‘The monster in the back seat’

The metaphorical representation of dementia in Flemish blogs


  • Silke Creten KU Leuven
  • Priscilla Heynderickx KU Leuven
  • Sylvain Dieltjens KU Leuven




Dementia, stigmatisation, discourse analysis, blogs, conceptual metaphor, discourse representation


People living with dementia (PWDs) often experience stigma that is reinforced by negative representations of the condition in discourse. This paper addresses the lack of research into this stigma by analyzing the representation of the condition in naturally occurring texts of people in direct contact with PWDs. Two blogs from Flemish family caregivers and one blog from a Flemish health professional were selected based on word count and keyword relevance, and studied both quantitatively and qualitatively. For the quantitative analysis keywords, n-grams, and collocations were identified in 225 blog posts, using Sketch Engine. For the qualitative analysis, 26 blog posts were analyzed by categorizing conceptual metaphors according to their conceptual mappings. The quantitative analysis indicates that the health professional employs a different approach in reporting, compared to the family caregivers. The qualitative analysis results in five conceptual mappings: PWDs as living dead, PWDs as trees, dementia as concealment, dementia as an
acting entity and dementia as an attack. The frequency of these mappings shows that the condition is being dissociated from the PWDs, and described with more negative metaphors than the PWDs themselves.

Author Biographies

  • Silke Creten, KU Leuven

    Silke Creten is working on a PhD in linguistics at KU Leuven (Belgium). In her research project, she looks into communication about dementia and communication with people living with dementia in Flanders, with an emphasis on the stigma surrounding the condition. Her research interests include discourse analysis, computational linguistics and sociolinguistics. 

  • Priscilla Heynderickx, KU Leuven

    Priscilla C. Heynderickx (PhD) is currently an Associate Professor at KU Leuven (Belgium). She teaches Dutch and business communication. Her research interests include medical discourse, death discourse and business communication. She has published and presented several papers on these subjects. She is editor-in-chief of Ad Rem, a Belgian journal of business communication.

  • Sylvain Dieltjens, KU Leuven

    Sylvain M. Dieltjens (PhD) is currently a Professor Emeritus at KU Leuven (Belgium). His research interests include medical discourse, death discourse and business communication. He has published and presented several papers on these subjects. He is also chairman of the board of the IBIS communications (Kortenberg, Belgium).


Alzheimer’s Disease International (2019) World Alzheimer Report 2019: Attitudes to Dementia. London: Alzheimer’s Disease International.

Amjad, Halima, David L. Roth, Orla C. Sheehan, Constantine G. Lyketsos, Jennifer L. Wolff and Quincy M. Samus (2018) Underdiagnosis of dementia: An observational study of patterns in diagnosis and awareness in US older adults. Journal of General Internal Medicine 33 (7): 1131–1138. https://doi.org/10.1007/s11606-018-4377-y

Anderson, Joel G., Alexis Eppes and Siobhan T. O’Dwyer (2019) ‘Like death is near’: Expressions of suicidal and homicidal ideation in the blog posts of family caregivers of people with dementia. Behavioral Sciences 9 (3): Article 22. https://doi.org/10.3390/bs9030022

Behuniak, Susan M. (2011) The living dead? The construction of people with Alzheimer’s disease as zombies. Ageing & Society 31 (1): 70–92. https://doi.org/10.1017/S0144686X10000693

Blackburn, Maxine and Afroditi Stathi (2019) Moral discourse in general practitioners’ accounts of obesity communication. Social Science & Medicine 230: 166–173. https://doi.org/10.1016/j.socscimed.2019.03.032

Bosangit, Carmela, Scott McCabe and Sally Hibbert (2016) Discourse analysis of blogs: Analyzing language to maximize the value of

consumption-oriented blogs as data source. In Yogesh K. Dwivedi, Gerald Kelly, Marijn Janssen, Nripendra P. Rana, Emma L. Slade and Marc Clement (eds) Social Media: The Good, the Bad, and the Ugly, 522–532. London: Springer. https://doi.org/10.1007/978-3-319-45234-0_46

Brooks, Hellen, Kelly Rushton, Karina Lovell, Rebecca McNaughton and Anne Rogers (2019) ‘He’s my mate you see’: A critical discourse analysis of the therapeutic role of companion animals in the social networks of people with a diagnosis of severe mental illness. Medical Humanities 45 (3): 326–334. https://doi.org/10.1136/medhum-2018-011633

Caldwell, Elizabeth F., Sarah Falcus and Katsura Sako (2020) Depicting dementia: Representations of cognitive health and illness in ten picturebooks for children. Children’s Literature in Education 52: 106–131. https://doi.org/10.1007/s10583-020-09405-w

