Receiving a diagnosis of Parkinson's disease can feel devastating, but you can still lead a full, active, and positive life with this condition. Since 1817, when it was introduced to the world by an English physician named James Parkinson, we’ve made leaps and bounds in discovering treatments and interventions for people with Parkinson’s.
Science still has some way to go, especially in solving the mysteries of what causes Parkinson’s and how we can cure it. But this Parkinson’s Awareness Month, we want to focus on advances in treatment, and one prime example is speech therapy. Speech therapists can help people with Parkinson’s effectively manage problems related to speaking, cognitive skills, and swallowing. And being able to communicate and stay connected with others is one way to keep living life to the fullest.
What is Parkinson’s disease?
Parkinson’s is a disorder affecting movement. Its symptoms usually begin gradually and worsen over time. Parkinson’s is characterized by symptoms such as:
Tremor (or trembling) in the hands, arms, legs, jaw, or head
Rigid muscles anywhere on the body, which limits one’s range of motion
Impaired posture, balance, and coordination
Slowed movement (also known as bradykinesia)
Difficulty swallowing, chewing, and speaking
Sleep disorders, such as waking up throughout the night, waking up early, or falling asleep during the day
Cognitive changes such as problems with attention, planning, language, and memory
Depression or other emotional changes
How does Parkinson’s affect speech?
Some of the motor symptoms connected to Parkinson’s, such as limited facial expressions, overall slowed movement, and stooped posture, make it difficult to speak clearly and loudly enough to be heard and understood by others. People with Parkinson's often speak very quietly and in a monotone-sounding voice, so it can be tough to convey much emotion. They may sound breathy or hoarse, or they may slur their words and mumble. Many people with Parkinson's speak very slowly.
The cognitive impairments connected to Parkinson's also affect clear speech production–for example, struggling to find the right words. Many people with Parkinson's have reported that these challenges make it extremely difficult to speak with family, friends, and colleagues. They often decide to limit social interactions because of this.
How speech therapy can help people with Parkinson's communicate
While there are medications to help with Parkinson's symptoms, speech therapy is by far one of the most effective interventions. One speech therapy treatment that has gained a lot of traction over the years is the Lee Silverman Voice Treatment (LSVT) LOUD. The goal of LSVT LOUD is to train patients with Parkinson’s to speak louder, at a normal intensity, while keeping a good voice quality. This intervention is conducted by a speech-language pathologist who provides exercises and strategies to improve the volume and overall clarity of one’s speech. Multiple studies have shown the effectiveness of LSVT LOUD. Not only does it improve the ability to speak, it helps lessen the social isolation that might result from communication challenges.
Tips to improve communication when you have Parkinson's disease
If you or a loved one is having communication problems, these strategies can be helpful:
When talking with others, choose a quiet place so everyone can be heard. Make sure electronics such as the TV and radio are turned off so there isn’t any competing noise.
Sit in a sturdy chair and in an upright position to help with voice projection and clarity.
Make sure everyone’s faces can be seen. This increases the ability to be understood significantly.
Stay hydrated. Having a well-hydrated voice makes it easier to speak clearly, and it decreases the chance of injuring your vocal system. Without proper hydration, your voice will sound like sandpaper on a piece of wood–gravelly and rough. Drinking enough water also helps you have a wider pitch and better vocal stability. And most important, the brain needs water to function.
If your speaking volume is quieter than you’d like, try using a voice amplifier so you can be heard anywhere you go.
How does Parkinson’s affect swallowing?
People with Parkinson’s can have swallowing disorders (known as dysphagia), which cause coughing, throat clearing, and/or choking on food, liquids, and even one’s own saliva. Many people with Parkinson’s report the sensation of having food stuck in their throat. In order to diagnose a swallowing problem, a doctor will perform a modified barium swallow study (MBSS). This X-ray will indicate where the swallowing problem is and whether liquids and food are “going down the wrong pipe.” If so, the person may be at risk of aspiration–when food or liquids go into your windpipe (trachea) and into your lungs. Over time, this can lead to aspiration pneumonia, which is extremely serious and requires hospitalization.
Swallowing therapy with a speech-language pathologist is often recommended in these cases. The speech-language pathologist will prescribe exercises to strengthen the muscles used to swallow. In some cases, diet changes such as thickened liquids will also be prescribed.
Caregivers, family, and friends can help individuals with Parkinson’s in the following ways:
Make sure you are face-to-face when speaking with each other.
If you’re not sure of everything the person with Parkinson’s said, repeat what you did hear–for example, “You want me to order the pizza and then do what?”
If you don’t understand anything that was said, ask the person to repeat themselves, speak more slowly, or spell out the words you did not understand.
When someone has voice or swallowing challenges, it’s important to be prepared for an emergency, should one arise:
Having a swallowing disorder increases the chance for choking, so your caregiver or partner should know the Heimlich maneuver.
If speech is an issue, you can buy an intercom in order to alert someone in the home that there’s an emergency. Or you can use bells or sounds to mean different things. For instance, a bell may mean you need something, and a horn may mean it’s an emergency.
If you have Parkinson’s and you’re usually alone, sign up for a medical alert monitoring system like LifeCall. In an emergency, the company will alert the right authorities, as well as your loved ones.
Parkinson’s is not a fatal disease. The most important thing you can do is manage the symptoms. Speech therapy is a proven intervention for many with Parkinson’s, and with the right interventions and care, it is possible to have a long, high-quality life with this condition.