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My mother currently lives in AL. She is suffering from dementia, mainly memory and executive processing function. Her doctor recommended speech therapy to help with her memory problems. She met with the therapist today, and when my sister talked to her right afterwards my mom was very upset. It seems that just talking with somebody about her memory problems made her realize how problematic they were, and that made her very sad. Most of the time she just does her best to deal with things and keeps a pretty good attitude. And she forgets that she forgets. I am just wondering if the speech therapy will be worth it. I don't even know what it would involve. Mom's understanding is still quite good (one of the reasons they don't think it is Alzheimer's), so it is mainly memory and problems making and following through with any plans. If there isn't much benefit we don't see a reason to make Mom unhappy. In case it makes a difference, she has been diagnosed with NPH (normal pressure hydrocephalus), which can cause cognitive and walking and incontinence problems. It is often treatable with a brain shunt, but tests indicate Mom is not a good candidate for the shunt.

I’m a speech pathologist and my mom just died of severe vascular dementia which robbed her, ultimately, of her ability to reason, form cogent verbaliztions, her vibrant personality, her ability to walk, and, finally, her ability to communicate in any form other than a brief hand squeeze. I found in working with mom as well as other clients that it’s most important to stay in the “here and now” - talking about what mom could visually observe (flowers, pets, neighbors, the current weather) as we went on walks in her wheelchair. When she was still able to occasionally recognize things, we’d go over her old family photo albums and talk about people, places and activities she once enjoyed. I would never and would strongly urge everyone, not to ask, “Do you know who that is?”, “Remember where this is?”, “What’s my name?”, “What should we do today?”. It’s best to put questions in an “or” construction format - “Would you like to color or look at an album?” Or “Would you like a banana or an apple?” This helps the dementia patient better formulate an appropriate response without constantly forcing them to “search” for a word that the individual may not be able to retrieve in a timely manner.

Ultimately, swallowing, feeding and recommending the most appropriate food choices is an important aspect in the role of the speech pathologist as the patient deteriorates. Aspiration and the ineffective/slowing motion of the epiglottis can cause aspiration which could lead to fluid buildup in the lungs and cause other significant health problems. Speech pathologists also help families and caregivers understand the significance of the health dangers of dementia and with predicting what stages may come next as the patient ages as well as the best ways to communicate. Just my thoughts and experiences.
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Reply to sscoale
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I’m a retired speech therapist and my mom survived a stroke which resulted in aphasia when she was 85. She refused to work with a therapist and more or less rehabbed herself until she fell and broke her hip at 90.
Following the hip repair surgery most of her functional language was lost and she stopped speaking altogether when she was about 93.
I agree with most if not all of the statements here. The personality of the therapist IS important. A bubbly college intern turned my mom off, but she related far better to people who were more matter of fact and stuck to business.
She could respond to written and picture cues, and we used them. In conversation, she needed one person to speak at a time, and we dealt with that.
My major concern was always that someone who didn’t know her would think her cognitive status was worse than it was, because of her language losses. Ultimately dementia overtook her issues with language.
I think her comfort and pleasure should determine whether speech/language therapy continues. If she still has skills that allow her caregivers and family connect with her, that also should be taken into consideration. In any event, family members should be given reports of assessment and therapy to help with their decision making regarding continued speech/language services.
Hope these thoughts can be of some help.
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Reply to AnnReid
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Well, I'm a speech therapist, and I worked with a number of patients with dementia. In the very early stages, when they can still learn things, I taught them techniques and tricks to support memory and word finding, like using notes and cues, or 'talking around' when they couldn't think of the name of an object. For some folks, just working on tasks makes them feel a little better; they don't feel so helpless. As others have said here though, it's different with everyone.

It sounds like your mom's doc may be thinking more of addressing the hydrocephalus-related deficits, although if she can't have a shunt I'm not sure what else medically can be done there. Anyway, you and she can talk, and I think it should be up to her. If she wants to try, go for it; if it upsets her, I would say not. Sending {{hugs}} to you both. :)
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Reply to LeahM116
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My husband is going to do speech therapy but that is for his aphasia. He will also be doing cognitive memory therapy. He is upset that I've been asked to assist in doing his meds and helping him with his memory by playing simple games with him.
It is not an easy road to travel on.

Keep your chin up.
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Reply to Val3rie
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chdottir, there are probably some personalities that take this harder than others. My mom was insulted I got her a pill box and refused to use it for a few months (then agreed). She resents a reminder list I posted on her door and won’t look at it. I read an article about music therapy for Alzheimer’s patients, maybe you could look into music instead or as a complement. Ask the therapist about it.

See if you can’t help frame it like going to an exercise class, she’s working out her brain to stay healthy. They’ll just be bummed out some days, we will too, I wouldn’t give it up quite yet! Your mom’s very lucky to have you and your sister. Good luck!
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Reply to Zdarov
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I would say to get a new therapist. The one my mom had in rehab gave us fabulous strategies to help my mom who kept saying she can't remember what she is supposed to do. We made written schedules and cues and we incorporated those with OT strategies. Visual cues, like a list of snacks she could make for herself posted on fridge would make her feel more independent. A daily schedule on her Walker would remind her of IL activities and to go to the bathroom, take a walk, etc. The ST really did the most to help us learn to help her. And he was very gentle about explaining her memory issues.
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Reply to Judysai422
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I guess I need to talk to the therapist. Mom has no problems with her speech, except for when she sometimes has problems coming up with the word she wants.

She is still extremely capable of communicating.

Susan
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Reply to chdottir
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Speech therapy doesn't help memory problem. But there are side effects of dementia that speech therapists can help with. Swallowing issues are at the top of the list. Get more information
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Reply to jjariz
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Talk to the therapist. Explain that the session upset Mom and why it did. I realize that speech therapy is more than just learning to talk again. I see it being good for a stroke victim or for someone with a speech problem. But these people can retain what they are taught. A Dementia patient can't retain the info. Reasoning and processing are no more. I can't see continuing with therapy if it upsets Mom. On the whole, my Mom knew something was happening and just went with it. When I'd ask a question she would just stand there. I'd say "Mom!", she'd say " I'm thinking".
My GF is a hairdresser. I would go to her shop and visit. She had a client who had Dementia. GF said "Dottie, u have a birthday coming" Dottie's answer was "Yes, but I can't remember what day. But...I will remember and call you tomorrow with the day". Isn't it better to have Mom this way then depressed because someone keeps bringing up her memory problem.
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Reply to JoAnn29
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I think it truly depends on the therapist. After my husband’s stroke, his speech therapist worked on much more than how to form words and sentences with him. He had aphasia, which means that the words and thoughts were in his brain but when he spoke, they came our garbled or nonsensical.

His therapist played the child’s game “Memory” with him. She also showed him flash cards with photos of things on them and he had to recognize what the photo was and verbalize it. I think it really helped him, although now, even 15 years later, he will still occasionally not be able to share a thought or idea.

If you decide to ask for therapy, Mom should be evaluated to make sure she’s a good candidate for help. Please don’t expect miracles, though.
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Reply to Ahmijoy
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Just bumping this up :)
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Reply to chdottir
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