Ageing with AAC

Also called Older AAC users, AAC and ageing, Growing older with a communication aid

Sight, hands and memory change with age. A system set up at thirty will not fit at seventy unless somebody changes it too.

What it is

Ageing with AAC is what happens when a person who has used a communication aid for years grows older and the things the aid depends on change: eyesight for reading the screen, hands for touching it, hearing for checking what it said, memory for where the words are. It also covers people who start using AAC late, after a stroke, with Parkinson's disease or with dementia, when learning a new system is harder than it was.

The systems are not built with ageing in mind, and neither are most services, which are organised around children.

Who it can help

Lifelong AAC users in their fifties and beyond, whose numbers are rising because the first generation of device users is now growing old. Older people who have lost speech and their families. Care home staff, who inherit both groups. Adult speech and language therapy services, which see far more of this than children's services do.

It is not a reason to take a device away. A system that has stopped fitting needs changing, not removing; a person who loses their aid at eighty loses their voice at eighty.

How it works

Each change has an answer. Failing sight: larger grid size, higher contrast, a big-key keyboard, auditory scanning where the device reads options aloud. Less accurate hands: touch settings with a longer hold or a keyguard, or a move to switch access. Hearing loss: a louder, lower voice; see voice speed and pitch. Memory: fewer pages, a stable layout that never changes, and quick phrases for the things that matter most.

For people with progressing conditions, the system needs reviewing on a schedule, not when it has already failed. For people with dementia, the aim shifts from generating language to supporting it: photographs, visual scene displays and a partner who knows the person's history. See dementia and communication.

Ownership matters too. A device funded through school or work decades ago may have no maintenance route now, and the adult AAC service needs to know the person exists before it breaks.

Getting started

This week, ask the person what has got harder: seeing, pressing, hearing, remembering. Make one change to match: bigger cells, a slower touch, a louder voice.

Check who the person's current speech and language therapist is. If the answer is nobody, ask the GP for a referral to adult community speech and language therapy and say the person uses AAC; see referring to speech and language therapy.

Make sure a low-tech backup exists and that whoever supports the person knows where it is. Older devices fail more, and so do older eyes.

Where to get help

Age UK advises on care and support for older people. Communication Matters has a growing body of work on ageing AAC users. Stroke Association and Parkinson's UK cover late-onset communication needs. Alzheimer's Society and Dementia UK cover communication as dementia progresses. AbilityNet helps older people with technology at home.