Initiating opening moves, on the other
hand, introduce material for negotiation, a
proposition or proposal. Our data do not con-
tain many attending moves (see Table 2),
which indicates that the participants did not
often find it necessary to call each other's
attention (back) to the conversation. In line
628, Mary uses a factual question directed at
Ms. Frances to initiate an exchange.
The basic function of sustaining moves is
to continue the negotiation of the material
initiated in an opening move. When a different
speaker makes a move, this is classified as a
reacting move. These come in two further
types, responses and rejoinders. Responses are
moves that contribute to the completion of the
negotiation currently under way, whereas re-
joinders delay the completion of the negotia-
tion. In line 629, F, after a hesitation marker
Open: Initiate: Question: Fact
React: Respond: Support: Reply
Continue: Prolong: Extend
Continue: Prolong: Elaborate
Continue: Prolong: Elaborate
Continue: Prolong: Extend
Continue: Prolong: Extend
Continue: Prolong: Extend
Open: Initiate: Question: Fact
React: Respond: Support: Reply
React: Rejoin: Support: Track
React: Rejoin: Support: Response
Continue: Append: Extend
React: Respond: Support: Reply
Qpen: Initiate: Statement
Continue: Prolong: Elaborate
and a two-second pause, uses a reacting move
that is further subcategorized as a response and
a supporting reply. Supporting moves confirm
expectations or content set up in initiating
moves (similar to what is labeled preferred
responses or second pair parts in adjacency pairs
in Conversation Analysis).'* Replying moves
negotiate a proposition introduced by a former
speaker and most often, as in this case, take the
form of elliptical clauses. Eggins and Slade's"*
framework for move analysis further subdivides
replies into accepting, complying, agreeing,
answering, acknowledging, and affirming re-
plies. We shall not discuss this level of analytic
delicacy here for reasons of economy of
space.
In theory, the negotiation initiated by
Mary's move in line 628 could have been
completed by Ms. Frances' minimal reply in
line 628. However, Ms. Frances chooses to use
a prolonging continuing move: the same
speaker keeps talking and chooses to prolong
the exchange by adding information to the
ongoing negotiation set up in the opening
move. Prolonging continuing moves are further
 APPLYING SYSTEMIC FUNCTIONAL LINGUISTICS TO DEMENTIA/MÜLLER, MOK 11

Table 2 Speech Function Moves

F B M R
Total moves 239 (NV 4) 175 142 (NV4) 109
Incomplete 5 1 0 0
(Unintelligible utterances) 9 3 0 0
Open 35 37 29 5
Attend 1 2 2 1
Command 7 0 1 0
Offer 0 2 0 0
Ouestion 20 14 18 4
Statement 7 19 8 0
Continue 66 73 33 13
Monitor 3 2 5 0
Prolong 55 61 21 11
Elaborate 21 9 9 7
Enhance 6 8 4 1
Extend 28 44 8 3
Append 8 10 7 2
Elaborate 2 1 4 1
Enhance 0 1 1 1
Extend 6 8 2 0
React: respond 92 37 51 65
S: register 37 7 8 19
S:engage 1 1 3 3
S: develop 17 10 10 1
Elaborate 7 2 6 0
Enhance 2 1 0 0
Extend 8 7 4 1
S: reply 31 16 22 29
C: reply 6 3 8 13
React: Rejoin 41 27 29 26
S: tracking 29 21 10 6
S: response 12 5 18 20
C:response 0 1 1 0
F, Ms. Frances; B, Ms. Beatrice; M, Mary: R, Rose; NV, nonverbal.

subcategorized into elaborations, extensions, which in turn is embedded in a specific context

and enhancements. The dividing lines be-
tween these two subcategories appear to
blur a little at times; however, they are
defined as follows: Elaborations clarify or
restate material that was introduced in a
previous move, or give an example. Exten-
sions introduce additional information, and
enhancements qualify previously introduced
material by giving circumstantial information
(time, place, cause, condition). By choosing to
continue and prolong the exchange, Ms. Fran-
ces reacts as much to the context of situation,
of culture, as to Mary's initiating move. In a
different situational context, say, a "fact-find-
ing" interview by a member of the nursing home
staff, a minimalist one-word answer might have
been entirely applropriate. However, in the con-
text of a visit and a friendly chat, Mary's
initiating question is likely to imply an invita-
tion to share further details once the negotiation
of the initial proposition has been accom-
pushed, and Ms. Frances complies. In fact,
she contributes a series of seven utterances
(reproduced as example 4):
12 SEMINARS IN SPEECH AND LANGUAGE/VOLUME 33, NUMBER 1 2012
(4)
628 F they live in L(city),
629 :;02
630 F they're not around here,
631 ;;03
632 F well they were in Kcity),
633 F but they;01 travel a lot,
634 F I do/n't know where they are now they>
635;;17
637 F but I have a sister Margot;03 and two brothers,
637 ;;07
638 F they'll X,
Ms. Frances' extensions and elaborations
continue the conversational topic established
by Mary's opening question. After each of Ms.
