speech and language therapy

[Suzanna]

hi to all,

just a quick thread to get some all important opinions from you all, hope everyone is having an even better day than the one before, or will have a better one tomorrow.

My mum has early onset AD, but this thread is coming more from suzanna 'the speech therapy student' rather than 'suzanna the daughter of an AD sufferer'

I am currently completing my final year of a speech therapy degree and designing a project to set up a training day/programme for carers of people with dementia, looking at communication strategies which may be beneficial in the earlier stages and also looking at management of eating and drinking problems as well as general support for carers. The motivation behind this, as well as on a personal level, is that i believe currently there are few areas in which specialist speech and language therapy provision for carers of people with dementia exist.

So, to cut to the chase, i was hoping that people might like to contribute to this, by not only sharing with me the experiences (if any) you have had with speech therapists (good or bad!) but also in telling me of what help you would like to see offered.

obviously, i understand if people are too busy to contribute (am fully aware of the level of time and both physical and mental stress involved in being a carer)but thought some of you may appreciate the opportunity to express an opinion on this, and hopefully contribute to changing the future of speech therapy provision for people in our situation.

many regards,

Suzanna

PS: if a moderator could let me know if i can post my email address for people to respond via, that would be great. thanks

 

[Kate P]

Hi Suzanna,

My mum started to lose her language very early on and now can barely speak at all.

It has always surprised me that we have never been offered help from a speech therapist or advise on how we could improve communication between ourselves and mum. Perhaps they feel it is too late and so not worth bothering with (mum can't really speak at all anymore).

To be honest some ideas of alternative communication would have helped a lot in the earlier stages would have been very helpful because to be truthful trying to explain to mum what you want her to do or why she can't do what she wants to do is like a bad game of charades.

 

[jenniferpa]

Suzanna - no, don't post your email on the board in plain sight. If anyone wants to communicate with you privately it should be done via the PM system (and you can share your email address there if you wish). However can I remind everyone that with the exception of the moderators, you cannot be sure exactly who anyone is, so be cautious.

Also I'm moving this thread to the appropriate area.

See here http://www.alzheimers.org.uk/talkingpoint/site/scripts/documents_info.php?categoryID=2&documentID=63

 

[daughter]

Hi Suzanna,

My Mum had a stroke at the beginning of January (and like a bolt out of the blue I have started to realise that she may have also some form of dementia, but I'm not sure I want to think about that too much yet). She now suffers from Aphasia and has to be prompted to show us what she wants, yet she can still understand what we say to her. My sister and I have been trying to devise methods to help her communicate, it would have been great to have been given more suggestions to try while Mum was in hospital.

We have found the following useful at times:

1. Cards with simple instructions (could be laminated).
2. A sheet of small photographs of relatives and friends for recognition and for indicating who they want to ask about.
3. A list of “What I want to talk about”.
4. A card for the person to carry with them (could be laminated).

We used (1) and (2) in hospital and the others now Mum is at home. I don't suppose these things will help everyone and I realise that they are not going to help people with advanced dementia, but they might be worth a try.

Mum finds singing songs easier than trying to say words. Phrases also seem to be a little easier for her to say, and she can say "stop biting your nails" annoyingly well! I've noticed that she says things better if she's not trying too hard. An illustration of this was one day Mum when was trying hard to to tell me something. After I had guessed unsuccessfully many times, she sighed, sat back in her chair and SAID CLEARLY “I can’t say anything”. She was as amazed as I was!

One more thing, I have noticed that Mum's speech therapy homework has line drawings that are not very clear to me, let alone to her! I sometimes wonder if she does not say which is the odd one out because she cannot distinguish the image, rather than not knowing the odd one out! I wonder if there is some reason why line drawings are used as opposed to actual photographs?

Good luck with your degree and with your future as a speech therapist.

 

[Suzanna]

thanks for responses thus far

thanks for your responses guys, i will keep people update as the project progresses if thats something people would want!?

Suzanna

 

[Skye]

Hi Suzanna

My husband has PPA (primary progressive aphasia), a rare form of dementia where the language centre of the brain is progressively destroyed, but dementia does not spread to other areas of the brain until (on average) six years.

We were never offered speech therapy. The rationale seems to be that stroke victims may recover their speech to some extent, so are worth treating. Dementia sufferers are going to continue to deteriorate whatever is done, so there's no point in treating them!

I think training in other ways of communication would have been helpful. As well as losing his speech, his comprehension, reading and writing also disappeared, so written signs quickly became useless.

PM me if you want more info.

