Speech Language Pathologist (SLP) to introduce MCI interventions?

Posted by pb50 @pb50, 16 hours ago

I am a 75yo female, retired from a banking career 3 years ago. I have MCI and all blood and genetic analysis says I have increased risk for Alzheimer’s. I didn't need a single test to know that when 70% of my mother and her siblings died of it.

Have any of you worked with a Speech Language Pathologist to develop intervention strategies for mitigating issues that include word retrieval, train of thought, difficulty in juggling multiple appointments etc? I have only had two sessions but other than crowding my schedule with 2 or more sessions a week, I’m not sure about it.

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Helen, Volunteer Mentor | @naturegirl5 | 13 hours ago

@pb50 This is a great question. One of my friends saw an SLP for word retrieval and planning - referred to as executive function. This was at Emory University and she said that the strategies she learned have been very helpful for her.

Did your physician or a neurologist refer you to speech-language pathologist? Does the SLP work in a hospital or medical setting?

My first career was in speech-language pathology and I was on the faculty in that discipline in university for over two decades. A speech-language pathologist has taken courses in their graduate studies that pertain to cognitive-communication disorders (memory, thinking, planning) which includes the symptoms you described. The SLP also has clinical rotations in their studies that include working with patients with cognitive-communication disorders. Not every SLP specializes in working with MCI, dementia, or Alzheimer's disorders.

Have you asked the SLP you are working with about their background? Have they worked with other patients diagnosed with MCI? How many years of experience does this person have? These are the kinds of questions I have asked health care providers if the information isn't already displayed on a website.

If you don't feel you are making adequate progress or the SLP you are working with does not have the experience you would like then I think it's very reasonable to ask to see someone else.

pb50 | @pb50 | 13 hours ago

I was referred to her by my neurologist. It’s a new service and I think she is the only one doing it in the rehab department.

She seems competent. I was tested a year ago by a neuropsych and while i had some gaps, it wasn’t saying Alzheimer’s yet. We have repeated a good bit of that. But i have APOE 3/4 and blood work that also puts me at higher risk. Plus I have a profound family hx. So it’s coming down the tracks 🙂

I tend to be very candid when i am retrieving a word. And if it doesn't come to the surface quickly I substitute or describe- whatever seems appropriate . But I am not trying to mask what is happening. The SLP wants me to focus on flow of communication and substitute quickly. That’s just one simple example that suggests we may have a different concept. The rest of what we talked about was whether and what my processes are for ensuring I take my meds and make my appointments. I don't know. It just seems simplistic. My biggest issue is that she immediately booked 15 appointments and there are two a week. That seems intense. I will speak to her about that.

I had an early career in Neurophysiology and then 20 years in Banking Regulatory Compliance program design. I am pretty good at problem solving. But I will continue to give it the college try. And I really appreciate your input.

Helen, Volunteer Mentor | @naturegirl5 | 11 hours ago

In reply to @pb50 "I was referred to her by my neurologist. It’s a new service and I think she..." + (show)

@pb50 There are a variety of strategies that one can use for word retrieval. In my opinion your strategy of work substitution or description sounds good to me.

It almost sounds to me that she doesn't know you and your skills well enough at this point to figure out what might work best for you. Instead of getting right to the "work" can you ask the SLP to get to know you better by asking you questions about you. What would she like to know? What do you do very well that has not changed over time? Do you continue to problem solve well? Your early career and then and your 20 years in Banking Regulatory Compliance program design is fascinating to me. Would you like to share more about that? What are your interests and hobbies? It would be best to include your interests and your preferences in the treatment objectives. Two times a week for how long each session? Yes, for outpatient treatment that does seem intensive to me but then I don't know. how these sessions are done on an outpatient basis these days. Scheduling you for all those sessions in advance does seem overwhelming. It's really up to you whether or not you want to go two times per week for 15 sessions.

These are my thoughts as they've occurred to me. I'm sharing the kind of information I shared with my students and how I worked with patients.

It's rather frightening to know about the APOE gene and your family history. It's good that you had thorough testing by a neuropsychologist.

What other things are you doing for yourself? Do you socialize with friends and family? Go for walks? Work out in the gym?