Recognising and responding to communication and swallowing difficulties in Parkinson's disease.

Background: Communication difficulties, including hypokinetic dysarthria and swallowing difficulties (dysphagia), affect a large percentage of people diagnosed with Parkinson's disease. Onset of these symptoms has been identified in up to 78% of people with early-stage Parkinson's disease. Communication difficulties are frequently disregarded until they have a significant impact on quality of life, while the person may often be unaware of indicators of dysphagia and the associated risk of aspiration pneumonia.

Objective: The aim of this article is to increase awareness of the importance of identifying and addressing the communication and swallowing difficulties experienced by people living with Parkinson's disease.

Discussion: Early identification, regular review and monitoring enable the clinician to support the implementation of evidence-based, effective interventions. Collaboration with the multidisciplinary team, including speech pathology, is needed to enable the person to live well with Parkinson's disease and to prevent aspiration pneumonia, a leading cause of death in Parkinson's disease. A vignette prepared in collaboration with a person living with Parkinson's disease and his wife provides an 'insider perspective' of the pervasive impact of difficulties with communication and swallowing.