Frances' continuing moves, other speakers
have the opportunity to take over, inasmuch
as the end of a move is a possible turn transfer
point, and "speaker change could occur with-
out turn transfer being seen as an interrup-
tion."'* However, in this case, the reluctance of
the other speakers to take over results in a
prolonged series of moves on Ms. Frances'
part: Rather than letting the conversation
flounder, she continues. The number and
(5)
638 F they'll X,
639;;11
640 F (louder) y'all from where?
, 641 M I/'m from O(city),
642 F O(city)?
643 M mhm,
644 F that/'s not too very far from here,
645 M mhm,
646 F uhhuh I used to go to O(city) often,
647 F I had a friend that lived;02 in O(city),
length of pauses between her turns indicate
that she is encountering some difflculty in
doing so, as does the abandoned move in
line 634. However, even after a 17-second
silence, none of the other participants volun-
teers a contribution, and Ms. Frances makes
another continuing move, which is followed
by yet another long pause. During this ex-
tended series of continuations, the intensity of
Continue; Prolong; Extend
Continue; Prolong; Elaborate
Continue; Prolong; Elaborate
Continue; Prolong; Extend
Continue; Prolong; Extend
Continue; Prolong; Extend
Unintelligible
Ms. Frances' voice gradually deteriorates, to
the point where her utterance in line 638
becomes partially unintelligible (indicated by
an X in the transcript, following SALT con-
ventions). This gradual deterioration could be
interpreted as a sign of fatigue. However, Ms.
Frances' next move indicates rather that she
has run out of things to say about her siblings
and needs someone else to make a contribu-
tion: After yet another long pause, she takes
charge of the conversation, and changes its
direction by opening another exchange, using
a factual question (see example 5).
Unintelligible
Open; Initiate; Ouestion; Fact
React; Respond; Support; Reply
React; Rejoin; Support; Track
React; Rejoin; Support; Response
Continue,; Append; Extend
React; Respond; Support; Reply
Open; Initiate; Statement
Continue; Prolong; Extend
Ms. Frances' opening question in line 640
is produced in a noticeably louder and clearer
voice than her previous continuing moves. In
using an opening question, Ms. Frances firmly
transfers responsibility to her addressees, in this
case the students, who are now obliged (if they
want the conversation to go on) to react and
negotiate the material introduced by Ms. Fran-
ces. Her question in line 640 is an illustration of
 APPLYING SYSTEMIC FUNCTIONAL LINGUISTICS TO DEMENTIA/MÜLLER, MOK
a pattern that the first author observed in many
conversations with Ms. Frances. She has a
stock of repetitive questions she uses, most
often when there is a lull in the conversation
(indicated by long interutterance pauses), or
when she herself runs into trouble formulating
an utterance. In this particular conversation,
Ms. Frances initiates the negotiation of her
conversation partners' origin (in all instances
but one, one or the other of the students) 11
times in total. This also occurred in other
conversations, along with other "favorite" ques-
tions eliciting marital status, whether one had
children, one's work, whether one was visiting,
and liked it here.^^
Multiple negotiations of the same factual
content of course lend a degree of repetitiveness
to a conversation, and indeed repetitiveness is
often cited as one of the hallmarks of discourse
involving participants with DAT^'': increasing
difficulties in laying down new memories, in-
cluding memories for very recent events, make it
hard for tlie person with dementia to keep track
of the content of an unfolding conversation;
hence repetitive content. However, further in-
vestigation of Ms. Frances' use of these repet-
itive opening moves reveals considerable
conversational skill. The questions are not ran-
domly placed (they don't, for instance, interrupt
ongoing exchanges), but rather open new ex-
changes when an ongoing exchange "fizzles
out," and when the conversation partners signal
reluctance to take over (by silence). In addition,
her questions were always entirely contextually
and culturally appropriate: In the context of
situation (a visit by two friendly strangers) and
culture (including the norms regarding inter-
generational interactions, which give Ms. Fran-
ces the right to, among other things, ask
personal questions of those friendly strangers),
it is acceptable that Ms. Frances, the "host" of
the interaction, asks questions about one's place
of origin, marital status, children, work, and so
forth.
