Dementia is an umbrella term for a range of conditions characterized by cognitive decline beyond what is expected in normal aging, as a result of brain cells degeneration. There are a few types of dementia, the most common being Alzheimer’s Dementia. Other forms include Vascular Dementia, Dementia with Lewy Bodies and Frontotemporal Lobe Dementia. Each person with dementia is unique, and the condition may present differently depending on the type of dementia and the stage of progression. However, common features of dementia include memory loss, communication difficulties, difficulty completing everyday tasks, and personality changes.
Dementia and Communication
As dementia progresses, it gradually affects the way a person communicates. Changes often include:
- Less frequent initiation of conversations
- Delayed responses
- Difficulty finding words they want to use
- Use of language that is vague or does not make sense
- Difficulty keeping up with conversations and processing information
- Difficulty expressing their thoughts and feelings
A decline in communicative ability is often frustrating and upsetting for persons with dementia and their loved ones. A person with dementia experiencing communicative difficulties may feel anxious, embarrassed, and/or depressed, and they may become withdrawn.
Dementia and Swallowing Function
People with dementia may also experience difficulties with eating and drinking. These difficulties may present as:
- Coughing or choking when eating and/or drinking
- Taking a long time to eat
- Refusing to eat and/or drink
- Holding food in their mouths
- Reduced appetite
Not everyone with dementia will develop a swallowing disorder, or dysphagia. However, many do and this may increase with the advancement of the disease. Below are some explanation on how dementia can affect feeding behavior and swallowing:
- Cognitive impairment: resulting in the inability to stay focused and attentive during meal times, difficulty following meal times or remembering if one has eaten, aversion to some types of food or food refusal, challenge with following instructions to participate during meal time
- Awareness and sensory issues: inability to recognize food or fluids, reduced sensory awareness of food or fluids in mouth during eating (thereby pocketing their food and not swallowing), changes in taste and smell preferences.
- Physical challenges: reduced ability to feed self with poor use of utensils and improper posture. The impaired ability to feed self may be made worse in the presence of cognitive deficits
- Swallowing disorder from reduced swallowing efficiency especially during acute illness
- Medication such as antipsychotics and antidepressants, which can cause dry mouth and drowsiness
Without the proper intervention, impaired swallowing function may result in dehydration, malnutrition and/or pneumonia (chest infection).
Author: Annie Lim, Speech Therapist