Caring for those in Need

Overcoming Speech and Communication Challenges for Patients with Alzheimer’s, Parkinson’s and Dementia

As we age, our bodies change in a wide variety of ways, some of which are unexpected. While people have come to expect physical challenges that accompany the aging process – such as eyesight or hearing changes – they may be surprised by changes that diminish a person’s ability to speak and express oneself. When speech and language skills decline, especially with the onset of Alzheimer’s Disease (AD), Parkinson’s and dementia, one’s independence and quality of life often dissipates.

BY Avivit Ben-Aharon, M.S.Ed., M.A. CCC SLP | September 2023 | Category: Elderly Care

Overcoming Speech and Communication Challenges for Patients with Alzheimer’s, Parkinson’s and Dementia

Assessing Speech and Language Skills  :  A Closer Look at Communications Challenges

Alzheimer’s Disease (AD)
For the 55+ million people worldwide who are living with AD or another form of dementia, communication is challenging because the individuals have trouble remembering.1 According to the National Institute on Aging, AD causes some people to get confused about language, struggle to find words or forget what they want to say.2 For example, the person might forget or no longer understand English, if it was learned as a second language, and prefer to use only the first language learned, such as Spanish. Other issues include:

  • Finding the right word or losing his or her train of thought when speaking
  • Understanding what words mean
  • Paying attention during long conversations
  • Remembering the steps in common activities – cooking,3 paying bills, or getting dressed
  • Dealing with background noises from the radio, TV, or conversations
  • Becoming very sensitive to touch and to the tone and loudness of voices
    These individuals may show signs4 of memory loss, challenges in planning or solving problems, confusion with time or place and trouble understanding visual images and spatial relations. All of these symptoms can lead to social isolation and diminished quality of life.
    To help make communication easier, experts offer these tips:
  • Make eye contact and call the person by name.
  • Be aware of your tone, how loud your voice is, how you look at the person, and your body language.
  • Encourage a two-way conversation, for as long as possible.
  • Use other methods besides speaking, such as gentle touching.
  • Try distracting the person if communication creates problems.

The Parkinson’s Foundation advises that most people with the disease experience a soft voice volume, that may be difficult to hear. Loss of automatic facial expression can be misinterpreted as boredom, anger or sadness.5
Mood changes in Parkinson’s, such as: apathy, depression or anxiety can also affect communication, as speech may become fast or slow, rushed, mumbled or slurred. Some people notice a stutter, or difficulty starting to speak, and their voices can become quieter, breathy, hoarse, or change in pitch.

The following tips can ease communications:

  • Try to have conversations one-on-one or in small groups.
  • Reduce or remove distractions, like TV, radio or music, when conversing.
  • Be close to each other when you talk, so it is easier to hear. Avoid yelling from another room in the house! Encourage the individual to take a deep breath before beginning to speak, to enhance his or her vocal loudness.
  • Give him/her time to respond or participate in conversation.
  • Do not make assumptions about how your loved one is feeling based on facial expressions.

Adopting the Use of Technology
According to Pew Research Center, the adoption of technology by Americans in the oldest age group has grown “markedly” over the past decade: 61% of those 65+ own a smartphone and 45% reported using social media.6 As the elderly become more comfortable with using new technology, it becomes easier for them to receive virtual care.
Dementia and gait impairments often coexist in older adults and patients with neurodegenerative diseases, such as AD and Parkinson’s.7 Since mobility issues often restrict someone’s ability to travel to clinics or treatment facilities, the availability of online speech therapy is key to accessing timely, ongoing care.
This option can relieve some of the burdens and stress for family members and caregivers. It improves quality of life for those who prefer the familiar surroundings of home, instead of traveling to brick and mortar offices. There is the benefit of scheduling flexibility, since often, SLPs working virtually offer wide availability, including evenings and weekends. Convenient access to care accommodates busy schedules, that may be strained by ongoing appointments with doctors or other treatment regimens.
Addressing Issues of Isolation and Loneliness
Virtual speech therapy also helps to address challenges of isolation and loneliness, key Social Determinants of Health (SDoH) that accompany these conditions.

  • Help Recovering Lost Memories: SLPs can work with patients to retrieve memories, helping people learn ways to recall daily tasks or more deep-seated memories. When patients can remember specifics, it helps them process thoughts and communicate better.
  • Increase Social Interaction: It’s not uncommon to see these individuals withdraw from friends, family, and regular social activities, when they develop communication issues. The onset of depression and loneliness can lead to more rapid deterioration. As people rebuild their ability to recall information and communicate clearly, they feel more confident, and are more likely to interact with others, and reconnect with friends and loved ones.
  • Changes in Behavior: When it’s tough to communicate, anyone might act out. When people with Parkinson’s, Alzheimer’s and dementia struggle to form thoughts and communicate, it can lead to poor behavior. Speech therapy helps patients feel heard, communicate more effectively, and abandon poor behavior that they may have used to get attention.

Research from the Alzheimer’s Association shows the number of people being diagnosed continues to go up, as the baby boomer population ages.8,9 It's estimated that 6.7 million Americans over the age of 65 are now living with Alzheimer’s, a number that is projected to grow to nearly 13 million by 2050. The U.S. will face an unprecedented wave of dementia and cognitive decline, and it is more important than ever that individuals have access to virtual care nationwide. 

Avivit Ben-Aharon, MS ED., MA CCC SLP is the Founder and Clinical Director at Great Speech, Inc, a virtual speech therapy company founded in 2014. She is recognized as a trail blazer for nationwide virtual access to speech therapy. It allows anyone to receive expert services to improve their communication, regardless of location or scheduling limitations. Her work has been featured on Forbes, Good Morning America, US News and World Report, Miami Herald and more. She holds an undergraduate and a Master of Arts degree in Speech-Language Pathology from The City University of New York. She earned a Master of Science in Special Education and Teaching from Hunter College. For more information: 

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