Dementia is not a normal part of aging- it is the leading cause of disability in Australia for people over the age of 65 years. According to the World Health Organisation (WHO), the number of people living with dementia worldwide is currently estimated at 50 million and is predicted to triple by 2050.
What is Dementia?
Dementia is a chronic and progressive syndrome resulting from acquired brain disease. It is characterised by a progressive decline in memory and cognitive areas such as: complex attention, executive function, learning and language. Over time, the severity of dementia has an impact on independent functioning and daily living activities (Hedge, 2016).
The impact of cognitive change on communication can have a significant impact on day- to day communication. For example, a decline in memory, attention, executive function and or language processing can make it challenging to follow or participate in a conversation (Groher, 2015). In conjunction, loss of memory and problems with judgment can cause challenges in relation to eating and nutrition for many people with dementia.
What is the role of Speech- Language Pathologists for people with dementia?
Speech- Language Pathologists play an important role in dementia related communication or swallowing difficulties. The role of SLPs include screening, assessment, diagnosis and treatment of people with dementia- they work as part of multidisciplinary team (ASHA, 2016). Within the scope of practice, the SLPs role includes but is not limited to:
How dementia affects communication and swallowing
Each individual who presents with dementia is unique and the difficulties experienced in communicating thoughts and feelings can affect the brain in different ways. According to Brush et. al (2011), communication changes in an individual with dementia include but are limited to:
Experiencing issues with swallowing is known as dysphagia. It is a condition which can be caused by several factors including damage to areas of the brain that control swallowing. In up to 70% of instances, people with dementia will experience dysphagia at some point, which can lead to a range of complications such as weight loss, malnutrition and aspiration pneumonia if lead untreated (ASHA, 2016),(Hanson et. al, 2013). The following strategies can help with managing dysphasia in people with dementia.
Difficulties are not limited to swallow function. Cognitive and behavioural changes associated with dementia can also impact eating (ASHA, 2016). Individuals may have difficulty shopping for groceries and planning and preparing meals independently.
People with dementia may also forget to eat, initiate eating less often or have difficulty determining the need to eat (Lee & Song, 2015).
As dementia progresses, the individual may become more distracted during mealtime or have difficulty self-feeding, recognising foods or using various utensils.
Strategies for Communicating with people with dementia
Instead of asking: ‘ What would you like for dinner?’, you could try… ‘Do you want fish and salad for dinner?’
What to do now?
If you know someone who presents with Dementia and requires Speech- Language Pathology Support, give us a call at Generation Physio, we have a friendly team of professionals that are dedicated to changing the lives of our clients. All of our clinicians are mobile and come to your own home to conduct an examination. Give us a call on 1300 122 884 to book a consultation today.
Article Written By Tue Nguyen
Tue is a Speech-Language Pathologist at Generation Physiotherapy. Tue has experience working with a range of complex communication clients who present with physical impairments, hearing loss, Cerebral Palsy (CP), Autism Spectrum Disorder (ASD), and Rett Syndrome.
Prior to joining Generation Physiotherapy, Tue was a Speech-Language Pathologist at the Queensland Department of Education (DoE). In this role, Tue focused on paediatrics and school age children. Tue is bilingual in Vietnamese and English and has previously focused on clients who are Culturally and Linguistically Diverse (CALD). In her role, Tue served as a Clinical Educator and was responsible for management of Speech Pathology university students undertaking clinical placements.
Learn more about Tue here.
American Speech-Language-Hearing Association. (2016b). Scope of practice in speech-language pathology [Scope of practice]. Retrieved from https://www.asha.org
Brush, J. A., Sanford, J., Fleder, H., Bruce, C., & Calkins, M. (2011). Evaluating and modifying the communication environment for people with dementia. Perspectives on Gerontology, 16, 32–40.
Groher, M. E. (2015). Issues and challenges in managing patients with dementia and dysphagia. Japanese Journal of Gerontology, 30, 61–67.
Hanson, L. C., Ersek, M., Lin, F. C., & Carey, T. S. (2013). Outcomes of feeding problems in advanced dementia in a nursing home population. Journal of the American Geriatrics Society, 61, 1692–1697.
Hegde, M. N. (2006). A coursebook on aphasia and other neurogenic language disorders. Clifton Park, NY: Delmar.
Hickey, E. M., & Bourgeois, M. S. (2018). Cognitive and communicative interventions. In E. M. Hickey & M. S. Bourgeois (Eds.), Dementia: Person-centered assessment and intervention (pp. 168–213). New York, NY: Routledge.
Lee, K. M., & Song, J. A. (2015). Factors influencing the degree of eating ability among people with dementia. Journal of Clinical Nursing, 24, 1707–1717.
Martini, A., Castiglione, A., Bovo, R., Vallesi, A., & Gabelli, C. (2014). Aging, cognitive load, dementia and hearing loss. Audiology and Neurotology, 19, 2–5.