Dementia may cause impairment of linguistic abilities, affecting both production and comprehension, which in turn affects communication (Mahendra & Hopper, 2012: Perkins, Whithworth & Lesser, 1998). The aim of the present study was to investigate and describe the communication strategies in everyday conversations between people with dementia and their interlocutors, and to describe the identified interaction phenomena based on a participatory perspective. The study was conducted at a home for people with dementia. Three people with known dementia and two health professionals participated in the study. Everyday interactions were filmed, and then transcribed and analyzed according conversation analytic principles. The transcribed data was also analyzed with ideas from positioning theory. The present study highlights the presence of trouble sources in communication between the person with dementia and carers and how these are handled by the participants in terms of strategies, competence and positioning. The study shows that all participants use communicative strategies when trouble sources occurs, but also that trouble sources in the conversation sometimes are ignored. How trouble sources are handled affects how participants acknowledge themselves and each other competence and how they position themselves and each other in the conversation. The study also demonstrates that Conversation Analysis can be an important tool to map strenghts and break downs in communication between people with dementia and key interlocutors. That knowledge could then form the basis for designing individual adaptations and strategies to facilitate communication.