Speech TherapyWords, Swallowing, and Memory

Speech therapists, properly called speech-language pathologists, work on more than speech. They help people find words again, understand what is said to them, swallow safely, and keep track of the day. After a stroke, a long hospital stay, or with Parkinson's or dementia, that work happens best at the table where you eat and talk every day.

If your doctor orders it and you qualify, Original Medicare covers speech therapy at home at no cost to you.

What speech therapy looks like at home

After her stroke, Mrs. Jackson knows exactly what she wants to say. The words just come out wrong, or not at all. Her therapist sits across the dining table with picture cards and a notebook. They practice the names of the people in the photos on the wall, then the things in the kitchen, then the sentences she needs most: "I need the bathroom." "Call my son." Her husband learns to wait, and to give her a choice of two words instead of asking an open question.

Mr. Nguyen coughs when he drinks. His daughter thought it was a cold. His therapist watches him eat and drink, checks how he swallows, and finds that thin liquids are slipping into the wrong pipe. They try a thicker texture and a chin-down position, and the coughing stops. The therapist writes a one-page guide for the whole family, with the safe textures and the warning signs.

What the speech therapist does

• Speech and language. Finding words, forming sentences, speaking clearly, and understanding others after a stroke or brain injury.
• Swallowing. Checks how you swallow, recommends safe food and liquid textures, teaches positions and exercises, and watches for signs of food or liquid going into the lungs.
• Voice. Loudness and clarity, including the soft voice that comes with Parkinson's disease.
• Thinking and memory. Attention, memory, and problem solving as they affect daily life: medicines, appointments, the stove.
• Ways to communicate when speech is hard: a picture board, written cues, or a simple device.
• Teaching your family how to talk with you, how to help with meals, and what to watch for.
• Reports to your doctor and adjusts the plan as you progress.

What the first visit looks like

The first visit usually happens within 24 hours after your doctor or the hospital sends the order. The therapist talks with you and your family, listens, watches you eat and drink if swallowing is a concern, and does some simple tests. The plan starts that day. You get one named coordinator who knows your case. We call before every visit, and we send the same therapist whenever we can. If someone else must come, we call first.

When to call

Call 911 for choking, trouble breathing, or sudden new trouble speaking, which can be a sign of stroke. Call your therapist or nurse for coughing or a wet-sounding voice during meals, a fever after coughing while eating, weight loss, or new confusion.

What family can do

• Slow down. One question at a time. Give time to answer. Offer two choices instead of an open question.
• Follow the texture guide at every meal, including snacks and medicines. Ask the therapist how to take pills safely.
• Sit upright for meals, and stay upright a while afterward, as the therapist suggests.
• Keep talking. Conversation is practice. Photos, music, and family stories all help.

Cost and who qualifies: with Original Medicare, covered home health is $0 if you qualify, and your doctor decides. See what Medicare covers, who qualifies, and what is not covered.

Our team speaks English, Spanish, Armenian, Russian, and Tagalog. Speak another language? Call (818) 579-4012 and ask whether we have staff who speak it. If we do not have staff who speak your language, we arrange a free interpreter.