Meeting with Speech Therapist

Yesterday I met with Jill Summersall who is the Speech Therapist who has been investigating Mam's difficulty in expressing herself. I met her at the Speech Therapy of the General Hospital and was with her for about an hour as we discussed the nature of Mam's problem and how we may be able to help her communicate better.

Mam's condition seems to be quite rare - a progressive dysphasia (aka aphasia) which has gradually got worse rather than having been attributed to a single event. Jill wanted to know how long ago I noticed that Mam had a word problem and I mentioned how I picked up on her growing inability to finish crossword puzzles about seven or eight years ago - something that was about more than mere tiredness. Jill thought this was significant - a high level language ability starting to atrophy.

Jill does not think that Mam is "confused". She thinks, as do I, that Mam knows what she wants to say but that she is finding it difficult to retrieve the word: especially if the word is one she doesn't use often. Mam will frequently describe the elusive word - and this is something we should encourage her to do when she's in difficulty. i.e. rather than us trying to prompt her; getting Mam to tell us about the word. For example, her description of the word "cactus" involved Mam saying "plant in desert", "when you touch it, it feels hot".

Mam's Occupational Therapist, Bulbul, has noticed elements of "dyspraxia". The OT observed Mam when she was using the toilet and saw that Mam was doing certain of her personal hygiene tasks in the wrong order.

A number of things are making Mam's communication difficult.

One is her short term memory. In one test, a few sentences of a short story were read to her and Mam was incapable of remembering anything that had been said to her. Her old knowledge, on the other hand, seems to be fine.

Another aspect is a linguistic impairment - again, something I've noticed for some time. Mam can get short sentences. Longer, more grammatically complex sentences (subclauses, passive voice) are presenting her with problems.

Jill has suggested that we keep sentences short and to the point AND that where appropriate, we write down what it is that we want to say to her so that she can run through it several times (as her short term memory is so poor).

Another thing is her very poor hearing - she must be encouraged to use her hearing aid.

On some tests, Mam scored very highly indeed - 85%, when naming common nouns.

We need to check with Mam's consulting physician (Dr Shaw) to see whether Mam is going to be sent for some kind of brain scan (PET scan) which
would highlight which areas of her brain had been affected and how. It may be that there IS something like vascular dementia (caused by furring
of blood vessels in the brain) but in the absence of any evidence, we cannot be sure for the present moment.

Summary

Overall, Jill was quite upbeat about Mam's abilities but she was perplexed as to why it's taken so long for her problem to have been presented to the
health service.

Mam's problem will likely deteriorate - but probably quite slowly. The more we can do to connect with Mam, the slower that degeneration will be. The more
socially isolated she feels through her speech difficulty, the greater the problem will get.

Strategies to help Mam

(*) As I said above, when Mam is stuck, encourage her to describe the word.

(*) Write down important things that we want to say to her so that she can go through it several times.

(*) Playing dominoes or cards.

(*) Jigsaws. I mentioned that Mam used to do these a lot. Jill suggested starting her off with a smaller - say 250 piece - set with a nice picture and helping her
get started.

(*) A bit more company would be nice.

I was handed a questionnaire that Peter and I are to fill in.

Paul