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Communicative intentions and liminal signs in interaction with people living with late-stage dementia
Lars‐Christer Hydén, Anna Mia Ekström, Ali Reza Majlesi. Journal of Pragmatics, 2025-01-20
Topic: Risk, prevention and care in population studies
This study examines the challenges caregivers face in interpreting the bodily behaviors of individuals with late-stage dementia as interactional signals. People with late-stage dementia often exhibit ambiguous, non-verbal conduct, referred to as liminal signs, which are not immediately recognized as communicative. Drawing on Goffman's distinction between "giving" and "giving off" information and Grice's theory of communicative intentions, we analyze interaction sequences where caregivers may or may not notice and respond to these signs. The findings highlight the potential for embodied conduct, such as non-verbal vocalizations and ge2stures, to serve as communicative signals. Three empirical examples show how contextual cues can help caregivers recognize these conduct as meaningful contributions, positioning the person with dementia as a partner in interaction and providing an opportunity for their agency to be expressed and their voice to be heard. The study therefore has theoretical implications for understanding liminal signs and practical implications for improving communication in dementia care. (c) 2025 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Key findings
- Drawing on Goffman's distinction between "giving" and "giving off" information and Grice's theory of communicative intentions, we analyze interaction sequences where caregivers may or may not notice and respond to these signs.
- The findings highlight the potential for embodied conduct, such as non-verbal vocalizations and ge2stures, to serve as communicative signals.
- Three empirical examples show how contextual cues can help caregivers recognize these conduct as meaningful contributions, positioning the person with dementia as a partner in interaction and providing an opportunity for their agency to be expressed and their voice to be heard.
- The study therefore has theoretical implications for understanding liminal signs and practical implications for improving communication in dementia care.
- This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Why it matters
This study examines how caregivers interpret ambiguous non-verbal behaviors, called liminal signs, in people with late-stage dementia. It has practical implications for improving communication in dementia care, but it does not address treating, curing, or preventing the disease itself.
Study details
- Evidence strengthLow
How this study scored 37/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of Pragmatics) |
| Journal's citation record | 2 / 4 | Journal of Pragmatics: journal h-index 230 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 3 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 4 / 6 | Cited 11.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 3 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Ali Reza Majlesi: h-index 12 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Stockholm University: institution h-index 972 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Total | 37 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Hydén, L., Ekström, A. M., & Majlesi, A. R. (2025). Communicative intentions and liminal signs in interaction with people living with late-stage dementia. Journal of Pragmatics. https://doi.org/10.1016/j.pragma.2025.01.006
Vancouver
Hydén L, Ekström AM, Majlesi AR. Communicative intentions and liminal signs in interaction with people living with late-stage dementia. Journal of Pragmatics. 2025. doi:10.1016/j.pragma.2025.01.006.
BibTeX
@article{hyden2025-b1b48f6c,
author = {Hydén, Lars‐Christer and Ekström, Anna Mia and Majlesi, Ali Reza},
title = {{Communicative intentions and liminal signs in interaction with people living with late-stage dementia}},
journal = {Journal of Pragmatics},
year = {2025},
doi = {10.1016/j.pragma.2025.01.006},
url = {https://doi.org/10.1016/j.pragma.2025.01.006}
}
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