Dementia disrupts communication not only as a cognitive process but as a relational practice, leaving people living with dementia (PLwD) at risk of exclusion when language fragments. This study examines how communication closeness, the felt sense of being understood, emotionally attuned, and socially connected, might be supported through Research in and through Design (Ri&tD). Drawing on formative mixed-reality studies and a participatory co-design workshop with PLwD, caregivers, and stakeholders, we iteratively developed a series of playful artifacts culminating in Neighbourly, a tactile board game designed to support relational interaction through rule-based, multimodal play. Across this design genealogy, prototypes were treated as Living Counter-Maps: participatory mappings that made patterns of gesture, rhythm, shared attention, and material engagement visible and discussable. Through iterative interpretation and synthesis, the study identifies three guiding principles for designing for communication closeness: supporting co-regulation rather than correction, enabling multimodal reciprocity, and providing a shared material focus for joint agency. The paper consolidates these insights in the Living Counter-Maps Framework, which integrates counter-mapping and Ri&tD as a methodological approach for studying and designing relational communication in dementia care.
Desai et al. (Thu,) studied this question.