In line 641, Mary's reacting move supplies
the answer (a supporting reply) to Ms. Frances'
question. Ms. Frances in turn reacts with a
tracking move. Tracking moves are a subcate-
gory of supporting rejoinders. Rejoining moves
are, as mentioned previously, defined as pro-
tracting an exchange, rather than moving it
13
toward completion. Tracking moves do not
indicate confrontation or disagreement (a chal-
lenge on the part of the speaker of the material
presented for negotiation by another speaker),
but rather seek to avoid potential misunder-
standing by, for instance, eliciting a clarifica-
tion or repetition of the previous speaker's
contribution. Tracking moves account for the
largest proportion of the rejoining moves in
this conversation, and also the larger part of the
one-word utterances (Eggins and Slade'' flir-
ther subcategorize tracking moves into check-
ing, confirming, clarifying, and probing
moves). Mary responds to Ms. Frances' track-
ing move in line 643, which resolves any linger-
ing doubt as to the information given in her
response in 641, and which in turn leaves Ms.
Frances the option to continue her earlier move
(642) in line 644, extending the information
thus far negotiated about Mary's hometown.
She often uses this utterance, or a close variant
(suitably adapting "not very far" to "far away,"
depending on the location negotiated), in ex-
changes she initiates by "Where y'all from?" or
"Where is your home?"; she does this six times
in this particular conversation.
Mary's reaction to Ms. Frances' assertion is
a noncommittal supporting reply, which closes
the present exchange. Ms. Frances makes an-
other opening move, offering the statement
that she used to visit Mary's hometown, and
thus in terms of the Field negotiated presenting
related information. As none of her interloc-
utors offers any comment, she follows up with a
continuing move, which prolongs the ex-
change, extending the information by provid-
ing an implicit reason for her having visited
O(city), that is, having had a friend there.
An analysis of conversational moves can be
used in a move-by-move reconstruction of how
participants in a conversation offer information
for negotiation and how through the process of
negotiation they construct and enact relation-
ships with each other as the conversation pro-
gresses, by, for instance, either supporting or
challenging each other's contributions, and by
taking charge or letting others determine the
openings of exchanges. For example, example 3
shows how Ms. Frances successfully rescues
the conversation from fioundering by changing
its direction and asking a question; she thus
14 SEMINARS IN SPEECH AND LANGUAGE/VOLUME 33, NUMBER 1 2012
projects herself as being in control of the
situation. Also, her extended turn, consisting
of prolonging moves (one of them abandoned)
separated by long pauses, shows that her inter-
locutors are reluctant to take over and control
the content and direction of the interaction. In
addition, a move analysis can be used to quan-
tify patterns in a conversation, as in Table 2.
Ms. Frances overall contributes the larg-
est number of moves, but Ms. Frances and
Ms. Beatrice make approximately the same
number of opening moves, and also the ma-
jority of the opening moves in the conversa-
tion. This indicates that the two older woman
are not reluctant to offer material for nego-
tiation, either by way of factual questions (Ms.
Frances' preferred technique) or statements
(slightly preferred by Ms. Beatrice). Rose
stands out as the reluctant participant, less
than 5% of her contributions are opening
moves. Continuing moves (most often pro-
longing moves) are also frequently used by the
two older women and far outnumber their
opening moves. This may indicate that once
a speaker is making a contribution, others in
this conversation are reluctant to take a turn
away from the present speaker (see example 3
again). However, it likely also speaks to a
conversational situation where the two older
women are not reluctant to expand on infor-
mation they themselves have offered for ne-
gotiation: By continuing, a speaker expands
an exchange on,her or his own terms, thus
having a more controlling stake in the con-
versation. This also indicates that the two
women with DAT don't feel intimidated by
their visitors, but feel encouraged to talk and
interact and to take (and keep) charge of the
conversation.
