Speech Problems with Dementia

The video clip below depicts how dementia impacts the ability to speak (time: 4 minutes).

Alzheimer’s disease and other dementias can have a tremendous impact on one’s ability to talk and use language as a means of communication. Initially, individuals with dementia are still able to communicate with some help, but as the disease progresses, so does the inability to communicate via speech. This loss of function is frustrating for the Alzheimer’s patient, their loved ones, and their caregiver. When trying to communicate with dementia patients, it can be helpful to understand the ways in which speech is lost and how Alzheimer’s patients attempt to compensate for this loss.

At first, an individual with dementia may have difficulty coming up with specific words, but they can usually give enough clues about the forgotten word that their ability to communicate is usually still intact. For example, a dementia patient might say, “I’d like to eat what we eat after supper. It’s cold and sweet. My favorite is chocolate.” From these clues, one is able to deduce that the missing word is “ice cream.”

As dementia advances, so do speech problems, and communicating becomes more difficult. Dementia patients might start using very general words and phrases when communicating, such as “it,” “the thing,” and “you know,” leaving no lead way for someone else to guess what it is they are trying to communicate. This can be aggravating and upsetting for the dementia patients – they want to communicate verbally, but they simply can’t do it like they want to. This can also be frustrating for caregivers and loved ones who want to communicate with the dementia patients, and want to help them communicate, but doing either is a challenge.

Problems with speech and communicating will continue to progress as the disease progresses, and eventually the dementia patient might only be able to use particular phrases or words. This extremely limited language might include simple greetings, such as “How you doing?” or “How’s it going?” Remember, the individual with Alzheimer’s disease wants to communicate, but they simply don’t have the words to express what they would like to say.

With time, speech problems may progress to the point that communication is no longer possible. A dementia patient may not be able to speak, or have garbled speech, or they could babble like an infant. At this stage of the disease, the brain is so badly damaged that the individual is seeking sensory stimulation, which may present in the form of oral stimulation. As a result, the dementia patient makes movements with their mouth that feels interesting to them, such as opening and closing the mouth, resulting in a smacking sound.