title: Speech Therapy Alzheimer’s: Language Rehabilitation, Swallowing, and Adapted Communication
description: Complete guide to speech therapy for Alzheimer’s: role of the speech therapist, language assessment, rehabilitation of communication disorders, aphasia, dysphagia, stimulation exercises, non-verbal communication techniques, and support for language evolution.
keywords: speech therapy Alzheimer’s, speech therapist, language disorders, aphasia, dysphagia, communication, rehabilitation, stimulation, assessment
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Alzheimer’s, 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 phrases.” “She no longer understands what we say.” “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’s disease. Your loved one searches for words, sentences unravel, conversation becomes impossible, and gradually, silence settles in. But the speech therapist, an expert in language and communication, can intervene to stimulate, preserve, and adapt remaining abilities, while teaching you strategies to maintain the connection despite the fading words.
This guide explains the crucial role of the speech therapist in supporting Alzheimer’s’s patients and provides you with keys to preserve communication until the end.
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Table of Contents
1. What is a speech therapist?
2. The role of the speech therapist in Alzheimer’s’s
3. The speech therapy assessment
5. Management of swallowing disorders
6. How to consult a speech therapist
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What is a speech therapist? {#qu-est-ce}
Definition
Speech Therapist: A paramedical professional specialized in communication disorders, oral/written language, and swallowing.
Etymology: “Ortho” (correct, straight) + “Phonè” (voice, sound).
Mission: To prevent, assess, and rehabilitate communication, language, and swallowing disorders.
Training
State Diploma: Bac +5 (Master’s 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)
- Observed language difficulties (words, sentences, comprehension)?
- Evolution (since when, progression)?
- Current communication (speaking? Understanding?)?
- Feeding (swallowing disorders)?
- Denomination (show images, name objects)
- Verbal fluency (name as many animals as possible in 1 minute)
- Repetition (simple/complex sentences)
- Automatisms (counting, reciting days of the week)
- Simple/complex commands (“Show me the door”)
- Questions (yes/no, multiple choice)
- Short text (story comprehension)
- Read words, sentences
- Write name, dictated sentences
- Slow decline
- Preserve abilities
- Maintain pleasure in communication
- Adapt strategies
- Show photo (apple)
- “What is it?”
- If searching: Hint (“It’s edible, it’s red…”)
- Alzheimer’s Training: Maintaining Communication
- SCARLETT: Language and Vocabulary Games
- Free Guide to Support Alzheimer’s’s Patients
Areas of Intervention
Children: Language delays, dyslexia, stuttering.
Adults: Aphasia (Stroke), voice (singers, teachers).
Elderly People: Alzheimer’s’s, Parkinson’s, Stroke.
Dysphagia: All ages (swallowing disorders).
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The Role of the Speech Therapist in Alzheimer’s’s {#role}
Specific Goals for Alzheimer’s’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: Neural networks for language (cognitive stimulation).
3. Support evolution
Stages: Adapt strategies according to 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’s (advanced stages).
Prevention: Aspiration, pneumonia.
Adaptation: Textures, postures.
When to Consult?
As soon as diagnosed: Even in mild stages (prevention, early stimulation).
Language disorders: Frequent word-finding difficulties, incoherent sentences.
Swallowing disorders: Coughing during meals, choking.
Difficult communication: Frustration (patient, caregiver).
Any evolution: Deterioration (reassessment).
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The Speech Therapy Assessment {#bilan}
Process
1. Interview
With caregiver:
Questions:
With the Alzheimer’s’s patient:
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, oral residues.
Specific tests: Varied textures (liquid, pureed, solid).
Assessment Results
Written report:
Preserved abilities: What the patient can still do.
Identified disorders: Aphasia (type), dysphagia (severity).
Severity: Mild, moderate, severe.
Recommendations: Rehabilitation, frequency, caregiver strategies.
Goals: Realistic, adapted to stage.
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Language Rehabilitation {#reeducation}
Principles of Alzheimer’s Rehabilitation
No cure: Progressive disease (inevitable decline).
Goals:
Stimulation > Strict rehabilitation (pleasure, functional).
Exercises for Mild/Moderate Stages
1. Denomination
Name objects, images:
Method:
Goal: Maintain vocabulary, lexical access.
2. Verbal Fluency
Name words in a category:
Example: “Name as many animals as you can in 1 minute.”
Stimulates: 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: Nursery rhymes, songs, poems (preserved procedural memory).
6. Working Memory
Repeat: Series of numbers, words (memory span).
7. Reading, Writing
Read texts: Aloud (maintain abilities).
Write: Journal, lists (as much as possible).
Exercises for Advanced Stages
Severely altered language:
Non-verbal communication:
Gestures: Pointing, nodding.
Facial expressions: Smiling, frowning.
Contact: Hand on arm (presence).
Music: Singing together (preserved musical language).
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: Depending on preference, mobility.
Adaptation: Exercises according to fatigue, mood, daily abilities.
SCARLETT Program
Complement to speech therapy:
Language games: Words, vocabulary, sentences.
Daily stimulation: 15 min/day (between speech therapy sessions).
Adapted progression: Levels adjusted.
