The Royal College of Speech and Language Therapists says therapists have clinical expertise in the areas of communication disorder and dysphagia (eating, drinking and swallowing disorder) and are therefore essential in the care and management of this population by the contribution of specialist knowledge and skills within the specialist mental health team. All people with dementia should have access to these specialist services.

A speech and Language Therapist is key in distinguishing the different types of the disease, especially as certain types of dementia have specific language impairments.

The Royal College of Speech and Language Therapists states:

• Speech and Language Therapists aim to maximise functional gain from residual skills based on specialist assessment.

• Speech and Language Therapists have specific skills in analysing, diagnosing and managing communication disorder and dysphagia and are trained to use a variety of techniques to do this.

• The role of the SLT encompasses working with clients, their carers and the multidisciplinary team from the early to late stages of the disease providing services that aim to enable people to retain a sense of independence/self worth and remain at home for as long as possible.

• The Speech and Language Therapist aims to reduce the impact of the communication disorder and/or dysphagia on the person and their carers by providing advice, training and support to them and the multidisciplinary team, for example to enable people to  participate in decision making.

How to help a person with dementia communicate

The Alzheimer’s Society has produced a factsheet that provides tips and advice for communicating with someone with dementia and on how to encourage the person to communicate in whichever way works best.

How to speak

It is advised that you speak clearly and calmly. Speak at a slightly slower pace, allowing time between sentences for the person to process the information and to respond. It is wise to avoid speaking sharply or raising your voice, as this may distress the person. Use short, simple sentences and don’t talk about people with dementia as if they are not there or talk to them as you would to a young child – show respect and patience. Humour can help to bring you closer together, and may relieve the pressure. Try to laugh together about misunderstandings and mistakes – it can help. You can also try to include the person in conversations with others. You may find this easier if you adapt the way you say things slightly. Being included in social groups can help a person with dementia to preserve their sense of identity. It can also help to reduce feelings of exclusion and isolation.

What to say

Try to be positive. Avoid asking too many direct questions. People with dementia can become frustrated if they can’t find the answer. If you have to, ask questions one at a time, and phrase them in a way that allows for a ‘yes’ or ‘no’ answer. Try not to ask the person to make complicated decisions. Giving someone a choice is important where they can cope with it, but too many options can be confusing and frustrating. If the person doesn’t understand what you are saying, try to get the message across in a different way rather than simply repeating the same thing. You could try breaking down complex explanations into smaller parts and perhaps also use written words or objects. As dementia progresses, the person may become confused about what is true and not true. If the person says something you know to be incorrect, try to find ways of steering the conversation around the subject rather than contradicting them directly. Try to see behind the content to the meaning or feelings they are sharing.

References and resources:

To read the full fact sheet go to www.alzheimers.org.uk/factsheets

For details of Alzheimer’s Society services in your area, visit alzheimers.org.uk/localinfo

For information about a wide range of dementia-related topics, visit alzheimers.org.uk/factsheets

Royal College of Speech & Language Therapists “Speech and language therapy provision for people with dementia” RCSLT Position Paper, RCSLT: London

This document is available from the RCSLT website: www.rcslt.org/resources/publications

Written by Rachel Harrison, speech and language therapist, on behalf of Integrated Treatment Services. www.integratedtreatmentservices.co.uk

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