Speech and Language Referral

suvi · August 15

My DH has AD and Logopenic Aphasia. Last summer his neurologist (in a Memory and Cognition Clinic) referred him for a speech and language evaluation, and after a 2 session lengthy assessment we were basically told that the aphasia was too far progressed for her interventions and it would just be frustrating for him. She gave us some basic strategies and also info for the future.

So, we check in with the neurology PA every 6 months which honestly is of limited help but I appreciate having someone to call about medication, etc. A month ago the PA suggested my DH have another speech and language evaluation with someone he knows (in a satellite clinic of the original eval!). This clinician will want to do her own assessment. I balked. The testing is such a rough procedure, my DH doesn’t want to (he would agree if I asked him though). The PA has not followed through with the referral anyway. I’m feeling guilty about letting it go and wondered if anyone has experience with these services. My DH is stage 5, sometimes some stage 6 signs. He has a lot of word finding issues, organizing his thoughts. It’s so hard to parse out what’s primarily language—it was very sobering how poorly he did on the evaluation.

blacksparky · August 15

My DW is in the same stage as your LO. At this point of her journey I will not introduce any procedure or testing that will possibly slow down or improve her terrible journey. Some people may think I’m just being selfish but in the long run my DW will die from this and I don’t want to see her suffer anymore than she has to.

SDianeL · August 15

my husband stage5-6 in memory care saw a speech therapist twice and it was a waste of time. He couldn’t understand the therapist and couldn’t remember the recommendations. The therapist stopped the visits after discussing with me. Knowing what I know now I would not agree to put him through that.

Vitruvius · August 15

My DW has a related dementia, Semantic Dementia aka Semantic Variant of Primary Progressive Aphasia. She was also referred to a speech therapist in early Stage 6. We stopped after one “training” session, which just confused and frustrated her. It also deeply embarrassed my DW. As we drove home from the session she tearfully asked “do you still love me?” somehow thinking her poor performance might affect the way I felt about her. So not only was it difficult for her, but her reaction was heartbreaking to me. The notion that mid Stage dementia patients can benefit from speech therapy seems ridiculous to me. Sorry to be so blunt.

Biggles · August 15

My DH is in the same boat. Speech therapy was stressful and useless. My decision for the last maybe 8 months is to go for comfort and no stress. I adore him and I will not put him under any more pressure or stress than just getting through the day as happily as we can, and we have lovely days. You have to do what you think is right. For us no more tests, probing or asking questions that make my DH feel more confused.

GothicGremlin · August 15

I'm so sorry, suvi.

My sister had a very close diagnosis - early onset Alzheimer's and the logopenic variant of Primary Progressive Aphasia. She was probably mid-stage 4 when she was diagnosed, so she was together enough that she and I could discuss her wishes, options, etc.

We tried speech therapy once, and to be honest (at least in my sister's case), it wasn't helpful. Like others have said, it was frustrating for her, and painful for me to watch.

You're right, it's all very sobering, and I felt the same way when she did poorly on the neurological exam.

I wouldn't feel guilty about letting this go.

Carl46 · August 15

I agree that speech therapy is ineffective with dementia. Speech therapy involves learning, forming new memories, which a person with AD cannot do.

bjtm1969 · August 16

We had a similar experience recently with the speech and language evaluation and subsequent appointments. The evaluation was so much more comprehensive than any of the neurologists have done but also very frustrating for my husband. It did give me an objective look at how poorly he was doing in a variety of areas. We were given a number of suggestions for memory aids, some of which we were already using. I knew we were not getting anywhere when my husband looked at the therapist and said "Why would I try that when I have my wife to help me?" At earlier stages in the disease, I believe speech and language therapy can be another support but it wasn't really helpful for us.

suvi · August 16

Thank you for the honest replies. The referral doesn’t make sense to me, especially a year after his last testing. A lot of the clinical input hasn’t made sense though. I appreciate the input.

Speech and Language Referral

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