Exploring the interactional dimension of social communication: A collective case study of older people with aphasia

Background: Increasingly, clinicians and researchers emphasise the need to investigate the social consequences of living with aphasia. While the importance of social affiliation and conversations has been acknowledged, there has been limited research that specifically addresses the impact of aphasia on this interactional dimension of communication. Aims: The aims of this study were to explore the insider perspective on the impact of aphasia on social communication and social relationships, and to explore components of the interactional function of everyday communication that are identified by older people with aphasia. Methods Procedures: This research utilised a collective case study design that included three older people with aphasia. Data from three sources were collected and analysed: a weekly diary that included information on the purpose of the person's daily communication; qualitative interviewing with a focus on the impact of aphasia on that person's social communication; and stimulated recall, in which the older person was interviewed following video replay of their everyday conversation with two regular communication partners. Outcomes Results: Findings from qualitative analysis of case-study data record factors that affect social affiliation and satisfaction in conversations for an older person with aphasia. The concept of connectedness was identified, together with the role of humour and story telling in furthering interactions. The role of phatic communion was revealed as relevant to establishing and maintaining social communication. Implications of this research are a renewed focus on the personal, relational, and environmental factors that influence the everyday communication of the older person. A diagrammatic framework for conceptualising the interactional dimension of social communication is proposed. Emergent themes hold relevance for programmes for older people with aphasia and their communication partners, including addressing, in therapy, the interactional nature of communication and including satisfaction ratings of social communication in outcome measures. Conclusions: Findings illuminate the interactional function of social communication and contextual issues for the person living with aphasia in older age.