Early diagnosis, and intervention with speech therapy, and the opportunity for people to access care "online" or "virtually" from licensed Speech-Language Pathologists (SLPs) may help to delay the onset or progression of issues which impact self-expression. With speech therapists available nationwide, virtual speech therapy offers increased access to personalized care and a specialized therapy plan that is tailored to each individual for more focused therapy sessions, and possibly faster results in a shorter time frame.

A key goal of an intervention plan is to maintain current cognitive function, as much as possible. This involves developing coping skills that enable individuals to manage their decline, as effectively as possible, and address memory loss or other cognitive deficits.

Speech and language therapy means not only working on speech-related issues, but also stimulating the brain so that language skills, including memory, also improve. This enhances a person's quality of life, interpersonal and familial relationships, and the impact of worsening symptoms.

ASSESSING SPEECH AND LANGUAGE SKILLS : A CLOSER LOOK AT COMMUNICATIONS CHALLENGES

ALZHEIMER'S DISEASE (AD)

For the 55+ million people worldwide who are living with AD or another form of dementia, communication is challenging because the individuals have trouble remembering.1 According to the National Institute on Aging, AD causes some people to get confused about language, struggle to find words or forget what they want to say.2 For example, the person might forget or no longer understand English, if it was learned as a second language, and prefer to use only the first language learned, such as Spanish. Other issues include:

• Finding the right word or losing his or her train of thought when speaking
• Understanding what words mean
• Paying attention during long conversations
• Remembering the steps in common activities — cooking,3 paying bills, or getting dressed
• Dealing with background noises from the radio, TV, or conversations
• Becoming very sensitive to touch and to the tone and loudness of voices

These individuals may show signs⁴ of memory loss, challenges in planning or solving problems, confusion with time or place and trouble understanding visual images and spatial relations. All of these symptoms can lead to social isolation and diminished quality of life.

To help make communication easier, experts offer these tips:

• Make eye contact and call the person by name.
• Be aware of your tone, how loud your voice is, how you look at the person, and your body language.
• Encourage a two-way conversation, for as long as possible.
• Use other methods besides speaking, such as gentle touching.
• Try distracting the person if communication creates problems.

1. who.int/health-topics/dementia#tab=tab_1.
2. nia.nih.gov/health/alzheimers-caregiving-changes-communication-skills
3. nia.nih.gov/health/adapting-activities-people-alzheimers-disease
4. cdc.gov/aging/healthybrain/ten-warning-signs.html
5. www.parkinson.org/sites/default/files/documents/addressing-communication-challenges.pdf.

PARKINSON'S

The Parkinson's Foundation advises that most people with the disease experience a soft voice volume, that may be difficult to hear. Loss of automatic facial expression can be misinterpreted as boredom, anger or sadness.5

Mood changes in Parkinson's, such as: apathy, depression or anxiety can also affect communication, as speech may become fast or slow, rushed, mumbled or slurred. Some people notice a stutter, or difficulty starting to speak, and their voices can become quieter, breathy, hoarse, or change in pitch.

The following tips can ease communications:

• Try to have conversations one-on-one or in small groups.
• Reduce or remove distractions, like TV, radio or music, when conversing.
• Be close to each other when you talk, so it is easier to hear. Avoid yelling from another room in the house! Encourage the individual to take a deep breath before beginning to speak, to enhance his or her vocal loudness.
• Give him/her time to respond or participate in conversation.
• Do not make assumptions about how your loved one is feeling based on facial expressions.

ADOPTING THE USE OF TECHNOLOGY

According to Pew Research Center, the adoption of technology by Americans in the oldest age group has grown "markedly" over the past decade: 61% of those 65+ own a smartphone and 45% reported using social media.6 As the elderly become more comfortable with using new technology, it becomes easier for them to receive virtual care.

Dementia and gait impairments often coexist in older adults and

patients with neurodegenerative diseases, such as AD and Parkinson's.7 Since mobility issues often restrict someone's ability to travel to clinics or treatment facilities, the availability of online speech therapy is key to accessing timely, ongoing care.

This option can relieve some of the burdens and stress for family members and caregivers. It improves quality of life for those who prefer the familiar surroundings of home, instead of traveling to brick and mortar offices. There is the benefit of scheduling flexibil

• 6 pewresearch.org/fact-tank/2022/01/13/share-of-those-65-and-older-who-are-tech-users-has- grown-in-the-past-decade/
• 7. ncbi.nlm.nih.gov/pmc/articles/PMC4119872