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From a Speech Pathologist Specializing in Parkinson's Care
In honor of Parkinson's Awareness Month this April Amplify Speech Therapy is highlighting effective communication specific to Parkinson's disease. Communication is negatively impacted by Parkinson's in several ways. It can cause people to speak at a reduced volume, and at a fast rate. It can cause mumbled or less clear speech. And it can cause speech to sound monotone and lacking in emotion. These changes are gradual, but over time can be detrimental to the success of everyday communication.
Learn important tips for effective communication from a Speech Therapist certified in Parkinson's treatment. Here you will find communication tips for the individual with Parkinson's and tips for those who know someone who has Parkinson's.
Communication Tips for the Parkinson's Patient
Tip #1 - Face Your Communication Partner
This is actually harder said than done. Parkinson's doesn't just affect your speech and volume. It can also take a toll on your posture, resulting in a stooped, forward lean. If your head is tilted down, your voice will be projected down as well. This only makes it harder to be heard. Before speaking, try to raise your head and make eye contact to be heard loud and clear.
Tip #2 - Speak Slowly, Overarticulate
Have you noticed that Parkinson's causes you to speed up certain activities like walking or speaking? Speaking rapidly only makes it harder to be understood. To make matters worse, Parkinson's can cause mumbled or slurred speech. Remind yourself to slow down. Use deliberate pauses between words and OVERarticulate. By overarticulating you are exaggerating and emphasizing the sounds of the words to make your overall speech more clear. These two communication strategies of speaking slowly and exaggerating go hand in hand and can make a big difference in speech clarity and the number of times you have to repeat yourself.
Approximately 90% of Parkinson's patients report communication difficulties at some point during the disease process.
Tip #3 - Breathe
Do you find you are running out of air before you've finished your sentence? That's a sign that you need to pause to take a breath before you can finish. If you don't pause, there will be the tendency to speed up, and as we mentioned in Tip #2, speaking slowly helps to be understood. So take a full breath before you start to speak, and when you run out of air, pause and take another breath before finishing your statement. This takes effort and practice. You may have to break up what you are wanting to say into smaller phrases or sentences. You may have to take more frequent breaths. You may need to focus more attention on your breath support when you are talking. But without breath, we don't have a voice.
Tip #4 - Schedule Important Conversations
Parkinson's medications are cyclical. There is usually an optimal time when they kick in and you feel at your best. During this window of time, it takes much less effort to do a lot of things, including talking. Then there is a period of time before and after this window when it takes more effort to communicate effectively. Time your phone calls, appointments, important conversations when your speech is at its best.
Tip #5 - Consider a Personal Amplifier
If you find you just can't get the volume you need to be heard or to do so takes too much energy, you might consider getting an amplification system. There are small voice amplifiers that you can wear around your neck or waist that have a microphone and a speaker. It will project your voice without extra effort. Others will be able to hear you and you can conserve your energy.
Tips for being a Good Communication Partner to Someone with Parkinson's Disease
If you know someone who has Parkinson's, the first 5 Tips above provide a good understanding of how difficult it becomes to be heard and understood when battling this disease. Here are some communication strategies you can consider to optimize communication with your loved one.
Tip #1 - Limit Noise and Distractions
Parkinson's creates enough obstacles with mumbled speech, low volume and reduced breath support. No need to add background noise and other distractions into the mix. Consider what you can do to reduce noise and distractions. This can give your loved one immediate success when communicating.
Tip #2 - Be Patient
Many times I have heard the patient with Parkinson's accuse their spouse of having a hearing loss. A hearing impairment may or may not be contributing to the communication breakdown, but it's important not to take it personally. With Parkinson's there is a decrease in perception of senses. This means there's a gradual decline in sensory feedback, such as hearing. And because this happens so slowly, most people with Parkinson's do not realize it. This is very problematic in their perception of their speaking volume. It may feel like they are speaking normally but what we hear is a whisper. They simply don't realize that they are using a soft volume. Here's where speech therapy can help. Having an outside person, specifically an expert in communication, give objective numbers on volume and offer training can dramatically improve communication success.
You might also find patience will go along way if you give your loved one extra time to finish their thought. Try not to finish their sentences for them. We all have difficulty finding the right word now and then. Sometimes this is heightened with Parkinson's. Give the space and time they need to have their voice heard.
"As much as Parkinson's is about movement, the end stage is being frozen. So the more I let that happen, the more I'm going to be stuck within that and unable to reverse it" – Michael J. Fox
Tip #3 - How to Ask for a Repeat
If you didn't understand something, ask your loved one to repeat only the part that you didn't hear. This will save precious energy and alleviate some of the frustration. Instead of asking "What did you say?" Try "You want me to get the what from the bedroom?" Or "I think you said.....Did I hear you right?"
Find your voice!
Don't let Parkinson's disease take over your voice! These tips are general strategies. Get personalized and effective speech therapy from a speech pathologist certified and experienced in working with Parkinson's. If Parkinson's has made it difficult to get to your appointments, find a speech therapist providing teletherapy (remote therapy).
I have been certified in LSVT LOUD, a research based Parkinson's voice treatment protocol, for 13 years and I have seen how an intensive voice program can reverse the effects of Parkinson's if caught at the right time. This is one condition where you want to start therapy before communication has been severely impacted.
Do you have more tips? Add them below in the comments.