Speech Therapy for Older Adults

What types of problems do SLPs address?

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

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

  • Apraxia. This disorder makes it hard to produce the right sounds in the right order when speaking.

  • Dysarthria. This is slowed or slurred speech caused by damage or weakness in the muscles used for speaking. These include muscles in the face, lips, tongue, and throat, and those used for breathing.

• Voice disorders (dysphonia) This is a lasting change in someone’s voice. They might sound hoarse, strained, raspy, or nearly silent. It may arise from speaking too much or too loudly, from using the wrong breathing method, or from problems with the voice box (larynx), like vocal nodules.

• 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 a stroke; neurological illnesses such as Parkinson’s disease, multiple sclerosis, and dementia; surgery; infections like Lyme disease or tetanus; or injury.

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

  • Aphasia. This language disorder affects a person's ability to communicate in oral and written formats. It's often caused by damage to the left side of the brain.

• 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:

• A stroke.

• A 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.

• Polyps, nodules, or other growths on the vocal cords.

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 doctors. 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 check different areas related to speech, plus 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. It can include:

• Exercises to strengthen the mouth muscles.

• Breathing exercises for greater control of the mouth and tongue.

• Perception exercises, such as ones to differentiate between certain sounds and syllables.

• Repeating sounds and practicing correct mouth movements.

• Exercises to make certain sounds and improve the fluency of speech.

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

• Help with understanding verbal and social cues and using these measures in everyday life.

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

• Help with communication using things like sign language, communication boards, and computer-assisted speech.

• Advice for people who need speech therapy, their parents, and other loved ones.

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 health care. Or they may have you come to their office.

How do you find an SLP?

Your doctor will write a referral for speech therapy services. Ask your doctor 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.