With the project ‘Knowledge stops Dementia’, the Deutsche Stiftung für Gesundheitsinformation und Prävention, together with the Akademie für menschliche Medizin, presents a broad spectrum of measures to prevent the development of dementia. Within preventive measures, speech therapy offers an important therapeutic component that enables dementia patients to maintain contact with their environment. Especially in the early stages of the disease, no time should be lost and no one should hesitate to seek speech therapy treatment. 

A guest article by speech therapist Karen Grosstück from Hamburg

In the course of dementia, many people affected by the disease suffer from problems in finding words, often also problems in understanding complex texts. The change in communicative skills often makes the everyday life of patients and caregivers very difficult. It is a complicated situation for the people concerned and also represents a major challenge for the social environment. Difficulties in communication can affect the relationship between partners or family members and  in the course of time, can also complicate care and support.

If you search for the right word more and more often, you might ask yourself: am I just dizzy or is it already the beginning of dementia?

Difficulty in finding the right word does not necessarily mean the beginning of dementia, but there are typical language symptoms and communicative problems in Alzheimer’s dementia that occur early on. 

These include:

  • Affected persons digress in conversation, abruptly change the topic or prefer to stick to recurring topics
  • Those affected show less and less motivation to initiate conversations or to participate in conversations in everyday life
  • Expressions become increasingly lacking in content
  • Word-finding disorders make it difficult to formulate your own thoughts
  • Language comprehension problems lead to misunderstandings in daily life
  • Conversation contents are quickly forgotten

This is where speech therapy can help. Speech therapists support people with dementia in their ability to communicate and advise relatives in dealing sensitively with altered communication skills. 

What do speech therapists do? 

Speech therapy deals with disorders of speech, speaking, voice and swallowing in children and adults. Speech therapists determine whether such a disorder exists and know how to treat it. After a diagnosis, treatment and consultation follow with the aim of improving the quality of speech, language, voice and swallowing. Speech therapy is a medical remedy and can be performed on an outpatient basis, as prescribed by the physician, or as part of an inpatient treatment. 

What exactly can speech therapy do for people with dementia in particular?

In cases of dementia, speech therapy can cover both speech and swallowing. Logopaedic services should therefore maintain the communication and the nutritional situation, under changed conditions, in the best possible way. The treatment is always based on the everyday life of the person affected and takes into account his or her previous life as well as the current life context. Already at the beginning of the illness, logopedic consultation and preventive offers can help to prevent communication disorders. 

The prerequisite for contact with a person with dementia is an exclusively resource-oriented view. Since learning in the classical sense can no longer take place, it is necessary to discover new possible approaches and adequate them to the patient, in order to support and maintain the abilities as long as possible. The most important resource here is often nonverbal communication. Communicative skills such as facial expressions, gestures and speech melody can remain stable for a long time in Alzheimer’s disease. Thus, the important principle in conversation is: It is more important how something is said and less important what is said. Principles such as “the tone makes the music” and “relationship before content” characterize communication with a person with advanced dementia.

What are the goals of speech therapy for dementia?

  • The preservation of the highest possible communicative independence of the affected person
  • The participation of patients in social life
  • The best possible quality of life for the affected person as well as relief, support and advice for relatives

The earlier a person with dementia has the opportunity to express his or her language problems and work on them in a logopaedic therapy, the more he can benefit from it in the future. Especially at an early stage of the disease, many people try to hide their language deficits, hide word finding disorders and thus get into additional stress situations. Here it helps to be able to discuss the problems with a speech therapist in a protected setting. For many of those affected, it is important to write down their thoughts or biography at this early stage of the illness. Speech therapy can make it possible: it works with the emotional abilities and cognitive reserves of a person and uses the neuronal plasticity of the brain, which is still possible in the case of dementia. 

Where can you find more information and help?

Unfortunately, the benefits of early logopedic treatment for people with dementia are still not widely known. Often patients come to speech therapy too late and are no longer able to benefit from speech-activating treatment. Therefore, it is important to us to point out this largely unknown but extremely effective therapeutic option in the course of the project Knowledge stops Dementia. You can find out more about the topics covered by speech therapy, the methods used in speech therapy, how swallowing can be supported and much more in the brochure ‘Speech Therapy and Dementia’ by the Arbeitskreis Logopädie Demenz Hamburg in cooperation with the Alzheimer Gesellschaft/ Kompetenzzentrum Demenz Schleswig-Holstein. 

Current addresses of speech therapy practices in your area with a focus on dementia treatment can be found at https://www.dbl-ev.de/service/logopaedensuche/ and on our website under Knowledge stops Dementia

To the author:

Karen Grosstück works as a speech therapist with a focus on neurological speech and language therapy. She runs a private practice for speech therapy and nutrition in Hamburg. Further information can be found here.

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Unfortunately, every year more and more people worldwide fall ill with Alzheimer’s disease or other forms of dementia. In 2016, there were already almost 2.0 million people affected in Germany, 10 million in Europe and 35.5 million worldwide. Unfortunately, the trend is rising, with 115 million cases of the disease predicted worldwide by 2050.

The fear of Alzheimer’s dementia is great, because until now this disease was considered incurable. There is still no effective drug, although the pharmaceutical industry has been working hard on it for a long time. The reason for this lies in the nature of the disease: it is now known that dementia is a generalised metabolic disease, which manifests itself in the central nervous system, i.e. in our brain. 

The good news, however, is that the US neurologist Dr. Dale Bredesen – after more than 30 years of intensive research – has shown that it is possible to prevent and cure Alzheimer’s dementia, at least as long as there is no overly advanced damage to certain nerve cells of the brain. According to his research findings, the causes of the disease are not only to be found in the genes, but our lifestyle is also decisive: undetected infections and chronic inflammation, long-term unhealthy nutrition or malnutrition, as well as exposure to certain toxins are essential factors that can trigger and also accelerate the disease.

Thus, dementia diseases such as Alzheimer’s disease would no longer be an unsolvable fate, as the disease is reversible through changes and adjustments in lifestyle. It is therefore also possible to protect oneself from dementia in a preventive way. Moreover, it has been shown in many dementia patients that the disease can be stopped or the course of the disease can even be reversed, even if one is in a slightly advanced stage. 

Since this great opportunity must be seized, the project Knowledge stops Dementia would like to give you the opportunity to find suitable contacts in the preventive and therapeutic field. On the following pages we have therefore started to list doctors, therapists and coaches who practice in the field of dementia prevention or dementia therapy. All the therapists mentioned work holistically and individually on the patient with basic pillars in nutrition therapy, exercise therapy and other holistic forms of therapy.  The identification and reduction of harmful substances and microbial loads is also part of the preventive as well as therapeutic approach, which is also particularly important in biological dentistry, for example. Please be aware, though, that the individual therapeutic approaches may vary and we cannot evaluate them in detail at this point.

In addition to the appropriate therapy, it is extremely important to treat dementia patients appropriately in everyday life, which can push relatives safely to their limits. It is therefore of particular concern to us to point out here projects and initiatives that offer dementia patients and in particular their relatives (and caregivers)  help and support, exchange of experience, special programs, but also to offer possible starting points and face-to-face counseling.. The first step has now been taken with the ‘Singing Hospitals’, but we are sure that more projects will follow in the near future!

Just have a look at our Webpage under ‚Links and Support’

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