Speech Problems with Dementia

This video clip depicts typical progression of the effects of dementia on ability to speak (time: 4 minutes).

With Alzheimer’s disease, the ability to talk and use language as a means of communication is greatly affected. Initially, an individual with dementia is 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. As the person trying to communicate with an individual with dementia, understanding the ways in which speech is lost and how an Alzheimer patient attempts to compensate for this loss is helpful.

Initially, an individual with dementia has difficulty coming up with specific words. However, the ability to communicate is still intact, as the person with Alzheimer’s is able to give enough clues for someone else to figure out the word they aren’t able to find and use. 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 becomes more advanced, speech problems become greater, and language becomes unclear. For instance, a dementia patient will use 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 is aggravating and upsetting for the person suffering from Alzheimer’s disease, as they want to communicate verbally, but they can’t do so very well. This is also frustrating and difficult for the caregiver or loved one, as they no longer can offer much help to the dementia patient trying to communicate.

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

With time, speech problems progress to the point that communication is no longer possible at all. A dementia patient may not speak at all, may have garbled speech, or may 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.