See also Communication
Acknowledgement
We would like to thank speech and language therapists Julia Johnson and Phil Maillard, Regional Neurosciences Centre, King’s College Hospital, London & Clinical Advisor on Progressive Neurological Disease, Royal College of Speech and Language Therapists, London, for their contributions.
We would also like to acknowledge the use of information from:
. ISBN-10: 1861563582.The evidence for the benefits of speech and language therapy programmes is increasing. One of these is the Lee Silverman Voice Treatment (LSVT) – an intensive Individual programme involving 16 sessions over a month that focuses exclusively on voice, especially volume. Improvements in voice loudness, intonation and quality have been recorded post-treatment and maintained for up to two years afterwards1. Although LSVT can be very effective, this method may not be appropriate for everyone and does not treat all the communication symptoms of Parkinson’s. It may be most beneficial for people who are newly diagnosed and those who are less cognitively impaired.
Between 50-80% of people with Parkinson’s experience some difficulties with swallowing, especially in the mid-advanced stages of the condition. Treating these is vital to prevent serious problems from occurring, such as aspiration (which can lead to chest infections) and choking.
Treatments that the speech and language therapist may suggest include:
In severe cases, the best solution may be an alternative method of eating and drinking – for example by a tube inserted directly into the stomach (gastrostomy feeding) or through the nose (nasogastric feeding). These approaches require the involvement of other members of the multidisciplinary team, including doctors and nurses. Nasogastric feeding may be only offered as options to people who are hospital inpatients in some countries.
See the section on Eating and Drinking on this website for more information [under construction].
Drooling (where people find saliva leaks out of their mouth) is a common problem that is partly related to swallowing difficulties and can cause considerable social embarrassment.
The problem may not be that too much saliva is produced, but that the natural tendency to swallow regularly is slowed down. This causes the saliva to accumulate in the mouth, rather than being swallowed regularly, and sometimes leak out of the mouth. Drooling is often aggravated by the stooped posture and poor lip closure that some people with Parkinson’s experience.
Treatment strategies may include:
Some mental processes are important factors in a person’s ability to communicate, learn and adapt. If these are impaired or slowed down, most strategies that a speech and language therapist may suggest will not work.
Depression, which is very common in Parkinson’s, can have a considerable affect on communication and a person’s motivation to adopt any approaches the speech and language therapist suggests.
Some people with Parkinson’s can also experience changes in cognitive functioning as the condition progresses. Sometimes these indicate the presence of a dementia, but in many cases they are specific to Parkinson’s and may include:
Speech and language therapists need to be aware of any cognitive problems that a person has. This will help them to communicate more effectively with their client and plan appropriate treatment strategies that take account of these factors.
The way we stand or sit. Postural problems, especially a tendency to stoop forwards, are common features of Parkinson’s.
Health profession that helps people of all ages who are disabled, ill or aged to remain independent and lead fulfilling lives at home, in work and through leisure pursuits. The methods they use include specific activities and equipment.
See section on Occupational Therapy.
A class of older drugs that are used to treat Parkinson's. They work by reducing the amount of acetylcholine in the body and thereby facilitate dopamine cell function.
Also called antimuscarinics.
See also Types of medication available.
A neurotoxin used in minute doses as a treatment for muscle spasms and dystonia.
Involuntary sustained muscle contractions causing abnormal movements and postures.
See section on Dystonia.
A mental state of melancholia, unhappiness or sadness characterized by decreased energy, reduced interest in sex, suppressed appetite, too much sleep or sleep disturbance, a pessimistic sense of inadequacy, a despondent lack of activity, despair, and discouragement.
Brain functions related to thought processes such as as thinking, reasoning and judgement, remembering, imagining, learning, intuition, sense and perception, and understanding.
The progressive deterioration in intellectual and cognitive abilities including impairment of memory, inability to pay attention and learn, make decisions and solve problems. This typically has an adverse effect on emotions, and learning capabilities and may affect language, personality and abstract reasoning and judgement.
Dementia is not a disease in itself, but a generic term given to a group of symptoms that characterize other diseases and conditions.