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Management of Swallowing Disorders {#deglutition}
Dysphagia Assessment
Speech therapist observes:
Swallowing: Liquids, solids (varied textures).
Signs of aspiration: Coughing, wet voice, choking.
Chewing abilities: Chewing effectively?
Meal duration: Too long (fatigue)?
Swallowing Rehabilitation
1. Muscle Exercises
Strengthening: Tongue, cheeks, lips (mobility, tone).
Example: Push tongue against palate, puff cheeks.
2. Postures
Chin down: Towards chest (protects airways).
Head rotation: Towards weak side (facilitates passage).
3. Swallowing Maneuvers
Supraglottic swallowing: Hold breath, swallow, cough (closes larynx).
Forced swallowing: Swallow hard (propulsion).
4. Texture Adaptation
Recommendations: Thickened liquids, pureed foods (according to severity).
Tests: Different textures (determine tolerated).
Practical Tips
Position: Sitting upright (90°).
Small bites: Reduce quantity.
Time: Allow time to chew, swallow.
Supervision: Never leave alone while eating.
Hydration: Thickeners (water, juice).
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How to Consult a Speech Therapist {#comment-consulter}
Prescription
Primary care physician: Prescribes speech therapy sessions.
Geriatrician, neurologist: Also (if specialized follow-up).
Prescription: Necessary (for reimbursement).
Prescription: “Assessment + rehabilitation of language + swallowing disorders in Alzheimer’s’s.”
Where to Find a Speech Therapist?
1. Private Practice
Private office: Directory (fno.fr – National Federation of Speech Therapists).
Home visits: Many travel (ideal for Alzheimer’s’s).
2. Hospital
Hospital, clinic: Geriatrics, neurology, rehabilitation services.
Consultations: On-site.
3. SSIAD, HAD
Home Nursing Care Service: Speech therapist in the team (sometimes).
4. Nursing Home
If resident: Freelance speech therapist (sessions on-site).
Cost and Reimbursement
Rate: €30-50/session (variable).
Social Security: 60% reimbursement (if prescribed).
Supplementary insurance: Additional coverage (check contract).
Overbilling: 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).
Reassessment: Every 6 months (to adapt).
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Caregiver Tips: Communicate Better
Communication Techniques
1. Calm Environment
No TV, radio (distractions).
Quiet place: Facilitates concentration.
2. Speak Clearly
Short, simple sentences.
Familiar words: No jargon.
Articulation: Slowly, distinctly.
3. One Idea at a Time
No multiple questions simultaneously.
Wait for a response before continuing.
4. Rephrase
If misunderstood: Repeat differently (don’t shout).
Patience: Allow time to find words.
5. Non-Verbal Language
Gestures: Accompany words (show object).
Eye contact: Face to face (attention).
Touch: Hand on arm (reassuring).
Facial expressions: Smiling, gentleness.
6. Value Efforts
Don’t correct errors systematically (frustration).
Encourage: “Yes, keep going.”
Praise: Efforts (not just successes).
7. Give Time
Don’t rush: Response can take 30 seconds.
Silence is OK: Don’t fill it immediately.
When Words Are Missing
Offer a word: If searching (but let them try first).
Multiple choices: “Do you want water or juice?”
Yes/no: Closed questions (if sentences are impossible).
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Testimonials
Claire, caregiver for her mother
“Mom constantly lacks words. The speech therapist came to our home (2 sessions/week). Vocabulary exercises, denomination. Also taught me: Speak briefly, patience, gestures. Mom speaks a little better, less frustrated. Communication improved. The speech therapist = Communication coach.”
Marc, son of his father
“Dad has severe dysphagia, repeated pneumonias. The speech therapist assessed: Mixed textures, thickened liquids, postures. Trained me to monitor meals. No more pneumonias since. The speech therapist saved Dad’s health (aspiration prevention).”
Sophie, caregiver for her husband
“My husband is in an advanced stage, hardly speaks anymore. The speech therapist said: Non-verbal communication. We sing together (musical memory is OK), I hold his hand, we look at photos. Even without words, the bond persists. The speech therapist gave me tools to maintain the relationship despite the silence.”
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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 the remaining ones, and teach you to communicate beyond words. With their help, silence becomes less heavy, gestures become language, and human connection survives the erasure of phrases. The speech therapist is the guardian of communication when words are no longer enough.
The keys to speech therapy intervention:
1. ✅ Comprehensive assessment (language, swallowing)
2. ✅ Regular stimulation (adapted exercises)
3. ✅ Preservation of abilities (slow decline)
4. ✅ Adaptation of communication (stages of evolution)
5. ✅ Training for caregivers (techniques)
6. ✅ Management of dysphagia (aspiration prevention)
7. ✅ Non-verbal communication (advanced stages)
You are not alone. Our Alzheimer’s training addresses communication. SCARLETT stimulates language daily. Free guide: All tips.
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DYNSEO resources to stimulate language:
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The speech therapist enters the silence and sows bridges within it. When words flee, they teach your loved one to catch them. When sentences break, they show you how to understand the fragments. And when silence settles in permanently, they teach you the language of gestures, glances, and clasped hands. Thanks to them, even without words, you remain connected. The speech therapist is the translator of the unspeakable.