Aims: Appreciative Inquiry is a change methodology, which is based on the
hypothesis that there is a positive core in every system. People living with dementia experience discourse, which malignantly positions them within society, potentially leading to negative consequences for them. This study aims to adapt the Appreciative Inquiry approach by using the positive experiences of people living with dementia to inform a mechanism of change to positively influence the discourse of family members/carers of people living with dementia, healthcare workers and lay people.
Methods: Appreciative Inquiry is adapted as the research methodology to support
democratic social research and action when considering positioning theory in the
discourse about people living with dementia. A four stage model was reconfigured, with a cohort of four people living with young onset dementia working through the first three phases (Discovery, Dream and Design). The outcome of these phases was presented to three natural discussion groups representing the three societal groups, whose discourse was analysed to consider whether the final phase of the model had been addressed (Delivery). Discourse data was analysed using positioning theory and thematic analysis.
Results: An original positioning theory framework was developed for the analysis of discrete discourse, with supporting models to describe the discursive route to what was perceived by people living with dementia as ‘ideal’ positioning. These original models/frameworks were supported by four conceptual findings. First, that people living with dementia are empowered to identify the requirements for positive verbal positioning using three phases of Appreciative Inquiry. Second, four positioning themes were identified to develop a framework to assess how people living with dementia experience verbal positioning by others. Third, that verbal positions are directly influenced by the outcomes of Appreciative Inquiry, resulting in a successful delivery. Fourth, there are five thematic positioning identities, which describe how the person’s experiences and view of themselves influence the positions they allocate. These identities act as facilitators and barriers to positive verbal positioning as defined by people living with dementia in an Appreciative Inquiry.
Conclusions: Appreciative Inquiry can be reconfigured to involve different
participants across phases, retaining its generative and transformative potential,
without foregoing its underpinning principles. People living with dementia can
successfully complete an Appreciative Inquiry exercise with outcomes that have the power to transform the discourse about people living with dementia by other
members of society. Positioning theory can be adapted to analyse discrete
discursive themes to understand how people living with dementia are positioned by others and what influences this positioning. Social action can be influenced by
people living with dementia using this adaptation of the Appreciative Inquiry
methodology.