Speech recovery in the conditions of the social service entity of the gerontological center «Ekaterinodar»

BACKGROUND. Statistics have recently shown a tendency towards an increase in the number of stroke patients, most often with consequences such as speech disorders, which occur in 30–40 % of the total number of patients, manifested by aphasia and dysarthria. In this regard, the urgent problem of gerontology is the recovery of speech in aphasia. The most common variants of aphasia that require the participation of a speech therapist include acoustic-gnostic, acoustic-mnestic, and semantic forms of it. Taking into account the age of the patients and concomitant diseases (chronic cerebral ischemia, hearing loss, impaired cognitive functions, decreased mood), most of them fail to achieve the desired positive correction results due to lack of motivation for rehabilitation.

OBJECTIVE. The aim of the research was to study the results of speech therapy rehabilitation in elderly and senile patients who were in the gerontological center (GC) «Ekaterinodar».

MATERIALS AND METHODS. Materials and methods. Since June 2024, a speech therapist has been employed at GC Ekaterinodar, who, in the direction of internists and/or geriatricians of the center, conducted a speech therapy consultation, which took into account the results of an initial examination by a medical psychologist to fill out a psychological passport indicating the cognitive and emotional sphere, the characteristics of socialization, and the character of the patient. A total of 15 patients (7 men, 8 women, average age (73.4 ± 2.3) years) with aphasia underwent corrective and rehabilitation work. In all cases, aphasia was a consequence of a stroke from 6 months to 10 years ago. The following types of aphasia were identified: gross sensorimotor (4 patients), acoustic-gnostic (3 patients), total (3 patients), acoustic-mnestic (4 patients) and afferent motor aphasia of moderate severity (1 patient). Different techniques developed by Russian scientists were used to correct aphasia (M. M. Shcherbakova, S. V. Kotov and others), an individual lesson plan was drawn up.

Age-related memory changes and the level of education were taken into account in each individual case. In the acoustic-gnostic form, work was carried out with global reading, the selection of semantic distortions, and the subject relationship of the word. In this group of patients, such techniques as solving crosswords, selecting synonyms, antonyms for words, and retelling the text were used. The speech therapy correction plan for the semantic form of aphasia included the analysis of schematic pictures, and in the case of a mild disorder, the identification of cause–and-effect relationships, the selection of prepositions, the solution of logical problems, and the correction of grammatical errors. In the acoustic-mnestic form, the basis of classes was visual perception, which was supplemented, depending on the severity of the violations, by creating sentences from individual words, solving mathematical exercises, and identifying logical errors in the presented text. In addition, all patients underwent elements of creative therapy, speech therapy massage, articulatory gymnastics, classes with teachers and psychologists. Statistical data processing was carried out using nonparametric criteria.

RESULTS. The results of the study. A total of 442 individual speech therapy sessions were conducted. Control studies have shown that after 3–6 months of individual speech therapy exercises combined with psychological exercises, all 15 patients showed positive dynamics of speech contact of varying degrees of severity against the background of an improvement in their psychological state.

CONCLUSION. Conclusions. Speech therapy work to overcome aphasia in elderly and senile people in social entities in synergy with psychologists allows achieving positive results and increasing social adaptation.