Dementia has been described as the biggest expanded caseload for speech and language therapists. Everyone with dementia experiences communication difficulties. The late Prof Audrey Holland revolutionised the work of speech-language pathologists in this field through four key lessons. Lesson 1: Do not be afraid to stand out when you have a novel idea that will help people – working with dementia was considered a novel field for speech and language therapists several years ago, yet people with dementia present with specific and complex speech, language and communication needs, identified several years ago in the research evidence led by Audrey Holland. Lesson 2: Look for strengths to support functional communication – focusing on residual strengths is more likely to result to result in lasting behaviour change for people with dementia, e.g. through the use of communication aids and books that leverage photos and written key words and sentences. Lesson 3: Use communication strategies to support identity, quality of life, and self-determination in adults with acquired communication disabilities, including those with dementia. Lesson 4: Shift from pathologising to coaching – work with, not on, people with dementia to address their key needs.
Four lessons: the development of speech and language therapy research for people with dementia care
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