Castaño, Emilia (2020) Discourse analysis as a tool for uncovering the lived experience of dementia: Metaphor framing and well-being in early-onset dementia narratives. Discourse & Communication 14 (2): 115–132. https://doi.org/10.1177/1750481319890385

Cerejeira, Joaquim, Luisa Lagarto and Elizabeta B. Mukaetova-Ladinska (2012) Behavioral and psychological symptoms of dementia. Frontiers in Neurology 3 (73). Online. https://doi.org/10.3389/fneur.2012.00073

Crespo Fernández, Eliecer (2006) The language of death: Euphemism and conceptual metaphorization in Victorian obituaries. SKY Journal of Linguistics 19: 101–130.

Demjen, Zsófia and Elena Semino (2017) Using metaphor in healthcare: Physical health. In Elena Semino and Zsófia Demjen (eds) The Routledge Handbook of Metaphor and Language, 385–399. London: Routledge.

Devos, Paul, Pieter Thomas, Francesco Aletta, Tara Vander Mynsbrugge, Patricia De Vriendt, Dominique van de Velde and Dick Botteldooren (2019) Towards understanding healthy and supportive acoustic environments: The case of a nursing home. Proceedings of the 23rd International Congress on Acoustics: Integrating 4th EAA Euroregio 2019, 4164–4169. Aachen, Germany: Deutsche Gesellschaft für Akustik.

Dieltjens, Sylvain M., Priscilla C. Heynderickx, Marianne K. Dees and Kris C. Vissers (2014) Linguistic analysis of face-to-face interviews with PWD with an explicit request for euthanasia, their closest relatives, and their attending physicians: The use of modal verbs in Dutch. Pain Practice 14 (4): 324–331. https://doi.org/10.1111/papr.12076

Evans, Simon C. (2018) Ageism and dementia. In Liat Ayalon and Clemens Tesch-Römer (eds), Contemporary Perspectives on Ageism,

–276. New York: Springer. https://doi.org/10.1007/978-3-319-73820-8_16

Expertisecentrum Dementie Vlaanderen (2019) Vergeet dementie. Onthou mens. Online: http://onthoumens.be.

Golden, Mindi A., Bryan B. Whaley and Anne M. Stone (2012) ‘The system is beginning to shut down’: Utilizing caregivers’ metaphors for dementia, persons with dementia, and caregiving. Applied Nursing Research 25 (3): 146–151. https://doi.org/10.1016/j.apnr.2011.02.001

Guo, Song (2013) Metaphor studies from the perspective of critical discourse analysis: A case study of business acquisition. Theory and Practice in Language Studies 3 (3): 475–481. https://doi.org/10.4304/tpls.3.3.475-481

Hansen, Hege, Signe H. Stige, Christian Moltu, Jan O. Johannessen, Inge Joa, Sveinung Dybvig and Marius Veseth (2019) ‘We all have a responsibility’: A narrative discourse analysis of an information campaign targeting help-seeking in first episode psychosis. International Journal of Mental Health Systems 13 (1): Article 32. https://doi.org/10.1186/s13033-019-0289-4

Herring, Susan C., Lois A. Scheidt, Sabrina Bonus and Elijah Wright (2005) Weblogs as a bridging genre. Information, Technology & People 18 (2): 142–171. https://doi.org/10.1108/09593840510601513

Heynderickx, Priscilla C., Silke Creten and Sylvain M. Dieltjens (2022) Rumor has it: ‘Dementia’. A discourse-analytical analysis of obituaries of people with dementia. OMEGA – Journal of Death and Dying. Online first. https://doi.org/10.1177/00302228211060594

Heynderickx, Priscilla C. and Sylvain M. Dieltjens (2021) If cemeteries could talk … A discourse-analytical analysis of epitaphs. OMEGA – Journal of Death and Dying 83 (4): 944–957. https://doi.org/10.1177/0030222819873768

Jones, Michael and Irit Alony (2008) Blogs – The new source of data analysis. Issues in Informing Science and Information Technology 5: 433–446. https://doi.org/10.28945/1019

Kannaley, Kristie, Shreya Mehta, Brooks Yelton and Daniela B. Friedman (2019) Thematic analysis of blog narratives written by people with Alzheimer’s disease and other dementias and care partners. Dementia 18 (7–8): 3071–3090. https://doi.org/10.1177/1471301218768162

Kilgarriff, Adam, Vít Baisa, Jan Bušta, Miloš Jakubícek, Vojtech Kovár, Jan Michelfeit, Pavel Rychlý and Vít Suchomel (2014) The Sketch Engine: ten years on. Lexicography 1 (1): 7–36. https://doi.org/10.1007/s40607-014-0009-9

Kilgarriff, Adam, Siva Reddy, Jan Pomikálek and Avinesh P.V.S. (2010) A corpus factory for many languages. In Nicoletta Calzolari, Khalid Choukri, Bente Maegaard, Joseph Mariani, Jan Odijk, Stelios Piperidis, Mike Rosner and Daniel Tapias (eds) Proceedings of the Seventh International Conference on Language Resources and Evaluation (LREC’10), 904–910. Valletta, Malta: European Language Resources Association, 2010.

