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Better health for people living
with dementia

Speech and communicating

The loss of communication that can come with dementia can be very distressing.

It affects the person living with dementia directly and has ripple effects for everybody around them. And it comes at a time when communicating is as important as it has ever been.

A comprehensive communication assessment by a speech pathologist can help with understanding a person’s communicative strengths and weaknesses. This will allow the development of a care plan that includes the best strategies to enable an individual’s communication. Early intervention can provide a person living with dementia, their carers and their family with strategies to continue to maximise communication.

Practice points

Speech pathologists:

  • identify the retained abilities and strengths, which often include early life memories, procedural memory, social rituals, intonation and melody of speech, and the ability to read aloud, recite and sing
  • create a communication-friendly environment
  • create opportunities for meaningful, satisfying communications
  • develop strategies to deal with communication breakdown
  • guide carers in the use of memory/ communication aids
  • assist with individual reminiscence work, including the production of a life story, whether in print, digital or other form.

Cai's story

For Cai, dementia significantly affects her ability to speak. At times it is distressing, both to her and to her husband Huynh, who cared for Cai while she was living at home. Cai saw a speech pathologist, who used different approaches at different times to support Cai’s communications. At one time, Cai was helped by a word relearning program that she used each day at home on her laptop. Cai also enjoys participating in a choir for people with communication impairment. She enjoys the social contact and loves music, so really gets involved in the singing. Now a memory book has helped Cai settle into new accommodation.

‘It has a dozen pages,’ says Huynh. ‘On the left is a photo and on the right is some text. It is very valuable – it helps her talk about who she is, what her life was like before, and who and what is important to her.’

Comment from speech pathologist Cathy

Behavioural interventions offer much to improve satisfaction and quality of life. As communication changes over time, so too do the needs of the individual and their family and caregivers. Comprehensive review by the speech pathologist at regular time intervals allows for monitoring symptom severity and emergence of new areas of language impairment. This monitoring of progression allows for planning appropriate interventions, education and support at the optimal time.