For The Health of It    
Speech Therapy in Convalescent Care - Why?

Our communication system which involves speaking, hearing and understanding the speech of others, reading and writing, is a unique human achievement. It plays a role in all aspects of everyday life. Disorders of communication are frequently found among older adults and may result from hearing loss, stroke, cancer or other diseases of the larynx (voice box), Parkinsonism, Alzheimer's disease, or other neurological disorders. The communication disorders vary widely and include difficulty with speaking and with understanding verbal messages. The effect of these disorders may be very frustrating and bewildering and may lead to severe withdrawal and isolation.

Speech-Language Pathologists, sometimes informally referred to as speech therapists, provide services necessary for the diagnosis and treatment of speech, language and swallowing disorders. Certified speech-language pathologists receive at least a Master degree from an accredited program, conduct a clinical fellowship year and pass a national examination to receive their Certificate of Clinical Competence (CCC) in speech language pathology from the American Speech-Language Hearing Association. In addition, California requires speech-language pathologists to meet licensing requirements.

What are the Disorders of Communication Which Most Frequently Affect Older People?

Dysarthria: Dysarthria interferes with normal control of the speech mechanism. Speech may be slurred or otherwise difficult to understand due to lack of ability to produce speech sounds correctly, maintain good breath control and coordinate the movement of the lips, tongue, palate and larynx. Diseases such as Parkinsonism, Multiple sclerosis and palsy, as well as strokes and accidents can cause Dysarthria. Many individuals with Dysarthria are over 65. Their communication skills often may be improved by appropriate therapy.

Aphasia: Aphasia is a complex problem which may result to varying degrees, in reduced ability to understand what others are saying, to express oneself, or to be understood. Some individuals with this disorder may have no speech, while others may have only mild difficulties recalling names or words. Other may have problems putting words in their proper order in a sentence. The ability to understand oral directions, to read, to write and to deal with numbers may also be disrupted. Strokes are the major cause of aphasia in the elder population. It has been estimated that there are over one million adults with aphasia in the United States today. Many can be helped to communicate more effectively.

Voice Problems: Laryngectomy, the surgical removal of the larynx due to cancer, affects approximately 8,000 individuals each year, most of whom are older. They can usually learn speech again by learning specific techniques, by using electronic devices or by surgical implant of voice prosthesis.  Other forms of disease may result in complete or partial loss of the voice. Most of these problems can be treated.

Other Communication Problems: Brain disease that result in progressive loss of mental faculties may affect memory, orientation to time, place, person and organization of thought processes; all of which may result in reduced ability to communicate.

What we look for here at Paradise Skilled Nursing:

Dysphagia: Dysphagia, or difficulty in swallowing can cause food to enter the airway, resulting in coughing, choking, pulmonary problems or inadequate nutrition and hydration with resulting weight loss, failure to thrive, pneumonia and death. Dysphagia may be due to various neurological, structural and cognitive deficits. It may be the result of head and neck trauma, stroke, neuromuscular degenerative diseases, head and neck cancer or encephalopathies.  Approximately 44% of persons over the age of 65 have difficulty swallowing and 61% of residents in Nursing homes have some form of Dysphagia.  Treatment varies greatly depending on the cause, symptoms and type of swallowing problem. A Speech-Language Pathologists may recommend exercises, position, or strategies to help swallowing more effectively and make recommendations for specific food and liquid textures that are easier and safer to swallow.

General Signs of Swallowing Problems:

Health Care Plan Coverage: Medicare and Medi-Cal and other federal and health programs provide payment for services. Most group and individual health care plans cover physicians services related to the cause of or the complication associated with communication and swallowing disorders. Health plans also may provide for speech-language pathologists to evaluate and treat impairments or loss of speech, language or swallowing that are caused by accident or illness. There may be a specific reference to speech-language pathologists  in your health care plan. Look for terms as speech therapy or speech pathology. Service may also be included in references to Physical therapy and other rehabilitation services or as other medically necessary services or therapy.

Dr. Ron Brown has administered various heath care facilities for the past thirty years and is best known locally for his development and opening of Country Crest in Oroville in 2002. Currently he oversees facility management of Paradise Skilled Nursing in Paradise and Shadowbrook Health Care in Oroville.  He can be contacted at
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