Role of Speech Language Pathologist in caring for people with dementia

Over the past few years, dementia has been a growing challenge because as the population’s life expectancy increases, it becomes one of the most significant healthcare issues facing the world (Saccasan & Scerri, 2020). In the UK, according to NHS (2021), it is estimated that at least 850,000 people have been diagnosed with dementia. It is a health condition that affects older people, and once they have reached 65 years old, their risk of dementia doubles every five years (NHS, 2021).

The impact of dementia on cognitive communication can significantly affect an individual’s daily activity. For example, according to Kaf et al (2011), a decline in attention, memory, language processing and executive function can make it challenging to participate or follow a conversation. Furthermore, loss of judgment and memory can lead to challenges related to nutrition and eating for many patients with dementia.

Specifically, the cognitive swallowing problems associated with dementia is known as dysphagia. According to Kaf et al (2011), dysphagia is a cognitive condition that is caused e several factors including the damage of brain areas responsible for swallowing. Dysphagia is experienced by up to 70% of people with dementia at some point in their lives, and this can lead to a range of issues such as malnutrition and weight loss.

The main challenges faced by dementia patients with dysphagia are not only limited to swallowing but also include the inability to shop around for food or independently prepare meals, forgetting to eat, and difficulties in determining the need to eat (Hopper et al, 2007). with the progression of dementia, the patient may become more prone to distraction at mealtime, and have challenges with recognizing food, self-feeding and using various types of utensils.

As such, a speech-language pathologist (SPL) can play a significant role in communication and swallowing difficulties related to dementia (Sharp & Shega, 2009). As per Berkman et al (2019), the SLP’s main role is to work as part of the multidisciplinary team in screening, assessing, diagnosing and treating people with dementia. According to Vitale et al (2011), one of the most important roles played by SLP is to educate other professionals in the multi-disciplinary team, third party players and legislators on the patient’s needs while diagnosing and managing cognitive swallowing and communication disorders related to dementia (Heuer & Willer, 2020).

Upon developing a treatment plan for cognitive-communication and swallowing difficulties, the SLP is supposed to ensure the patient adheres to the treatment prescriptions while documenting the progress (Vitale et al, 2011). Similarly, according to Saccasan & Scerri (2020), the SLP is responsible for providing indirect intervention to dementia patients through individual caregivers and ensuring there is an adequate environmental modification to suit the patient’s needs.

Due to the speech-language challenges, dementia patients may find themselves discriminated against in social situations. For instance, too much noise in the background when talking to the patient may cause distraction and prevent them from effectively communicating (Berkman et al, 2019). as such, it is the role of SPL professionals and caregivers to ensure that there is minimum destruction when communicating with the patient.

Lastly, it is the role of SLP, in collaboration with the caregiver to ensure that the patient has a regular and familiar dining environment and to ensure the food is cut and prepared in a manner that can be easily picked (Sharp & Shega, 2009). Moreover, Saccasan & Scerri (2020) insisted that the SLP should work together with the caregiver in modifying the diet and ensure that the food is visually appealing.

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References

Berkman, C., Ahronheim, J. C., & Vitale, C. A. (2019). Speech-language pathologists’ views about aspiration risk and comfort feeding in advanced dementia. American Journal of Hospice and Palliative Medicine®, 36(11), 993-998.

Heuer, S., & Willer, R. (2020). How is quality of life assessed in people with dementia? A systematic literature review and a primer for speech-language pathologists. American Journal of Speech-Language Pathology, 29(3), 1702-1715.

Hopper, T., Cleary, S., Oddson, B., Donnelly, M. J., & Elgar, S. (2007). Service delivery for older Canadians with dementia: A survey of speech-language pathologists. Revue canadienne d’orthophonie et d’audiologie-Vol, 31(3), 115.

Kaf, W. A., Barboa, L. S., Fisher, B. J., & Snavely, L. A. (2011). Effect of interdisciplinary service learning experience for audiology and speech-language pathology students working with adults with dementia.

NHS (2021) Mental Health, Dementia. Retrieved from https://www.england.nhs.uk/mental-health/dementia/ (Accessed on 21/5/2021).

Saccasan, N., & Scerri, C. (2020). Dementia knowledge, attitudes and training needs of speech–language pathology students and practitioners: A countrywide study. International Journal of Language & Communication Disorders, 55(6), 955-970.

Sharp, H. M., & Shega, J. W. (2009). Feeding tube placement in patients with advanced dementia: the beliefs and practice patterns of speech-language pathologists.

Tomoeda, C. K. (2001). Comprehensive assessment for dementia: A necessity for differential diagnosis and management. In Seminars in speech and language (Vol. 22, No. 04, pp. 275-290). Copyright© 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.:+ 1 (212) 584-4662.

Tomoeda, C. K., & Bayles, K. A. (1990, November). The efficacy of speech-language pathology intervention: dementia. In Seminars in Speech and Language (Vol. 11, No. 04, pp. 311-320). © 1990 by Thieme Medical Publishers, Inc..

Vitale, C. A., Berkman, C. S., Monteleoni, C., & Ahronheim, J. C. (2011). Tube feeding in patients with advanced dementia: knowledge and practice of speech-language pathologists. Journal of pain and symptom management, 42(3), 366-378.