We help the person with dementia to use strategies to preserve communication and cognitive functioning for as long as possible with a focus on the cultural adaptation of the cognitive and linguistic stimulation in the Arabic context.
Over 46 million people around the world live with dementia. As the number of people with dementia worldwide continues to rise with population aging, there is a need for all regions to develop services that can meet the needs of people with dementia and their families. Alzheimer’s disease currently affects nearly 100,000 people in Morocco. Alzheimer’s disease and other dementias affect not only memory and thinking skills, but also communication abilities. Speech therapists play an important role in helping patients with dementia to communicate more meaningfully, which can improve their quality of life.
The Alzheimer Day Care Centre in Rabat, Morocco, is among the first of its kind in North Africa. Over the two years that it was developed, The Moroccan Alzheimer Association has been working with the government to ensure that the concerns and interests of people with dementia and their carers were heard. The clinical management of the centre is under the supervision of Prof. Dr Mustapha El Alaoui Faris, consultant neurologist and neuropsychologist. According to him: “In the case of Alzheimer’s, it is a very heavy burden for the family, because the patient … should never be left alone”. The centre also includes speech therapy, neuropsychology, occupational therapy, and physiotherapy.
The day care centre offers people with Alzheimer’s disease and other dementias the opportunity to be social with other residents, and to participate in stimulating cognitive activities, music, exercise programs, art therapy, Snoezelen therapy, gardening, and physical exercise in a friendly, safe environment.
As a speech and language therapist (SLT) and neuropsychologist, I contribute to the screening, assessment, diagnosis, and treatment of persons with dementia. From our experience we try to manage the cognitive, communication, and swallowing deficits associated with dementia. Also, we help the person with dementia to use strategies to preserve communication and cognitive functioning for as long as possible with a focus on the cultural adaptation of the cognitive and linguistic stimulation in the Arabic context. The goal of this intervention is to preserve the person’s quality of life for as long as possible in the onset stage of the Alzheimer’s disease.
Illiterate patients are the main challenge for us in speech therapy. Thus, the neuro-cognitive and linguistic assessment is sometimes limited to the spoken language because of the inability of Illiterate patients to access and use written language. On the one hand, the development of culturally adapted and validated visuo-spatial and non-verbal tests in Arabic is recommended to overcome this barrier and to estimate accurately the severity of the cognitive impairments without over-pathologizing or under-diagnosing. On the other hand, a home-based dementia care is the next step for us to implement in speech therapy, which could hopefully develop a sustainable model of care that reduces health care costs and engage actively the caregivers.
To sum up, SLTs need to be aware and prepared to address differences in language, culture and origin when dealing especially with Alzheimer’s patients. It’s a very lengthy process that requires cross-cultural training, commitment and preparation from all parties. The policy architecture on ageing and health in Morocco has been consolidated in recent years, with an emergence of national frameworks due to the commitments to global agendas (including the United Nations’ Sustainable Development Goals and the World Health Organization’s Global Strategy on Ageing and Health). There is an urgent need for a significant research effort to help promote and inform consideration of dementia in national health agendas.
Mohamed Taiebine is a speech and language therapist, neuropsychologist, and member of Irish Association of Speech & Language Therapists (IASLT).