title: Speech Therapy Alzheimer: language rehabilitation, swallowing and adapted communication
description: Comprehensive guide to speech therapy Alzheimer: role of the speech therapist, language assessment, communication disorders rehabilitation, aphasia, dysphagia, stimulation exercises, non-verbal communication techniques and language evolution support.
keywords: speech therapy Alzheimer, speech therapist, language disorders, aphasia, dysphagia, communication, rehabilitation, stimulation, assessment
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Alzheimer, speech therapy, speech therapist, language, communication, aphasia, dysphagia, rehabilitation, stimulation, assessment
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Reading time: 30 minutes
"Mom can’t find her words anymore." "Dad keeps repeating the same sentences." "She doesn’t understand what we tell her anymore." "He chokes while eating." "How to maintain communication? Can a speech therapist help?"
Language and communication disorders are among the most frustrating symptoms of Alzheimer's disease. Your loved one searches for words, sentences unravel, conversation becomes impossible, and gradually, silence sets in. But the speech therapist, an expert in language and communication, can intervene to stimulate, preserve, and adapt the remaining abilities, while teaching you strategies to maintain the connection despite the words that are fading away.
This guide explains the crucial role of the speech therapist in Alzheimer's support and gives you keys to preserve communication to the end.
Table of Contents
1. What is a speech therapist?
2. The role of the speech therapist in Alzheimer's
3. The speech therapy assessment
What is a speech therapist? {#qu-est-ce}
Definition
Speech Therapist
Paramedical professional specialized in communication, oral/written language, and swallowing disorders.
Etymology
"Ortho" (correct, straight) + "Phonè" (voice, sound).
Mission
Prevent, evaluate, rehabilitate communication, language, swallowing disorders.
Training
State Diploma: 5 years (Master level).
Skills:
- Oral language disorders (articulation, vocabulary, syntax)
- Written language disorders (reading, writing)
- Voice disorders (dysphonia)
- Swallowing disorders (dysphagia)
- Stuttering, cluttering
- Communication disorders (aphasia, autism)
Fields of Intervention
Children
Language delays, dyslexia, stuttering.
Adults
Aphasia (stroke), voice (singers, teachers).
Elderly
Alzheimer, Parkinson, stroke.
Dysphagia
All ages (swallowing disorders).
The role of the speech therapist in Alzheimer's {#role}
Specific Objectives for Alzheimer's
1. Maintain communication
Preserve
Existing language abilities.
Slow down
Linguistic decline.
Adapt
Communication to remaining abilities.
2. Stimulate language
Exercises: Vocabulary, word memory, comprehension.
Activation: Language neural networks (cognitive stimulation).
3. Support evolution
Stages: Adapt strategies based on disease progression.
Transition: To non-verbal communication (advanced stages).
4. Train caregivers
Communication techniques: How to speak, listen, understand.
Strategies: Maintain connection despite word loss.
5. Manage dysphagia
Swallowing disorders
Common in Alzheimer's (advanced stages).
Prevention
Wrong routes, pneumonias.
Adaptation
Textures, postures.
When to consult?
Upon diagnosis
Even mild stage (prevention, early stimulation).
Language disorders
Frequent word-finding difficulties, incoherent sentences.
Swallowing disorders
Coughing during meals, choking.
Communication difficulty
Frustration (patient, caregiver).
Any evolution: Aggravation (re-evaluation).
The speech therapy assessment {#bilan}
Procedure
1. Interview
With caregiver:
Questions:
With person with Alzheimer's:
Observation: Spontaneous conversation.
2. Language tests
Oral expression:
Comprehension:
Reading, writing:
3. Swallowing tests
If disorders
Observation
Drink water, eat bread (texture tests).
Signs
Coughing, wet voice, mouth residues.
Specific tests
Varied textures (liquid, pasty, solid).
Assessment results
Written report
Preserved abilities
What is still possible.
Identified disorders
Aphasia (type), dysphagia (severity).
Severity
Mild, moderate, severe.
Recommendations: Rehabilitation, frequency, caregiver strategies.
Objectives: Realistic, adapted to the stage.
Language rehabilitation {#reeducation}
Alzheimer's Rehabilitation Principles
No cure: Progressive disease (inevitable decline).
Objectives:
Stimulation > Strict rehabilitation (pleasure, functional).
Exercises for mild/moderate stage
1. Denomination
Name objects, images:
Method:
Goal: Maintain vocabulary, lexical access.
2. Verbal fluency
Say words of a category
Example
"Say as many animal names in 1 minute."
Stimulate
Semantic memory, word retrieval.
3. Complex sentences
Describe images
Show scene
"What is happening?"
Construct sentences
Syntax, coherence.
4. Comprehension
Commands: "Show me the window, then touch your nose."
Short stories: Read, ask questions.
5. Automatisms
Recite: Rhymes, songs, poems (procedural memory preserved).
6. Working memory
Repeat: Series of numbers, words (memory span).
7. Reading, writing
Read texts: Aloud (maintain abilities).
Write: Journal, lists (as long as possible).
Exercises for advanced stage
Very altered language
Non-verbal communication
Gestures
Pointing, nodding head.
Facial expressions
Smiling, frowning.
Contact
Touch hand (presence).
Music
Sing together (musical language preserved).
Familiar objects
Show, touch (sensory stimulation).
Goal
Maintain connection (even without words).
Sessions
Frequency
1-2 times/week (or more as needed).
Duration
30-45 min (limited attention).
Home or office
According to preference, mobility.