 

[SB-SLP]

Speech Pathologist's view of treatment

I have been a Speech Pathologist for 21 years. I worked in the field for 13 years and then semi-retired and just kept up with readings and continuing education. I have recently returned to the field (3 weeks) and continue to have much enjoyment when working with Alzheimer/Dementia patients while working in Independent and Assisted Living plus Memory Care settings. So first I want to relay that there are therapists that are working with this population and that the input of a Speech Pathologist can be SO important. I was speaking with a patient today (with short tem memory deficits and mid-stage Demenita) and I told him we were doing "Thinking Therapy". He seemd to "get it". The brain needs to be used and exercised to perform at its peak. I utilize "Brain exercises" that involve thinking and talking activities that are utilized for a variety of reasons. 1) to find the positive and strong abilites that one continues to have i.e. reading, memories, labeling, performing a certain task, following directions...1 step, written, from pictures. 2) to utilize this strength with the patient in completing other daily tasks. 3) to be busy in maximizing the patient's participation throughout the daily activities. Dementia patients do not have the capacity to learn new information however they have the capacity to participate in tasks utilizing the skills they still have. One example would be a person who can feed themselves if they hold the cup in one hand and a spoon in the other. They have the tactile and visual connections with both hands and they maintain attention much better. Each new food/item is presented when one cup is emptied. They are able to self-feed much longer when provided with this assistance/set-up rather than a tray of food and condiment packets. Too many distractions can result in an overwhelmed person who then is unable to perform at any level.
So I wanted to share with you that a Speech Pathologist can be a vital component of dementia care for maximizing level throughout daily tasks and for altering the envirnoment to allow the person with the most participation and enjoyment while being safe and comfortable. The brain is an magnificent thing and "Thinking Therapy" should enhance the person's abilities and their envirnoment.

 

[lesmisralbles]

Speech Thearapy

Ron had a visit from a speech therapist.
A very nice young thearapist.
She tried everything with Ron. BUT, if he does not practice what she preached, it will not work.
He does not practice what she preached
I have tried
You can lead a horse to water, but you cannot make it drink
Barb X

 

[joycepaula]

New speech therapist in this forum

Hi all,

I've found your comments so far quite helpful. I am an experienced speech therapist, but am only now starting to work with patients with dementia and Alzheimer's. Are there any other speech therapists out there on this forum?

Thanks, joycepaula

 

[Winnie Kjaer]

My husband has Vascular dementia due to 2 small and one very large stroke. He received speach therapy after his first stroke when he suffered severe disphasia and aphasia but he could identified every one of the cards he showed him except one, so he said there was nothing more he could do for him the rest would come. My husband eventually spoke more and more, but nearly always said the opposite to what he meant. i.e. left for right, yes for no cold for hot and so forth, but you could not guarantee it would be every time so you could not take it he meant the opposite. We were given a large plastic card with loads of different pictures on for the every day things we use. He was also given a large clock in cardboard so he could move the hands and learn to say the time. It worked for a while but then he had his big stroke, and is talking less and less. We had another visit from a different speech therapist recently who was lovely she offered him a visiting friend, suggested ways of getting him to express himself rather than just doing what he points at because I know what he wants, but it does not work for us. It becomes a battle. I was also told never to agree with him when he says something wrong, but to correct him, again that does not work for us.
It is hard for the speech therapist I am sure because she does not understand his responses but I found neither of them any help at all.

 

[susiesue]

My husband was given speech therapy right at the start of this dreadful journey.

After approx six visits the Speech Therapist wrote to our GP to say she couldn't see the point in continuing as my husband did not concentrate

It would seem she had no experience with dementia as she would have known that 'not concentrating' is part of the illness.

 

[joycepaula]

Degree of dementia is important

Hi Sue,

Sometimes there isn't much that can be done if a person's comprehension is severely affected and his behavior doesn't allow for intervention. I would hope that the speech therapist tried everything she could think of to help your husband.

You are right that dementia can be a "dreadful journey". I hope you are getting the support you need to cope with such a difficult time in your life.

--joyce

 

[Helen33]

Hello Joyce

My husband has a semantic dementia of the fronto temperal lobe and we were not referred to a speech and language therapist at all. It was only reading something from Talking Point that I realised that this could help us and so I self referred and now have one.

I said to the S&L therapist that my understanding was that it was important for her to work with me because it was more likely that I would be the one that would need to be doing the changing. She agreed. I felt it important that I learn to communicate in the best ways possible in order for my husband to get the most out of his life. If I can learn new approaches then I can then help Alan. I have learnt quite a lot in a short time and I really feel that people with FTD and/or their carers ought to be referred to a S&L therapist at the earliest opportunity in order to best benefit from learning how to communicate differently and positively.

Love