Indirect Interventions to Facilitate Communication in Alzheimer's Disease

Abstract

Indirect interventions are designed to maximize the functioning of individuals with Alzheimer's disease (AD) through training of caregivers, modifying the physical environment, and developing therapeutic routines and activities. In this article, characteristics of AD caregivers are described, caregiver communication strategies are discussed, and examples of caregiver communication training programs are provided. Environmental modifications and routines and activities to improve communication are detailed.

Aspects of communication in Alzheimer's disease: clinical features and treatment options

“…For example, conversation, storytelling, socialization, and music therapies have all shown some positive effects on measures of language and communication in patients with AD (Brotons and Koger, 2000;Tappen et al, 2002;Mahendra and Arkin, 2003;Arkin, 2007;Phillips et al, 2010). From a management perspective, indirect interventions, such as caregiver training and environmental modification, may also be helpful in prolonging communication through improved interpretation (Hopper, 2001;Schiaratura, 2008;Egan et al, 2010).…”

Effects of four years of exercise, language, and social interventions on Alzheimer discourse

“…SLPs need to look beyond just providing dysphagia services to conducting cognitive screenings and assessments to determine profiles of spared and impaired abilities, and then structuring interventions that engage individuals' spared abilities. Further, to ensure that AD patients receive the services they need despite reimbursement constraints, SLPs must think creatively about indirect interventions, that is, working with caregivers (Hopper, 2001), students, and volunteers in administering interventions as described in this article. SLPs can seek to establish partnerships with universities and local speech pathology training programs and offer undergraduate and graduate students clinical training opportunities, thus providing an inexpensive means for delivering individual and group interventions for dementia patients.…”

“…Clinicians need to develop new cost-effective ways to deliver a wider range of services in long-term care settings. They also need to stay abreast of empirical evidence about the efficacy and effectiveness of short-term, long-term, direct, and indirect interventions to maintain and/or improve function and quality of life in dementia patients (e.g., Arkin, 2001;Camp, Foss, O'Hanlon, & Stevens, 1995;Clare et al, 2000;Hopper, 2001;Mahendra, 2001;Moss, Polignano, White, Minichiello, & Sunderland, 2002, and other articles in this issue). Furthermore, clinicians need to participate in collaborative research efforts to fill gaps in the research concerning non-pharmacological interventions.…”

Speech recognition in Alzheimer's disease with personal assistive robots

“…In order to be useful in practice, these communicative systems need to mimic some of the techniques employed by caregivers of individuals with AD. Often, these caregivers are employed by local clinics or medical institutions and are trained by those institutions in ideal verbal communication strategies for use with those having dementia (Hopper, 2001;Goldfarb and Pietro, 2004). These include (Wilson et al, 2012) but are not limited to relatively slow rate of speech, verbatim repetition of misunderstood prompts, closedended (e.g., 'yes/no') questions, and reduced syntactic complexity.…”