Dementia: A Speech Therapist’s Perspective

Recognizing and Responding to Changes in Memory Has Value

Most of us notice “senior moments” from time to time – a speech language pathologist can evaluate your ability to learn and to remember.  Learning language and developing the understanding of concepts, math, science and social interaction are all related.  Our brains gradually develop throughout childhood and become fully developed by about the age of 25 years.  By the age of 40 our brains typically have been functioning very well with the use of frequent new learning, adding life experiences, which adds to our long-term memory.  Between 40 – 50 years of age there are underlying changes in the processing speed of neurons.  There are hormonal changes taking place, which we may not notice.  There is often a decrease in quality sleep emerging.  Our ability to use insulin to promote use of carbohydrates for fuel in our brains sometimes begins to decrease.  As we continue the aging process beyond 50 and into retirement years common changes have been noted, such as: 

Decrease in brain mass – areas of the brain related to higher level thinking, memory and processing emotions begin to shrink starting around age 60-70

Decline in brain cell connections and fewer connections available – slows the speed of processing information – thinking and understanding become slower

There is no Cure for Alzheimer’s Dementia, so we Must Focus on Prevention

 It is common for a person to experience a sense of embarrassment, shame and fear in moments of forgetting.  Not being able to think of a word, forgetting someone’s name, not remembering where an item was placed can cause emotional stress.  Once someone has established higher level thinking and has lived a life with effective learning, he may avoid recognizing such changes in function as signs. Since Alzheimer’s is known to have no cure, most people experience fear and avoidance, which increases anxiety. Ignoring changes in memory, learning, reaction time and functional language can not only prevent an opportunity to search for underlying problems, it can actually make the problem worse. Being honest with your doctor and/or speech therapist and asking questions can be the first step in preventing or slowing down the progression of dementia.

There are many factors, which result in memory lapses and / or confusion, therefore it is essential to explore why you are experiencing these changes.  It is important for loved ones to watch for and respond to such changes, as some people lack awareness of these changes or will make excuses.  

Common factors which impact changes in learning and remembering items are:

  • Urinary tract infections
  • Thyroid imbalances
  • Depression
  • Alcohol or drug abuse
  • Side effects from medications
  • Sleep Apnea 
  • Dietary (vitamin or mineral deficiencies) 
  • Metabolic dysfunctions (dehydration, kidney failure, COPD)
  • Infections
  • Heart disease
  • Brain tumors
  • Environmental toxins
  • Concussions – brain trauma 

Alzheimer’s Disease is Only One Form of Dementia

Dementia is a set of symptoms vs a disease, so addressing the underlying symptoms can reverse some types of dementia

These factors can present as dementia (a set of symptoms impacting multiple cognitive deficits). If these reversible causes are all ruled out and the dementia is progressive, there is a greater chance of you being diagnosed with another type of dementia.  Given the above list of reversible causes, it is important to be very open with your doctor who takes the time to listen and to test / explore possibilities. In addition, a speech language pathologist can help improve memory loss deficits and many other cognitive functions.

An Ounce of Prevention is Worth a Pound of Cure, A Stitch in Time Saves Nine

These are common sayings which apply to this topic, as ignoring changes in memory and learning can often lead to dangerous and / or expensive situations.  Here are two examples:

An elderly woman listens to the doctor explain that her insulin dose needs to be changed.  She responds affirmatively, yet does not fully understand and later does not recall the details.  Therefore, she does not adjust her insulin, which results in unsafe blood sugar levels.  She arrives in the emergency room a couple months later, due to poorly controlled blood sugar.  

An elderly man is instructed on purchasing and using a walker, as his balance is impaired and his blood pressure sometimes drops quickly.  He does not recall the details, while he is shopping for the walker.  He becomes upset and confused by his inability to remember and leaves the store without purchasing a walker.  As he is walking to the dining room in his senior apartment building, his blood pressure drops and he falls.  He is taken by ambulance to the hospital and requires surgery for a broken hip.  

These are examples of situations where lack of recall, self-awareness or impaired judgement result in serious situations.  Not recognizing and responding to issues in time can end up being quite costly, painful or even fatal.  

To summarize, openly discuss concerns with your family and medical provider. Many medical issues can make memory and learning difficult. Some of these issues can be managed by your healthcare provider, resulting in improved learning, memory and quality of daily life.

Information provided by Dawn Witcraft, Speech Language Pathologist at Prairie Rehabilitation.

Dawn Witcraft, MA CCC-SLP completed her undergraduate degree from St. Cloud State University and her Master of Arts from the University of South Dakota in 1995. She has targeted training in strategies for working with those facing various forms of dementia and has a passion for educating others about dementia. Dawn works mostly in skilled nursing facility and outpatient settings, but in the past has worked in school settings with students from birth to 21 years of age, as PRN support in hospitals and at a pediatric therapy clinic.

