Speech Therapy for Older Adults

Speech therapy is a type of rehabilitation therapy that focuses on helping people with speech, language, communication, and swallowing disorders. These types of problems can be caused by many things, including disability, injury, and disease. In some older adults, these problems may also occur with normal aging.

Speech therapy is done by specially trained speech-language pathologists (SLPs), also called speech therapists. Read on to learn how speech therapy can help you or a loved one.

What types of problems do SLPs address?

SLPs work to assess, diagnose, prevent, and treat a wide range of disorders for older adults, including:

• Speech problems due to normal aging. Older adults may have trouble speaking as their vocal cords and their voice box (larynx) muscles get weak over time.

• Speech disorders. This is when a person has trouble making word sounds correctly. These disorders can be caused by muscle weakness, stroke, brain injury, or dementia. Common speech disorders include:

  • Aphasia. Full or partial loss of the ability to understand or express written or spoken words.

  • Apraxia. Inability to make basic speech sounds.

  • Dysarthria. Slowed or slurred speech due to damage or weakness in the muscles used to speak.

• Social communication disorders. A person may have trouble communicating in socially appropriate ways. For instance, they may ask very direct questions or make rude comments. This can occur after a brain injury.

• Swallowing disorders (dysphagia). These are problems with eating and swallowing. They can occur after stroke, illness, surgery, or injury.

• Language disorders. These occur when someone has a difficult time understanding other people or expressing their own ideas, thoughts, and feelings. These problems can affect spoken or written words.

• Cognitive-communication disorders. A person may have trouble with their memory, paying attention, and organizing their thoughts. This can be caused by dementia, brain injury, or a stroke.

What conditions can be helped by speech therapy?

Many conditions can affect an older adult’s ability to speak, swallow, and communicate. Speech therapy can be helpful if you are dealing with or recovering from things such as:

• Stroke

• Traumatic brain injury

• Parkinson disease

• Multiple sclerosis

• ALS (amyotrophic lateral sclerosis or Lou Gehrig disease)

• Cancer

• Head and neck surgery

• Head and neck cancer

• Dementia

• Trouble eating and drinking

• Hearing loss

What happens during a speech therapy session?

Speech therapy starts with an assessment to find out your level of function, and to learn about your needs and goals. The SLP will review your health history and talk with you. They may also talk with a family member, caregiver, or other healthcare providers. The SLP will look at any social or cognitive issues you are having as well. You may also need to take some tests. These help the SLP to evaluate different areas related to speech, as well as your ability to express yourself and understand others. Based on the assessment, and any test results, the SLP will create a treatment plan for you with short-term and long-term goals.

Treatment will vary depending on your condition and ability level, and can include things such as:

• Exercises to strengthen the mouth muscles

• Breathing exercises for greater control of the mouth and tongue

• Repeating sounds and practicing correct mouth movements

• Changing the diet to softer or pureed foods for easier swallowing and eating

• Help with understanding verbal and social cues

• Finding other ways to communicate if needed, such as with a letter or picture board or a communication device

Where are speech therapy sessions held?

SLPs work in many different settings in the community. They work with older adults in hospitals, assisted living centers, skilled nursing facilities, and rehab facilities. An SLP may also go to your home as part of home healthcare. Or they may have you come to their office.

How do you find an SLP?

Your healthcare provider will write a referral for speech therapy services. Ask your provider for a recommendation for an SLP in your area.

How is speech therapy paid for?

Speech therapy sessions may be covered in part by Medicare for people age 65 or older, by Medicaid for people with low incomes, or by private health insurance. Medicaid coverage varies by state. Check with your state Medicaid agency for more information. And always check with your insurance company to see what your specific plan covers.

To learn more

For more information about speech therapy, visit the American Speech-Language-Hearing Association (ASHA) .