How could a speech and language therapist help with swallowing problems?

'My brother has advanced dementia and is having difficulties swallowing. Why has he been referred to a speech and language therapist?'

Speech and language therapists (SALTs) assess difficulties with swallowing and communication. They can offer support through swallowing and speech exercises, dietary advice and changes to medication. 

Difficulties in swallowing, known as dysphagia, may arise from a number of medical causes. In dementia they may be caused by damage to parts of the brain that co-ordinate the muscles responsible for swallowing. SALTs can assess the extent of these difficulties using a variety of swallow tests.

Nutrition

Difficulties with swallowing may make it harder to eat an adequate and nutritious diet. SALTs may help here by modifying the types, size and consistency of a person's food. They can also suggest nutritional supplements such as milkshakes, juices or soups that are easier to swallow and are fortified with nutrients.

In cases where swallowing is extremely difficult, SALTs might suggest alternative methods of feeding, such as feeding tubes.

Swallowing

SALTs can also guide a person through exercises that train the muscles used in swallowing. They may also help them to adjust their posture. This both improves someone's ability to swallow and reduces the risk of food accidentally going into the windpipe and lungs (this is called aspiration and can be life-threatening).

Speech

Dementia may affect a person's ability to speak fluently. This may be due to problems with the muscles that allow us to form speech, known as dysarthria. Alternatively people may have difficulty understanding and using words and sentences, which is called dysphasia.

SALTs can help in both cases through various exercises such as naming pictures, repeating words and teaching techniques that strengthen the muscles of the mouth.

Next steps

• Read more articles from Dementia together magazine.