Adaptation
Exercises based on fatigue, mood, abilities of the day.
EDITH program
Speech therapy complement
Language games
Words, vocabulary, sentences.
Daily stimulation
15 min/day (between speech therapy sessions).
Adapted progression
Adjusted levels.
Managing swallowing disorders {#deglutition}
Dysphagia evaluation
Speech therapist observes
Swallowing
Liquids, solids (varied textures).
Signs of wrong routes
Coughing, wet voice, choking.
Chewing abilities
Chews effectively?
Meal time: Too long (fatigue)?
Swallowing rehabilitation
1. Muscle exercises
Strengthening: Tongue, cheeks, lips (mobility, tone).
Example: Push tongue against palate, inflate cheeks.
2. Postures
Chin tuck: Toward chest (protects airways).
Head rotation: weak side (facilitates passage).
3. Swallowing maneuvers
Supraglottic swallow: Hold breath, swallow, cough (closes larynx).
Effortful swallow: Swallow hard (propulsion).
4. Texture adaptation
Recommendations: Thickened liquids, blended foods (according to severity).
Tests: Different textures (determine tolerated).
Practical advice
Position
Sit upright (90°).
Small bites
Reduce quantity.
Time
Allow time to chew, swallow.
Supervision
Never leave alone to eat.
Hydration: Thickeners (water, juice).
How to consult a speech therapist {#comment-consulter}
Prescription
General practitioner
Prescribes speech therapy sessions.
Geriatrician, neurologist
Also (if specialized follow-up).
Prescription
Necessary (reimbursement).
Prescription
"Assessment + rehabilitation language disorders + Alzheimer's swallowing."
Where to find a speech therapist?
1. Private
Private practice: Directory (fno.fr - National Federation of Speech Therapists).
Home: Many make house calls (ideal for Alzheimer's).
2. Hospital
Hospital, clinic: Geriatrics, neurology, rehabilitation department.
Consultations: On site.
3. SSIAD, HAD
Home Care Nursing Service: Speech therapist in team (sometimes).
4. EHPAD
If resident: Freelance speech therapist (sessions on site).
Cost and reimbursement
Fee
30-50€/session (variable).
Social Security
Reimbursement 60% (if prescription).
Insurance
Complement (check contract).
Fee overruns
Some private practitioners (sector 2).
Frequency
Mild stage
1 session/week (stimulation).
Moderate stage
1-2 sessions/week.
Advanced stage
As needed (often reduced, or focus on dysphagia).
Re-evaluation
Every 6 months (to adapt).
Caregiver advice: communicating better
Communication techniques
1. Calm environment
No TV, radio (distractions).
Quiet place: Facilitates concentration.
2. Speak clearly
Short sentences, simple.
Familiar words: No jargon.
Articulation: Slowly, distinctly.
3. One idea at a time
No multiple questions simultaneously.
Wait for response before continuing.
4. Reformulate
If not understood: Repeat differently (do not shout).
Patience: Allow time to search for words.
5. Non-verbal language
Gestures
Accompany words (show object).
Eye contact
Face to face (attention).
Touch
Hand on arm (reassures).
Facial expressions
Smile, gentleness.
6. Value
Do not correct mistakes systematically (frustration).
Encourage: "Yes, keep going."
Congratulate: Efforts (not just success).
7. Give time
Do not rush: Response may take 30 seconds.
Silence OK: Do not fill immediately.
When words are missing
Suggest a word
If searching (but allow to try first).
Multiple choices
"Do you want water or juice?"
Yes/no
Closed questions (if sentences impossible).
Testimonials
Claire, caregiver for her mother
"Mom constantly misses words. Speech therapist came home (2 sessions/week). Vocabulary exercises, denomination. Also taught me: Speak briefly, patience, gestures. Mom speaks a bit better, less frustrated. Communication improved. Speech therapist = Communication coach."
Marc, son of his father
"Dad severe dysphagia, repeated pneumonias. Speech therapist assessed: Mixed textures, thickened liquids, postures. Trained me to monitor meals. No more pneumonias since. Speech therapist saved Dad's health (preventing wrong routes)."
Sophie, caregiver for her husband
"My husband advanced stage, almost no speech. Speech therapist said: Non-verbal communication. We sing together (musical memory OK), I hold his hand, we look at photos. Even without words, the bond persists. Speech therapist gave me tools to maintain the relationship despite the silence."
Conclusion: Words fade, the bond remains
The speech therapist cannot prevent words from escaping, but they can slow their departure, teach your loved one to use those that remain, and teach you to communicate beyond words. With their help, silence becomes less heavy, gestures become language, and the human connection survives the erasure of sentences. The speech therapist is the guardian of communication when words are no longer enough.
Keys to speech therapy intervention:
1. ✅ Complete assessment (language, swallowing)
2. ✅ Regular stimulation (adapted exercises)
3. ✅ Preserving abilities (slow down decline)
4. ✅ Adapting communication (evolution stages)
5. ✅ Caregiver training (techniques)
6. ✅ Dysphagia management (preventing wrong routes)
7. ✅ Non-verbal communication (advanced stages)
You are not alone. Our Alzheimer's training addresses communication. EDITH stimulates language daily. Free guide: All advice.
DYNSEO resources to stimulate language:
The speech therapist enters the silence and builds bridges there. When words escape, they teach your loved one to catch them. When sentences break, they show you how to understand the fragments. And when silence sets in permanently, they teach you the language of gestures, looks, squeezed hands. Thanks to them, even without words, you remain connected. The speech therapist is the translator of the unspeakable.