About Prairie Rehabilitation 

At Prairie Rehabilitation our Physical Therapy, Occupational Therapy, Hand Therapy and Speech Therapy experts are passionate about helping our patients reclaim their way of life and function. It’s about you; you are unique with distinct qualities, abilities, and needs. At Prairie Rehabilitation we embrace the philosophy of “Patient First” care; treating each individual with precise and personalized care. To achieve the best results and to speed your recovery, we are committed to utilizing the most clinically proven and current concepts in rehabilitation. 

A full list of our outpatient clinic locations can be found here. For those who cannot make it to out to one of our clinics, we also offer our Prairie at Home program. More information on this programcan be found here. Telehealth appointments (also known as video visits) are another option to receive the therapy you need from the comfort of your own home. More information on telehealth can be found here.

Everything You Need to Know About Telehealth for Physical Therapy, Occupational Therapy and Speech Therapy



 You’re probably hearing a lot about telehealth, or “video visits” as a way to receive treatment, but you’re not quite sure what it is and what it means to you as a patient. We want to answer the questions you may have in regards to telehealth for physical therapy, occupational therapy and speech therapy.  You don’t have to suffer through the COVID-19 crisis in pain, Prairie Rehabilitation is here to help. If you have any questions other than the ones listed below, please call our main office at 605-334-5630.

We asked one of our physical therapists, Jeff Steinberger, for his perspective on working with patients via telehealth. Steinberger has worked primarily with low back and hip pain patients but has patients with other injuries scheduled for the coming weeks. Here’s what he had to say: 

“As a physical therapist, I have found telehealth very convenient for my patients. With minimal moving of the camera to demonstrate and observe, it has been easy and very safe for those that we have chosen to use video visits. Video or virtual visits have been very handy and I expect will become much more common in the future due to the ability to complete from the home.”

What is telehealth?

Telehealth is the means to deliver therapy to people in need of services through secure technology—smartphone, tablet, or computer with a camera. Your therapist is responsible for developing a plan of care and for providing the delivery of that care. You receive a comprehensive visit with your therapist in the comfort of your home.

What do I need to participate?

Prairie Rehabilitation is offering telehealth to patients via a device—smartphone, or a tablet, or a computer with a camera. Our patient care coordinator schedules your appointment; you receive a secure link via email. Click the link, and you are ready to go.

How will I benefit from telehealth?

1. Convenience. There is no transportation time or costs. You can save money on gas, and the time it takes to drive to the clinic.

2. More convenience: there’s no need to take time off work. You can schedule your appointment during a break, over your lunchtime or before or after work. You can see your therapist from anywhere you feel you have enough privacy.

3. Even more convenience: eliminate child or eldercare issues. If you are caring for others or even serving as a teacher, you don’t have to find someone to fill in for you, which is even more challenging during social isolation.

4. Ergonomic evaluation: Let us help you get comfortable—from home work stations, sleeping positions, and other postural positions that may create pain.

5. Less exposure to illness – you won’t have to leave your home for therapy.

What if I just had surgery, or I’m getting ready for surgery; will this help me?

Physical therapists and occupational therapists are movement specialists, and movement affects improvement. Keeping your body and joints in motion is essential pre- or post-surgery.

We recognize that not all medical situations are right for telehealth, and you can trust our honest assessment of your case.

Does my insurance cover telehealth?

During the current public health emergency, most insurance companies are covering this service as if you were present in the clinic.

Is telehealth secure?

Absolutely. We are using the latest technology, which is HIPAA compliant. You are in the privacy of your own home, so you may access wherever you are most comfortable.

Who can I contact to find out if telehealth is right for me?

A list of our clinic locations may be found by clicking here, or through our Contact Us form here.

Video on Positive Adult-Child Communication Goes Viral

October 6, 2016 – Atlanta Speech School’s video “Every Opportunity” has gone viral around the country and world. The video stars a young boy who explains how he feels when an adult ignores him or loses patience with him. The story goes on to demonstrate how positive changes in adults’ communication behavior can profoundly affect a child’s vocabulary, language, speech, spelling, reading and other literacy skills to help them prosper into adulthood. Initially picked up by the Huffington Post, the video was then featured on the Scary Mommy blog, and HLN’s Weekend Express interviewed Comer Yates, the school’s executive director.

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The Art of Communication

August 23, 2016 – I recently traveled with my daughter, Hannah, on a class trip to China. We expected to visit and learn about the iconic landmarks on our itinerary—Great Wall of China, Forbidden City, Olympic Village. What we didn’t expect was to learn about speech-language pathology and rehabilitation during our tour. However, a visit to a clinic in Chengdu taught us that the field of speech-language pathology is relatively new to China.

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