Within the still-dominant medical discourse on dementia, disorders of language feature prominently among diagnostic criteria. In this view, changes in ability to produce or understand coherent speech are considered to be an inevitable result of neuropathology. Alternative psychosocial accounts of communicative challenges in dementia exists, but to date, little emphasis has been placed on people with dementia as social actors who create meaning and context from their social interactions. This article draws on Bakhtin’s concepts of the carnivalesque, heteroglossia, polyphony and dialogism to analyse a series of interactions involving people with dementia in day and residential care environments. It argues that many of the communicative challenges faced by people with dementia arise from the social environments in which they find themselves, and that the utterances of people with dementia in the face of these social challenges show many of the hallmarks of cultural resistance identified by Bakhtin.