It is a relatively new concept as most cannot see how they connect, but speech therapy has become one of the essential parts for the nursing home, rehab, or home health models of care. It doesn’t only benefit the patient who has difficulty swallowing, communicating, or those with disorientation or poor memory with their loved ones, family, and caregivers, as the speech therapy itself, can help reduce falls. To help serve the patient, the speech therapists will focus on three main areas.
Those who suffer from impaired cognition/dementia are about 60% of the patients who will be the ones who fall, and 60-80% of these will actually fall before one year of their initial diagnosis. Most speech therapists will use cognitive training – retraining, development of auditory and visual aids to promote improved cognition and safety, skilled communication tasks all work to reduce falls.
It seems difficult to understand by some, but it is true, that hearing loss plays a significant part in falls for the patient. Research has shown there is a link between untreated hearing loss of the individual and an increased risk of falls. So many things will cause the loss of hearing such as family history, exposure to loud sounds, chronic disease, only to name a few. For the therapists to determine if the patient has a hearing loss, they will ask a few questions such as:
- Do you have a hard time understanding what others are saying?
- Do you hear noises or ringing in your head and/or ears?
- Do you feel any discomfort or pain in your ears?
- Have you ever noticed a sudden progression of loss of hearing?
- Do you ever experience balance issues or dizziness?
- Have you had any drainage lately in your ears?
- Does anyone else in your family have any trouble hearing?
Once the therapist has determined if the patient has hearing loss, they can provide the education that will include auditory and visual aids along with sequencing and reasoning tasks that will all help improve the maintenance and using hearing aids.
Proper hydration and nutrition by itself can reduce fall risks. Poor nutrition results in the patient having a decreased appetite that can lead to energy being reduced and this affects the ability of the patient to perform daily activities safely. The patient being poorly hydrated can lead to dizziness, and if they are hypovolemic, it can also cause their risk of falling to increase. The patient who suffers from difficulty swallowing, the speech therapists, can diagnose, then treat and start developing plans to safely improve their fluid and nutrition intake to reduce their swallowing risk.
Speech therapy can evaluate cognition and evaluate the level for the patient’s development of their activity-based dementia program. They can also give education on how to approach and communicate the strategy to use with the patient that has cognitive impairment that includes:
- Look at the patient and talk to them face to face
- Make your grammar simple
- Ask them no/yes and questions that have only 2-choices
- Validate with them, no confrontation
There are many facilities are being successful by using these strategies to reduce falls. The person-centered approaches also seem to increase the patient’s quality of life.