Registered with the Allied Health Professional Council (APHC), Beatrice Teo is an experienced speech therapist who has worked with adult and paediatric patients. Driven by her passion to help patients improve and recover, she combines conventional and evidence-based approaches for optimal results. Through her efforts, she hopes to improve her patients’ quality of life and inspire others living with speech and swallowing difficulties not to lose hope.
The information on speech therapy and the story of Alice in this article are a transcript from Beatrice’s sharing session at Homage.
Unlike what you have watched in The King’s Speech (where speech therapy helped a king overcome his stuttering), speech therapy is not limited to only the treatment of speech difficulties. Rather, speech therapy encompasses treatment for both communication and feeding/swallowing difficulties. These difficulties are faced by individuals across all ages, though the causes are generally different.
There are numerous reasons why adults are seeking speech therapy. It can arise from conditions dating back to birth or from medical conditions arising as they age. Some commonly observed conditions are stroke, Parkinson’s, dementia, Pneumonia or even cancer.
The story of Alice and her journey of recovery
Through the story of Alice, a stroke survivor, we experience how speech therapy has helped her and her family. (Names have been changed to protect the family’s privacy.)
Alice survived a severe stroke and was placed on a tracheostomy and NGT feeding tube. During the family meeting in the hospital, Alice’s recovery seemed bleak. She was unable to do the simplest tasks and even needed assistance to support her feeding and breathing. At one point, the family considered sending her to a nursing home, as they felt ill-equipped to care for her. But after much consideration, her husband still decided that it was better for Alice to receive care at home.
Here are some ways in which speech therapy has supported Alice in her journey to recovery:
‘The Golden Period’
The first 90 days after recovery of a stroke are referred to as the ‘golden period’. For stroke survivors like Alice, this represents a window of opportunity – the earlier rehabilitation takes place, the more effective the recovery.
Making mealtimes safe and right
The stroke affected Alice’s ability to swallow. This difficulty in swallowing is oftentimes referred to as dysphagia in a clinical setting.
During her hospitalisation, the priority was stabilising her condition post-stroke. Infections arising from possible choking on food and drinks would have set her back on her recovery. Hence she was intubated to minimise the risk of pneumonia (lung infection) and a speech therapist was brought in to help the family and Alice adjust to this new addition.
Establishing safe feeding techniques, in terms of positioning and rates of feeding, is the first step. Alice’s family had to learn how to tube feed safely and accurately. This helps the family caregiver and the recipient to have a common basis of understanding.
As her health improved, the goals of speech therapy also shifted. From safe feeding techniques to weaning Alice off the feeding tube. Exercises were introduced to strengthen the muscles responsible for swallowing. This was facilitated by tools or head-weight exercises.
As Alice regained her strength, the speech therapist introduced solids to her diet. Thickeners were also prescribed to ease swallowing by slowing down the flow of food to her stomach. Her food consistency graduated from a blended diet to a normal diet as her muscles grew stronger, till she was finally weaned off from her feeding tube.
Improving appetite through the aesthetics
In a home setting, the speech therapist sometimes doubled up as a chef. Imagine a dish of delicious chicken rice all blended together. This foreign concoction will not sit well in anyone’s stomach.
All of us are attracted to beauty. It is no surprise that this applies to our food as well. Beautiful plating whets our appetite, and more so when we are unwell. Enhancing the aesthetics of meals, therefore, becomes an essential part of speech therapy. Proper meal preparation techniques, from preparing to plating of dishes, were also imparted to Alice’s family to make her mealtimes enjoyable.
Therapy to regain speech
During the earlier phase of Alice’s recovery, she was often unable to express herself coherently post-stroke. Understanding her needs and wants was a constant challenge for her caregivers. Hence, prescribing the right treatment that matched her speech difficulties was vital in the recovery process.
Her cognitive abilities were unaffected by the stroke and she was able to understand language. She had no problem connecting words to sights and objects. Rather, her speech difficulties came about mostly from her expression of language.
Through interacting with Alice, her speech therapist observed that her muscles were too weak to form the correct forms needed for clear pronunciation. The speech therapist taught Alice muscle strengthening exercises. Gradually, her clarity in speech returned and Alice was able to vocalise better.
Family is equally important
Speech therapy and a therapist that provide care are just one aspect of the rehabilitation process. Patience, empathy and understanding from the family play an equally important role in motivating a loved one towards recovery. Like Alice, it is only through therapy and constant support from her family that made her recovery possible.
Today, through the combined efforts of Alice, her family and Beatrice, the home speech therapist, Alice no longer requires intubation. She now focuses her everyday efforts on regaining her speech ability with the hope that she can speak with clarity in the future.
- Jacobs, D., & Lang, J. (2018). Difficulty swallowing can be a serious health risk. Retrieved 3 January 2020, from https://www.straitstimes.com/singapore/health/difficulty-swallowing-can-be-a-serious-health-risk