Touch and talk in residential caregiving in Taiwan

Abstract

Interpersonal touch, or skin-to-skin contact, is a fundamental interactional resource in ordinary and institutional interactions. Previous research has examined interpersonal touch in diverse contexts such as family interactions (e.g., Cekaite, 2010; M. H. Goodwin & Cekaite, 2018), dance (e.g., Keevallik, 2021), sports (e.g., Meyer & Wedelstaedt, 2020), martial arts (e.g., Lefebvre, 2020, 2023; Råman & Haddington, 2018), medical and healthcare encounters (e.g., Guo et al., 2020; Nishizaka, 2007, 2010, 2011, 2017, 2020a, 2020b), and therapeutic settings (e.g., Merlino, 2021). In care settings, it is critical to monitor interpersonal touch to avoid abuse and misconduct (Cekaite & Mondada, 2021). Recent studies have begun to explore how participants use touch in care interactions, particularly in mundane care activities like drinking (Majlesi et al., 2020), eating (Ekström et al., 2022; Hydén et al., 2022; Majlesi et al., 2020; Wiggins et al., 2024), and moving from one place to another (Hippi, 2021; Majlesi et al., 2021, 2022; Marstrand & Svennevig, 2018). Yet most findings are based on single-case analyses or a limited number of participants. Moreover, little is known about care interactions involving multilingual participants, especially in East Asia. This dissertation addresses this gap by examining interpersonal touch in multilingual institutional care interactions in Taiwan. Using multimodal conversation analysis (C. Goodwin, 2000; Mondada, 2016, 2018a, 2019; Robinson et al., 2024; Streeck et al., 2011), it investigates how caregivers and elderly residents, whether sharing or not sharing a first language, use interpersonal touch and other interactional resources to accomplish everyday care activities. The data come from approximately 96 hours of video- and audio-recorded interactions collected at a private residential home in Taiwan. Participants include 86 Taiwanese residents and care staff (from Taiwan and Vietnam) in 2018, and 104 similar participants in 2019. The 2 analytical focus is on two interactional phenomena that involve the most recurrent use of touch: drinking and walking. Additionally, the study examines residents’ resistance during these activities and the corresponding responses by care staff. The findings reveal that care staff primarily coordinate touch with talk and organize their spatial orientation to prompt residents to drink proffered fluids or walk, support walking in progress, and lead or guide movement. While caregivers use both successive and simultaneous configurations of talk and touch in drinking, they predominantly employ successive configurations in walking. The engagement of talk suggests that care staff treat residents as partners in the interaction. In the absence of talk, the interaction often reflects habitual patterns between participants; however, the lack of talk in prompting residents to drink or walk may also indicate that care staff position residents as passive care recipients rather than active coparticipants. When residents refuse to drink or walk, care staff generally persist in seeking compliance rather than attending to the residents’ wishes. In general, international and Taiwanese caregivers employ similar multimodal practices. Contrary to previous studies and a recent national survey reporting language barriers between international caregivers and Taiwanese care recipients, this study did not observe such barriers. This study advances knowledge about interpersonal touch in coordination with other interactional resources in care interactions. It also contributes to the literature on touch and agency in intercorporeal interaction, specifically, how participants sense, interpret, and respond to one another through touch, and how residents execute agency in their responses to caregivers’ embodied directives (Hydén et al., 2022; Majlesi et al., 2022; Meyer et al., 2017). Lastly, it expands our understanding of care delivery in multilingual interaction.