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Speech Therapy For Dementia

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Dementia is an umbrella term for abnormal brain changes that affect a variety of cognitive functions, resulting in loss of memory, communication problems, issues with information processing, and behavior and personality changes. Alzheimer’s disease is a medical condition within this broad group of different diseases.

Towards the later stages of this progressive syndrome, the memory loss that dementia patients experience can sometimes result in speech problems. Referred to as aphasia, dementia patients might forget words or language and even be rendered unable to speak. Can speech therapy and working with a speech language therapist help?

Speech therapy for dementia focuses on areas such as voice-volume recognition, fluency, mouth coordination, and articulation to improve a senior’s ability to express themselves. This treatment is proven effective, even for older adults with more severe symptoms of dementia. 

If you’re at the point where you’re strongly considering a speech therapist for your senior with dementia or Alzheimer’s disease, this article is for you.

First, we’ll talk about how dementia affects speech and communication skills. Then we’ll delve into the benefits of speech therapy and whether this service is covered by Medicare.

What Type Of Dementia Affects Speech?

There’s a reason that not all dementia patients end up with reduced speech or no speaking abilities at all by the end of the disease process. Different types of dementia affect different cognitive areas.

Only certain forms of dementia affect speech. One form is vascular dementia, which is caused by a blockage (such as a series of small strokes) or reduced blood flow to the brain. Another is frontotemporal dementia, which is actually a group of disorders.

Frontotemporal dementia occurs mostly in the brain’s temporal and frontal lobes, which are the same parts of the brain that influence language skills, behavior, and personality. Progressive nerve cell loss and atrophy (shrinking of the lobes) leads to a loss of in these regions.

To compound that, the brain begins building up substances that can further interfere with how well brain cells function. 

Symptoms Of Frontotemporal Dementia

Since language, behavior, and personality are all affected with frontotemporal dementia, these areas are where symptoms tend to manifest. 

The following motor symptoms may occur:

  • Issues with walking
  • An increased rate of falls
  • Crying or laughing during inappropriate situations
  • Muscle weakness
  • Swallowing issues
  • Lack of coordination
  • Muscle twitches and spasms
  • Rigidity
  • Tremors

Behaviorally, family members with dementia may experience these symptoms:

  • Wanting to put anything and everything in their mouths, even nonedible items
  • An interest in eating nonedible items
  • Eating changes, such as wanting to eat only sweets or carbs
  • Lack of personal hygiene
  • Apathy but not depression

Problems with executive functions, such as

  • An increase in compulsive behavior
  • Fewer inhibitions and poor judgment
  • Lack of empathy 
  • Inappropriate social behavior 

Finally, these speech symptoms are caused by frontotemporal dementia:

  • Difficulty in properly constructing sentences
  • Forgetting what words mean
  • Having a hard time identifying items by name
  • Troubles with reading and comprehending language

Causes Of Frontotemporal Dementia

What causes frontotemporal dementia in dementia patients? Family history is not always indicative of developing this form of dementia. That said, if other members of your family have frontotemporal dementia, that does increase your chances of developing it.

Genetic mutations can cause frontotemporal dementia as well. A link exists between amyotrophic lateral sclerosis or ALS and frontotemporal dementia, although experts still aren’t sure precisely what that link is.

Having one does not cause the other as far as current research indicates, but that could possibly change in the future.  

What Does A Speech Therapist Do For Dementia Patients?

As a child, you might have received speech therapy to help you overcome a lisp or other common mispronunciation issues. Speech therapy for someone with cognitive deficits is different, as it’s a lot more advanced and doesn’t only affect physical speech.

Here’s what might be included as part of your senior’s speech therapy treatment plan.

Eating And Swallowing Assessments

Speech-language pathologists or SLPs will first assess how your senior one eats and swallows. You might wonder, what in the world does this have to do with your senior’s speech inabilities? 

A lot, actually.

If a senior can’t eat, then they’ll also struggle with mouth coordination that can limit their speech. By addressing mealtime difficulties, the senior with dementia might have an easier time with speech. 

Memory Regurgitation And Other Speech Techniques

Speech language pathologists who work with dementia patients regularly can identify the language struggles these patients experience.

Through employing speech techniques such as memory regurgitation and visual speech perception, a senior with dementia may find it easier to associate names and meanings to certain words.

Their language abilities may also be restored to some degree. 

Voice-Volume Recognition

If your senior shouts at times when they shouldn’t due to their dementia, a speech pathologist can reduce this rate of behavior. They may also assist the elderly who mumble their way through conversations for better fluency.  

Liaisons With Adult Caretakers And Medical Staff

All along, an SLP works with adult children and caretakers, as well as occupational therapists, physical therapy, and the rest of the medical staff supporting your senior.

If the SLP notices an issue with your senior’s health, whether that’s related to their speech or not, they’ll bring it to your attention, as well as alerting your senior’s doctors, nurses, and other caretakers. 

Together, this multidisciplinary team plays an important role in the dementia care of your senior and their ability to carry out activities of daily living for as long as possible after their initial diagnosis. 

Does Speech Therapy Help Dementia Patients?

What if you are strongly considering speech therapy for your senior with dementia, but you’re not completely sure yet? How do you know rehabilitation services like this will even work?

Speech therapy can indeed help dementia patients. A 2018 report in The American Journal of Speech-Language Pathology reviewed a series of studies about patients with moderate to severe dementia and the effect of speech therapy on these patients.

The researchers state the following: “Preliminary evidence was found to support communication interventions for people with moderate-severe dementia. The use of cognitive stimulation approaches, which use a group treatment model and conversation, as a therapy medium show promise as direct intervention options.”

That said, it’s important to keep your expectations reasonable. For example, if you’re expecting your senior parent or loved one to speak like they did before they were diagnosed with dementia, you might be disappointed. 

The goal of speech therapy for dementia is not to restore the dementia patient’s quality of speech and cognitive skills back to pre-dementia levels. While that would be phenomenal, it’s just not likely as the disease progresses.

Instead, an SLP will strive to help a dementia patient maintain the quality of life they have now by retaining the speech abilities they possess at current. That includes helping dementia patients identify words and family names based on the use of memory books, reminiscence, and photos as well as utilizing other speech therapies. 

Dementia, as we’re sure you know, is an incurable disease. Without intervention from a professional, your senior’s dementia will continue to rob them of their speaking abilities. 

Does Medicare Cover Speech Therapy For Dementia Patients?

Okay, so you’re ready to begin looking for an SLP for your senior with dementia. Before you do though, you’re curious who’s going to foot the bill for their speech therapy. Does Medicare cover it (or other dementia testing) or will you have to pay out-of-pocket?

According to Medicare’s website, if your senior has Medicare Part B insurance and their speech therapy is deemed “medically necessary,” then yes, their insurance will pay for the costs of therapy. 

So how do you prove to Medicare that your senior parent or loved one’s speech therapy is medically necessary? Medicare’s site states that a healthcare provider or doctor must certify that the senior needs speech therapy.

Once that occurs, you’d pay for 20 percent of the amount that Medicare approves for speech therapy. The senior’s Part B deductible should cover everything else. 

Conclusion 

Speech therapy for frontotemporal dementia allows a senior to restore some of their speech, item recognition, and swallowing and eating abilities. While the therapy cannot turn back the hands of time and allow a senior to speak with the cognition they did before they developed dementia, speech therapy does improve the elderly’s quality of life in their current condition.

Since speech therapy is usually covered by Medicare Part B insurance, we hope it’s something you consider for your senior with dementia if you believe it will help! 

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