It’s Not Just Your Voice: Parkinson's Communication Barriers

We communicate with more than our voices. When our voices, vision, hearing, and facial expressions are threatened, we do not want to be seen as "different" by others. Parkinson’s disease (PD) can cause diminished communication and often increased feelings of being isolated or wanting to self isolate.

Impact on vision

Our aging processes can impact our vision. Parkinson’s, however, throws real curves into the loss of acuity. Parkinson's or medications used to treat PD, can cause the muscles that rotate the eye ball vertically and horizontally to no longer synchronize, resulting in double vision.^1,2

The muscles that help with focusing your eyes may also be affected. Blurry vision, double vision, reading difficulty, objects viewed in the wrong place, and inability to focus on objects are typical symptoms. The results: difficulty driving safely and reluctance to participate socially when reading and/or recognizing faces are required.^1,2

If you are experiencing vision problems, inform your neurologist and find an ophthalmologist with specific Parkinson’s knowledge. There are optical corrections to compensate for your vision issues. My glasses with special prisms have restored my vision to 20/20.

Hearing loss

Aging causes hearing loss. However, one study found that Parkinson’s disease may also affect the cochlea, the sensory organ of hearing. Researchers found that dopamine helps protect the cochlea. But inadequate dopamine can lead to damage of the cochlea and cause hearing loss. ^3,4

Another study found that people diagnosed with Parkinson’s reported greater difficult in hearing words people were speaking compared to a control group. Those with Parkinson's were more likely to withdraw from social contact as result of hearing loss.⁵

Talk to your neurologist and ask for a hearing evaluation. You might be a good candidate for hearing aids. My hearing aids have significantly improved my hearing and made social interaction more normal. I can now hear people without trying to read lips.

Facial expressions

We communicate with our expressions. Another Parkinson’s symptom is reduced facial expression, also known as hypomimia or facial masking.⁶

Parkinson's Foundation explains, "When the muscles of the face are stiff or take longer to move, it can be hard to crack a smile, raise your eyebrows or otherwise express your feelings using your face, which is an important part of how we communicate."⁷

Medicines that reduce rigidity may help with facial masking. A speech therapist can suggest facial exercises that may also relieve masking. While I do not, as of yet, have facial masking, I know several people who have reduced masking by performing the exercises while looking in a mirror.⁷

Your voice matters

Speech changes that can occur with Parkinson’s include:⁸

• Speaking quietly or softly
• Speaking in one tone
• Speaking rapidly
• Mumbling or stammering
• Breathy or hoarse voice
• Slurring words
• Trailing off at the end of sentences

Medications may help with speech difficulty but the primary treatment is speech therapy. Parkinson's-specific programs include Lee Silverman Voice Treatment (LSVT) LOUD and Parkinson Voice Project SPEAK OUT! I have started to notice hoarseness so it’s time for a baseline speech evaluation.⁸

Stay engaged

All the diminished communication skills have medical and physical treatments. One of the most important treatments is within your power: Do not self isolate. Do not be embarrassed over the physical manifestations of your symptoms. Stay engaged socially and keep communicating!