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Augmentative Communication for Older Adults

This resource delves into the issues on communication for older adults, from seasoned language users to overcoming challenges. It explores diseases like ALS, MS, and offers strategies, from compensatory to multimodal systems, to aid in maintaining and improving communication skills. The importance of stakeholder empowerment and success in AAC implementation is emphasized throughout.

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Augmentative Communication for Older Adults

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  1. Augmentative Communication for Older Adults Challenges and Considerations Caryn F. Melvin PhD CCC-SLP

  2. “Words are, of course, the most powerful drug used by mankind” Rudyard Kipling

  3. Issues on the Plus Side • Seasoned language users • Seasoned, effective communicators • Understand the power of communication • Motivation • Problem solving ability • Educated • World knowledge • Cognition ?

  4. Challenges and Considerations • Remembering normal communication • Change in social role • Change in family dynamics • Grieving • Financial worries • Self esteem • Have observed others with impairments • Other health issues

  5. Measuring and Evaluating the Communication Difficulty • Impairment • Functional limitations • Disability

  6. Common Adult Disease Processes Requiring Augmentative Communication • ALS* • MS* • Parkinson Disease* • B-Stem CVA • Severe Aphasia • Others (SCI, GBS, TBI)

  7. Progressive or Acute Disease? It impacts more than just management!

  8. ALS Parkinson’s Huntington’s Progressive Supranuclear Palsy MS * CVA TBI Gullian Barre syndrome Progressive and Acute Disease

  9. Progressive Disease and AAC • ALS • Parkinson Disease • PSP • MS • Do not always have expressive deficits • Huntington’s Disease

  10. No Detectable Disorder • Obtain base line information/scores • Answer questions • Provide education re: disease • As warranted • Provide info re: options for communication • Avoid details re: end stage of the disease • Unless asked directly • Use phrases like; • If you should need this___ • Some people experience____

  11. Obvious Disorder/Intelligible • Minimize environmental interference • Reduce rate • Confirm topics • Confirm listener understanding • Voice amplification • For Parkinson and PSP • Possible AAC assessment/intervention • In specific situations

  12. Reduced Intelligibility • Complete AAC assessment • If not already done • Prosthetic Aids • Palatal lift, alphabet board etc • Reduce breath groups • Compensatory strategies* • Maintaining communication opportunities* • Support group • If warranted

  13. Loss of Useful Speech • Total reliance on AAC • Develop yes/no system for • mealtimes • emergencies • bed/times of excessive fatigue • Eyegaze boards

  14. AAC with Non Progressive Disorders • Working backwards • TBI • Cognitive deficits • CVA • Language disorders, Apraxia • B Stem CVA • Cognitive and lang. Skills generally OK

  15. No Useful Speech • No useful speech • yes/no system • If no recovery beyond this stage; • initial choice making • eye gazing or blinking • pointing • head or hands • multipurpose electronic AAC device • may need scanning due to fatigue

  16. No Useful Speech • Re-establishing subsystem control for speech • AAC for interactions • Tx focuses on • increasing respiratory support • improving phonatory and velopharyngeal control • strengthening oral motor musculature • coordinating actions of all subsystems

  17. Return of Speech • Independent use of natural speech • Compensatory strategies to increase intelligibility • Alphabet board supplementation • AAC for writing? • Maximizing speech naturalness • work on appropriate breath groups and stress patterns • No detectable speech disorder • Rare

  18. Multimodal Systems • Natural speech • Gestures • High tech • Voice output devices • Low tech • Alphabet boards • Picture/word books • Writing

  19. Compensatory Strategies For All AAC Users • Establish breakdown and resolution strategies • Quiet environment • Face your listener • Adequate lighting • Try natural speech but know when to switch to AAC

  20. Maintaining Communication Opportunities for All Users • Topic setter cards • Alphabet board supplementation • Remnant books/memory books • Loop tapes/single message tapes • Miniboards • High Tech for specific situations • Writing, telephone, strangers

  21. Topic Setter Cards • Family • TV shows • Outings • Church • “Stories” • Any hobby or interest

  22. Single Loop Technology • Go Talk button records one 10 second message • Big Mack • Big Step by Step

  23. A B C D E F G H IJ K L M N O P Q RS T U V W X Y Znew word 1 2 3 4 5 6 7 8 9 10

  24. “Almost” Final Thoughts • Stakeholders • Empowerment • Perceived success Vs failure with AAC

  25. “Good communication is as stimulating as black coffee, and just as hard to sleep after.”Anne Morrow Lindbergh

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