Koteyko, Nelya and Daniel Hunt (2018) Introduction: Discourse analysis perspectives on online health communication. Discourse, Context & Media 25: 1–4. https://doi.org/10.1016/j.dcm.2018.08.002

Lakoff, George and Mark Johnson (1980) Metaphors We Live By. Chicago: University of Chicago Press.

Lawless, Michael, Martha Augoustinos and Amanda LeCouteur (2018) Dementia on Facebook: Requesting information and advice about

dementia risk-prevention on social media. Discourse, Context & Media 25: 44–51. https://doi.org/10.1016/j.dcm.2018.01.011

Lexical Computing (2021) Sketch Engine [software]. Brno: Lexical Computing. Online: https://www.sketchengine.eu/

Lupton, Deborah (1992) Discourse analysis: A new methodology for understanding the ideologies of health and illness. Australian Journal of Public Health 16 (2): 145–150. https://doi.org/10.1111/j.1753-6405.1992.tb00043.x

Orr, Elizabeth, Susan M. Jack, Wendy Sword, Sandra Ireland and Lois Ostolosky (2017) Understanding the blogging practices of women undergoing in vitro fertilization (IVF): A discourse analysis of women’s IVF blogs. The Qualitative Report 22 (8): 2206–2230. https://doi.org/10.46743/2160-3715/2017.2927

Oscar, Nels, Pamela A. Fox, Rachael Croucher, Riana Wernick, Jessica Keune and Karen Hooker (2017) Machine learning, sentiment analysis, and tweets: An examination of Alzheimer’s sisease stigma on Twitter. Journals of Gerontology Series B: Psychological Sciences and Social Sciences 72 (5): 742–751. https://doi.org/10.1093/geronb/gbx014

Pack, Rachael, Carri Hand, Debbie L. Rudman and Suzanne Huot (2019) Governing the ageing body: Explicating the negotiation of ‘positive’ ageing in daily life. Ageing and Society 39 (9): 2085–2108. https://doi.org/10.1017/S0144686X18000442

Parker, Ian (2004) Discourse analysis. In Uwe Flick, Ernst von Kardorff and Ines Steinke (eds) A Companion to Qualitative Research, 308–312. London: SAGE Publications.

Peel, Elizabeth (2014) ‘The living death of Alzheimer’s’ versus ‘Take a walk to keep dementia at bay’: Representations of dementia in print media and carer discourse. Sociology of Health & Illness 36 (6): 885–901. https://doi.org/10.1111/1467-9566.12122

Rains, Stephen A. (2014) The implications of stigma and anonymity for self-disclosure in health blogs. Health Communication 29 (1): 23–31. https://doi.org/10.1080/10410236.2012.714861

Sontag, Susan (1977) Illness as Metaphor. New York: Farrar, Straus and Giroux.

Tay, Dennis (2017) Using metaphor in healthcare: Mental health. In Elena Semino and Zsófia Demjen (eds) The Routledge Handbook of Metaphor and Language, 371–384. London: Routledge.

Thomas, Bronwen (2017) Whose story is it anyway? Following everyday accounts of living with dementia on social media. Style 51 (3): 357–373. https://doi.org/10.1353/sty.2017.0030

Van Gorp, Baldwin and Tom Vercruysse (2011) Framing en Reframing: Anders Communiceren over Dementie. Brussels: Koning Boudewijnstichting.

Vandeurzen, Jo (2016) Naar een dementievriendelijk Vlaanderen: Dementieplan Vlaanderen 2016-2019. Brussels: Kabinet van Vlaams minister van Welzijn, Volksgezondheid en Gezin.

World Health Organization (2017) Global Action Plan on the Public Health Response to Dementia 2017-2025. Geneva: World Health Organization.






How to Cite

Creten, S., Heynderickx, P., & Dieltjens, S. (2022). ‘The monster in the back seat’: The metaphorical representation of dementia in Flemish blogs. Communication and Medicine, 18(1), 51–65. https://doi.org/10.1558/cam.22492