Written by Heather McCurdy, M.S., CCC-SLP, CBIS
Heather provides in home speech therapy services in Northwest IN, and virtual services for the IN residents.
Let's begin with a brief overview of dementia.
- Definition: dementia is a combination of cognitive + behavioral symptoms as a result of a disease.
- Common diseases that can cause dementia include: Alzheimer's disease, Parkinson's disease, Frontotemporal lobar degeneration, Lewy Body disease, Vascular diseases, Huntington's disease, infections, Traumatic Brain Injury (TBI) and substances or medications
- Dementia is most commonly caused by Alzheimer's disease
Is dementia a normal part of aging?
NO! Typically dementia symptoms are present years before a diagnosis is given.
How is dementia diagnosed?
The DSM-5 is utilized to diagnose dementia and specific criteria must be met to obtain an accurate diagnosis. A differential diagnosis (or determining the type of dementia) can be completed after a dementia diagnosis has been given. A neurologist and neuropsychologist may be a part of the diagnostic team.
What is the purpose in obtaining a diagnosis?
- The progression of the dementia type can be known, therefore, planning can occur & education can be provided
- Resources such as caregiver support groups and respite care can be provided
- Treatment services can be provided to provide the person with dementia (PWD) independence for as long as possible
What is the SLPs role in serving a person with dementia and their family?
- Education for caregivers. This may consist of environmental modifications or recommendations on how best to communicate with the PWD. In addition, speech therapy can aim to alleviate some of the caregiver burden with proper implementation of environmental modifications and direct treatment strategies.
- Recommendation and implementation of environmental modifications (i.e. creating a "Memory Station," labeling of clothing in dressers)
- Intervention to specifically target cognitive communication (which may include internal memory strategies & external memory strategies) and cognitively stimulating home exercise program. The goal of training strategies is to promote overall independence OR decrease an undesired behavior (i.e. asking repetitive questions). The goal of providing a home exercise program is to cognitively stimulate the brain to create new neural pathways and strengthen existing ones to slow the progression of the disease.
- Providing baseline cognitive testing. This can be useful to determine the extent to which the disease has progressed.
- Brain health education and resources can be discussed. There are certain controllable factors that contribute to overall brain health which can include diet, exercise, and social connection. This education will only be provided if and when the patient and/or the family are appropriate.
Are services actually covered since progress won't be made?
Yes, Medicare part B is required to cover "maintenance program" services due to the Jimmo settlement from 2015. Specific qualifications have to be met in order to receive services as part of a maintenance program, however a SLP can determine eligibility for a maintenance program; it is worthwhile to inquire about services!
Below are some resources for caregivers & SLPs. There are many additional resources available that aren't listed; this is simply an initial list.
Resources for caregivers:
- Alzheimer's association. www.alz.org/
- Dementia Society of America. www.dementiasociety.org/
- Dementia. www.asha.org/public/speech/disorders/dementia/
- National Memory Screening. http://nationalmemoryscreening.org/screening-sites-info.php
Resources for SLPs:
- The "ICF- Dementia" is a tool to provide person-centered care.
- The "Memory Handbook" has a lot of information about strategies and general information that can be provided to families or PWD.
For patient-centered goals to promote independence and maintain quality of life, schedule a free virtual consultation by clicking the button.
Heather McCurdy is the owner and speech-language pathologist (SLP) at Mindful Speech Therapy. She is particularly passionate about those who sustain traumatic brain injuries as well as adults with dementia. She strives to provide functional, meaningful and relevant treatment.
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