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.