“In conversation with Jenny and Rebecca, speech and language therapists”

As speech and language therapists working with people with dementia, we’re often asked ‘what is it that you actually do?’  It’s an important question – how can anyone understand what we can’t do when they don’t know what we can?  We want to provide hope and goals to work with but we don’t want to raise unrealistic expectations.  We work with people’s retained strengths to support their weaknesses.  We can’t change the speech/ language symptom but we can find ways round the problem.  We can develop strategies to support families and carers to set up the best communication environment. 

We can promote carer understanding of why something specific has become more difficult for someone with dementia.  We’re problem-solvers who offer best advice – speech, language, environment, eating, drinking & swallowing.  Let’s think about what we’re frequently asked:

Q. What is the best way to help someone find a word?

  • Everyone is different, and it may need trial and error to find out what works for them.
  • Encourage the person to say it different words.
  • Can they fetch or point to something that gives a clue to what you are trying to say?
  • Have a stock of resources such as calendar, map, newspaper, address book which  can be used to indicate the word or name the person is looking for
  • If the person is able to read, labels and lists of words can be useful or a keying or pocketbook with family names
  • It may help to have a sheet of favourite topics so you can focus on the subject at the beginning of the conversation.
  • Make use of photos and emojis in messaging.
  • Remember, if you know what the person is trying to say, they have already succeeded in communicating and there is no necessity to say the actual word.  If they still want the satisfaction of saying the word, do they prefer a written prompt, the sound of the first letter, or a lead in phrase eg “knife and…….”

See Tips for Talking for more suggestions

Q.  We are obliged to wear masks on the ward, which makes it very hard to communicate. Is this compulsory?

Wearing your mask protects the other person from infection, and local guidance in hospitals and care homes reflects this.  We are allowed to remove them to assist communication if the person is struggling to understand. Before you decide not to use a mask, think about the following:

  • Try a see-through mask.
  • Cut out background noise
  • It is important to optimise hearing. Make sure hearing aids are worn and working, or use a personal listening device such as  Crescendo 60 – Sarabec Hearing Products or similar

If you decide to take off your mask, try to keep your distance and take other precautions, such as opening the window, and don’t visit if you have any symptoms of infection.

Q. My wife keeps asking for her mother as though she is still alive, what should I do?

This is a difficult question because you do not want to upset the person & everyone brings their own personal history. 

  • Avoid contradicting or telling her she is wrong
  • Try to acknowledge the feelings and lead the conversation round, for example “We had some lovely times on holiday with your mum didn’t we?  Here’s the picture of when we went to Blackpool.”
  • Try to identify any specific triggers – does she ask for mum when she feels upset or anxious?  Is there a pattern?  Sometimes it can be an expression of a feeling that’s hard to express
  • I personally don’t feel comfortable with talking as though it is true that the Mum is still alive, but this does work for some people. You have to be true to yourself as well as trying to maintain trust

Q. My partner is having some trouble eating and drinking, spitting out food and sometimes coughing. What should I do?

  • There are a few things you can do to check the mealtime environment. Sitting up at the table in a quiet environment makes eating and drinking easier.
  • Try keeping a note every time there is a problem, you may notice a pattern and learn what to avoid.
  • Tastes can change when you have dementia, or as you get older, so don’t assume the person still wants the old favourites. Try making some changes and see what goes best.
  • Adding sweet sauces or chutneys often helps, as the person’s ability to detect sweet flavours may be reduced, so food can taste more bitter than it used to.
  • If the person is coughing or choking frequently, struggling to swallow medication, having chest infections or losing weight, speak to the GP. You may need help from a Speech and Language Therapist, dietitian or other health professional
  • Regular and thorough cleaning of the teeth and mouth, whether you have teeth, dentures or no teeth, is very important to prevent the build up of bacteria in the mouth and reduce the risk of chest infections.

Helpful resources

Eating and Drinking for a person with dementia which you will find here

Oral health and dementia which you will find here

Communication and Mealtimes toolkit which you will find here

Contributors

Jenny Keir & Rebecca Kellett, Speech & Language Therapists NHS Tayside/ NHS Lothian

we posted this blog during #DAW2022 adn decided to share it again just in case you missed it.

Source link

Comments are closed.