5 things you should know about: Speech & Language Therapy for people living with dementia

  1. The title “Speech and Language Therapist” can be misleading.

Although lots of our training is about spoken language, we cover all aspects of human communication. Everybody uses non-verbal communication in all  interactions, whether it is in the way we use eye contact, what facial expressions we have, laughter, yawning, sighing, whistling, crying out, shrugging,  what position we are sitting in. Things we do, objects we fetch, what we wear, all convey a message too. If I put the kettle on, my colleagues expect a brew up, even if I don’t say anything. If I put on my walking boots, everybody knows I am going for a walk.  All of these things are forms of communication, and if the use of words is limited, as can happen with dementia, how we use non-verbal communication becomes all the more important.

  1. It follows that Speech and Language Therapy doesn’t always focus on speech.

Even if spoken language is good, when a person has dementia they often need more time to process a message or plan a response. Thinking about the way non-verbal communication can support speech can really help us to give the person that little bit of extra time they need to take part in a conversation successfully. A spoken word is gone in a flash, whereas a picture, object, newspaper headline or even a gesture can last much longer, helping the person to hold on to what has been said.

  1. Speech and Language Therapy is not just about working with the person with dementia.

The changes and adaptations have to be made by their communication partners. As well as thinking about what non-verbal communication we use and how we can adapt it for the person with dementia, it is important for us to learn their ways of using behaviour to communicate. Each of us has a repertoire of habitual behaviours, and they all mean something. If we are good at reading what is behind the behaviour, we can respond appropriately and are helping the person communicate their feelings and wishes effectively.

  1. The people closest to the person with dementia are the best therapists.

Recognising a person’s attempts to communicate is all about valuing them as an individual. When communication is limited, for whatever reason, it is very easy for a person to become isolated, withdrawn and unhappy or distressed. The more we know about a person, the things in their life which make them feel proud or happy, the people, places, music, other things they are fond of and why, the more we can support them to be themselves and feel valued.

  1. Speech and Language Therapists often help people with dementia who have difficulty eating and drinking.

Sometimes this involves avoiding certain foods or modifying the texture. If a person is coughing or choking, or having frequent chest infections, a Speech and Language swallowing assessment may be needed. But perhaps surprisingly, thinking about the communication techniques already described can sometimes solve less severe problems. Knowing the person well, knowing their preferences and routines, thinking about the environment and how they respond to it, being sensitive to what their behaviour is communicating and making sure they have all the time they need, can all make a huge difference.

Thank you for reading my post.

  • What questions or comments would you like to leave for me to answer?
  • What resources could we share to make sure we all have good conversations?

Rebecca Kellett, specialist Speech and Language Therapist, NHS Lothian

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