Reacting moves are more often responses
rather than rejoinders in this conversation; this
pattern is strongest with Ms. Frances and Rose.
This indicates that the interlocutors by and
large successfiiUy collaborate in bringing the
negotiation of material presented in an opening
move to a timely close. The circumstance that
most responding moves are supporting rather
than confronting moves also speaks to a con-
versational atmosphere that is mutually sup-
portive, rather than confrontational. By far the
largest proportion of rejoining moves used by
the two older women are tracking moves, that
is, moves that delay the completion of an
exchange not by challenging a previous move,
but rather attempt to (re)establish mutual
understanding. Given that both older women
are somewhat hard of hearing, it is not surpris-
ing to encounter many tracking moves.
DISCUSSION AND OUTLOOK
Social isolation is a pressing concern in demen-
tia care. The opportunity to create and maintain
positive social relations becomes increasingly
difficult as the cognitive-communicative de-
clines associated with DAT progress. This is a
challenge particularly in residential care: Typi-
cally, persons with dementia don't move out of
their famUiar home environment and into a
new, residential care environment until DAT
has progressed to the extent that they can no
longer live independently. Given that it be-
comes increasingly harder to lay down new
memories and therefore gradually accumulate
common ground with others (whether resi-
dents, care staff, or visitors) that can serve as a
basis for positive long-term relationships, two
aspects become increasingly important: the dis-
cursive construction of interpersonal relation-
ships in the moment of interaction, and
therefore the opportunity to engage in positive
and productive social interaction.
Using extracts from one conversation as an
example, we have illustrated the use of several
tools out of the SFL arsenal that can be used to
investigate how people relate to each other in
conversation. The proportions of talk produced
by the two older woman with dementia, as
compared with the two students, show that
they perceived this as a situation conducive to
talk. We briefly explored the use of address
terms and saw that Ms. Frances' use of terms of
endearment enacts a friendly relationship be-
tween the older and the two younger women, a
relationship that is not entirely symmetrical in
terms of power and/or status, in that it would
not be appropriate, by local cultural norms, for
a younger person to reciprocally use the same
terms of endearment. In turn, the consistent
use of "Ms." plus first name on the part of
the students enacts the corresponding part of
that same relationship, as that of a younger
 APPLYING SYSTEMIC FUNCTIONAL LINGUISTICS TO DEMENTIA/MÜLLER. MOK
participant who owes and expresses respect to
the older one.
Ms. Beatrice's metaphor "my little maman"
(explicitly introduced by her as a metaphorical
expression) neatly captures a complex relation-
ship she feels she has with her friend. In
addition, we saw that she has constructed in
her mind a narrative representation of a remem-
bered reality to sustain and explain both the
metaphor and the relationship. Seen purely
from a dementia-as-deficit perspective, such
confabulations can be dismissed as indications
that a person loses her grip on reality. However,
viewed from an interpersonal perspective, we
find that both the metaphor and the narrative
sustaining it speak to positive interpersonal
meanings, and thus can become an important
indicator of a person's emotional and social
well-being.
A consideration of the conversational
moves used by the participants showed Ms.
Frances and Ms. Beatrice largely in control of
the flow of conversation: they contributed the
overall largest proportion of opening and con-
tinuing moves, thus negotiation of content
happened largely on their terms. In addition,
reacting moves were far more often responses,
rather than rejoinders, which means that par-
ticipants on the whole interacted coUaboratively
to smoothly advance the negotiation of propo-
sitions offered in opening moves. The circum-
stance that there were far fewer confronting
than supporting moves also contributes to the
creation of a supportive and positive interaction.
In research on the communicative skills
and deficits of persons with DAT, it is com-
monly accepted that structural, syntagmatic
aspects of language (phonology and syntax)
tend to be well preserved until comparatively
late in disease progression.^'' However, an
analysis of interpersonal aspects of language
use also reveals skillful use of the relevant
paradigms. Given that language use patterns
that construct and enact relationships, status,
and identities in conversation are the result of
lifelong processes of socialization, it is safe to
assume that the relevant memories are quite
deeply embedded and habitual. This in turn
means that enabling social interactions, such as
casual conversations "staged" (if need be) in
facultative contexts, is likely to give rise to
15
interactions that permit persons with dementia
to enact, and mutually support, positive social
relationships, which in turn will be an impor-
tant factor in counteracting social isolation.
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