Speech Therapy Interventions for Voice Disorders in Aged Care Patients

Voice disorders in aged care residents are remarkably common. Studies estimate that up to 89% of people with Parkinson’s disease experience a voice disorder, and 95% of aged care residents have at least one communication impairment, ranging from dysphonia (hoarseness) to difficulties with swallowing (dysphagia) Speech Pathology Australia. These disorders can severely impact nutrition, social participation, and overall quality of life. 

Age-related changes, such as vocal fold atrophy (presbyphonia), neurological conditions (stroke, Parkinson’s), and cognitive decline (dementia), all contribute to altered voice quality, reduced loudness, and impaired speech clarity. Early, targeted speech therapy can maintain or restore safe swallowing, improve intelligibility, and boost confidence in social interactions. Speech pathologists in aged care settings conduct assessments, develop individualised plans, and work alongside nursing and allied health teams to ensure residents remain engaged and nourished Better Health Channel. 

What are the activities for speech therapy for seniors? 

Speech therapy for older adults includes a range of evidence-based exercises and activities: 

1. Vocal Hygiene & Warm-Up 

• Hydration and Optimisation: Encouraging adequate water intake and avoiding irritants (e.g. caffeine, smoking). 
• Gentle Phonation: Lip trills and humming to warm up the vocal folds and reduce strain. 

2. Respiratory-Voice Coordination 

• Diaphragmatic Breathing: Exercises to support sustained phonation and loudness practices. 
• Sustained Vowel Phonation: Holding sounds like /a/ at comfortable pitch and volume to strengthen vocal fold closure. 

3. Pitch and Loudness Exercises 

• Pitch Glides: Sliding from low to high pitch to enhance vocal range and flexibility. 
• Maximum Phonation Time (MPT): Measuring and extending the duration a vowel can be held on one breath. 

4. Lee Silverman Voice Treatment (LSVT LOUD) 

• An intensive program proven to improve vocal loudness and clarity, especially in Parkinson’s disease. 

5. Articulation and Resonance Training 

• Speech Sound Drills: Targeting precise consonant and vowel production. 
• Resonant Voice Therapy: Maximising forward placement of voice to reduce vocal effort. 

At Physio Inq, our Speech Pathology team tailors these activities to each resident’s needs, delivering sessions in-home or via telehealth for convenience. 

What interventions are available for speech and language problems? 

Beyond voice exercises, seniors benefit from a spectrum of interventions: 

Swallowing (Dysphagia) Management 

– Postural Techniques: Chin tuck, head turn to protect the airway. 

– Diet Modifications: Thickened liquids, texture-modified foods. 

– Mealtime Strategies: Small bites, slow rate, alternating solids and liquids. 

Augmentative and Alternative Communication (AAC) 

– Low-Tech Aids: Picture boards, communication books. 

– High-Tech Devices: Tablet-based apps with speech output for residents with severe expressive difficulties. 

Cognitive-Communication Therapy 

– Memory Strategies: External aids (calendars, reminders). 

– Problem-Solving Tasks: Sequencing activities to maintain executive function. 

Group Therapy & Social Skills 

– Conversation groups to practice turn-taking, topic maintenance, and listening skills within a supportive peer environment Connected Speech Pathology. 

Telehealth Services 

– Remote sessions that provide continuity of care and caregiver training in the home or facility setting. 

These interventions are integrated into each resident’s care plan, often in collaboration with Occupational Therapy and nursing staff to reinforce strategies throughout daily routines. 

What does a speech therapist do in aged care?

Speech pathologists in aged care perform a broad range of functions: 

1. Comprehensive Assessments 

• Evaluating voice quality, articulation, language comprehension, and swallowing safety using standardised tools. 

2. Individualised Therapy Planning 

• Developing goals, such as increasing vocal loudness, improving safe swallowing, or enhancing social communication, and mapping out weekly interventions Better Health Channel. 

3. Direct Therapy Delivery 

• One-on-one and small group sessions focusing on exercises, swallowing drills, and communication tasks. 

4. Mealtime Management 

• Training care staff on safe feeding techniques, optimal positioning, and consistency adjustments to reduce aspiration risk. 

5. Caregiver and Staff Education 

• Providing in-service training on communication strategies, alternative communication aids, and the Aged Care Quality Standards’ emphasis on “dignity of risk” Speech Pathology Australia. 

6. Interdisciplinary Collaboration 

• Regularly liaising with physiotherapists, dietitians, nurses, and GPs to ensure a cohesive approach to resident care. 

By embedding speech pathology within the aged care team, residents benefit from coordinated interventions that address both physical and social dimensions of communication.

What are intervention techniques in speech therapy?

Advanced speech therapy techniques for voice and communication disorders include: 

1. Lee Silverman Voice Treatment (LSVT LOUD) 

• Intensive, daily sessions focusing on increasing vocal loudness by a systematic, high-effort approach. 

2. Melodic Intonation Therapy (MIT) 

• Utilises musical elements (melody, rhythm) to facilitate speech in residents with non-fluent aphasia or severe motor speech impairments. 

3. PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets) 

• Tactile-kinesthetic cues applied to the orofacial region to shape accurate speech movements, useful in dysarthria. 

4. Integrated EMST (Expiratory Muscle Strength Training) 

• Using a resistance device to improve cough strength and swallowing safety by strengthening expiratory muscles. 

5. Cognitive-Linguistic Therapy 

• Drill-based exercises targeting naming, word retrieval, and sentence construction for residents with language deficits post-stroke or due to dementia. 

These techniques are selected based on the resident’s diagnosis, tolerance, and rehab goals, and are applied within a broader therapy plan to maximise functional communication and safety Speech Pathology Australia. 

Frequently Asked Questions (FAQs) 

Q1. How often should speech therapy sessions be held for seniors? 

A: Typically 1–2 times per week, adjusted based on the severity of the disorder, resident tolerance, and goal complexity. 

Q2. Can voice exercises help with swallowing difficulties? 

A: Yes: improving respiratory support and laryngeal closure through voice tasks often transfers to safer swallowing. 

Q3. Is telehealth effective for aged care speech therapy? 

A: Research indicates telehealth can be as effective as face-to-face sessions for many speech and swallowing interventions, especially when family or staff assist Better Health Channel. 

Q4. Do residents need a GP referral to see a speech pathologist? 

A: No referral is strictly necessary, but a GP or Aged Care Assessment Team referral may be required to access certain funding (e.g., Medicare CDM plans). 

Q5. How long before improvements in voice are noticeable? 

A: Mild improvements may emerge within 4–6 weeks, but more substantial gains, especially with programs like LSVT LOUD, often require 4 weeks of intensive practice. 

Voice and communication disorders need not limit a senior’s engagement or safety. Through targeted speech therapy activities, a variety of evidence-based interventions, and collaborative care within aged care settings, residents can regain confidence, maintain nutrition, and connect with others more effectively. 

Take the Next Step: 

If your facility or loved one requires specialised speech therapy support, contact us to arrange an assessment. Explore our services: 

• Speech Pathology 

• Exercise Physiology 

Let’s work together to ensure every senior’s voice is heard and every mealtime is safe and enjoyable.

Date Published: Wednesday, May 14, 2025