How Does Dementia Affect Language and Communication?

Dementia is a disease that causes memory loss. It can also cause loss of language, communication abilities, and problem-solving skills. Dementia is a progressive disease, which means it gets worse over time. Alzheimer’s is the most common type of dementia, making up about 60% to 80% of diagnosed dementia cases.  

There are many challenges that come with this disease, including difficulties with talking and overall communication. This article covers the early signs of dementia, how dementia affects language, and how speech therapy can support people with dementia and their loved ones.

What are warning signs of dementia or Alzheimer’s?

While dementia must be diagnosed by a physician, there are some early warning signs. If you notice any of these signs in yourself or a loved one, contact a doctor to be screened for dementia:

  • Memory changes that are big enough to make daily life more difficult, such as routinely missing appointments or forgetting friends’ and family members' names

  • Difficulty with familiar tasks, like cooking or getting ready for the day

  • Changes in communication skills, such as not being able to find the right words or express thoughts clearly, or repeating questions in a conversation

  • Becoming disoriented; not knowing where you are or what time it is (getting lost while driving is one example)

  • Impaired judgment, such as not recognizing if you’re hurt, or not being able to solve a problem

  • Difficulty with abstract thinking, such as remembering what numbers or symbols (like street signs) represent

  • Placing items in the wrong spot or in odd places

  • Mood changes, such as becoming scared or suspicious for no clear reason

  • Loss of initiative, such as difficulty starting regular tasks and routines

  • Difficulty with visual-spatial information, which can lead to bumping into things or not realizing how close or far away an item is

There is currently no cure for dementia. However, there are different ways the disease can be managed. That’s why it’s so important to speak with a doctor as soon as you suspect something could be going on.

Do people with dementia or Alzheimer’s stop talking?

Communication changes typically start early on in dementia. As the disease progresses, it’s likely that the person will continue to lose more of their communication abilities. Toward the final stages, they may not be able to talk.

Before that point, however, you may notice gradually increasing difficulty of communication. The person may have trouble with word-finding or expressing what they think or feel. They may become confused while speaking with others. People with dementia often have difficulty understanding other people in conversation.

How does speech therapy help people with dementia?

Speech therapy can offer meaningful support for people with Alzheimer’s or dementia. It can also teach helpful communication techniques to their family and caregivers. Let’s look at what speech therapy for dementia commonly entails.

Not surprisingly, speech therapy will focus on helping the person improve their communication skills. While it’s unlikely for the person to gain back lost skills due to their disease, they can improve their ability to talk with others. Different communication strategies can help them do this.

Some of these strategies may include using writing or pictures to communicate. Family members can also change how they talk with the person with dementia, which will lead to more successful communication. It may be helpful to: 

  • Modify the environment, such as turning off the TV or turning on the lights

  • Speak more slowly

  • Keep sentences simple

  • Repeat information

  • Give the person choices when asking them questions, such as: “Would you like water or juice?”

Speech therapy may also work on maintaining cognitive skills or compensating for deficits. The person with dementia may practice memory or problem-solving tasks. These might include making sure to lock the door at home, use an oven mitt while cooking, or wipe up liquids that have spilled.

Feeding and swallowing therapy for dementia

Speech therapy can also help with problems related to eating. People with dementia will likely have difficulty with feeding and swallowing as the disease progresses. The muscles they use for chewing and swallowing may not work as well, which can put them at risk of choking. Speech therapists can recommend diet changes and determine what types of foods the person can most safely eat.

Speech therapy can also teach feeding strategies to help the person eat as safely as possible. These techniques might include alternating food and liquid to help the person clear their mouth more easily, and thickening liquids to slow down how fast they’re swallowed.

Every person with a feeding or swallowing disorder will have different needs, diets, and modifications. It’s important to be assessed and treated by a speech therapist who specializes in this area.

How do I find a speech therapist for dementia?

If you or your loved one is not yet being seen by a speech therapist, it’s important to find one and begin treatment as quickly as possible. Speak with your doctor or other health care professional. They can likely refer you to a speech therapist. You can also speak with family members or friends to ask for recommendations as well.

Dementia is a challenging disease for everyone involved. A speech therapist will be able to provide communicative and feeding support throughout your time together. It’s also helpful to join a local or virtual support group, which can improve quality of life for both the person with dementia and their caregivers. Two good resources to find support groups are the Alzheimer's Association and the Alzheimer’s Foundation of America.

No one should have to deal with dementia alone, and your speech therapist will be right beside you every step of the way.

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