How might Parkinson’s affect communication?

Parkinson’s can cause a number of communication difficulties: speech, facial expressions, handwriting and body language are affected in many people. This obviously has a profound impact on how a person with Parkinson's interacts with everyone from family members to complete strangers.

The ways in which Parkinson’s can cause communication difficulties include:

• Handwriting : people complain their writing becomes hard to read. It becomes small, cramped and ‘spidery’. Whilst writing starts at normally, it tends to reduce in size as the page progresses. This is known as micrographia and is one of the earliest signs of Parkinson’s, caused by tremor and lack of co-ordination
• Speech : it may be slurred or become monotonous with limited variation or expression in the voice, as well as a lack of volume. Some people find that as they talk, their speech becomes faster and incomprehensible. Using the telephone and communicating in social situations where there is a lot of people or noise can be difficult
• Facial movement and body language : both can become slow or even diminished. Facial expressions, such as smiling or frowning, may become difficult to make. Body language often lacks spontaneity, and gestures, such as nodding, may be missing. By contrast, abnormal involuntary movements - known as dyskinesias - may make it difficult to control the face and mouth sufficiently to speak or otherwise communicate.

These difficulties can impact considerably on quality of life and can contribute to a very misleading picture of the affected person, resulting in assumptions being made about them - often which are erroneous and very distressing. For example, people may assume that, rather than having Parkinson's disease, the person is drunk or unintelligent¹. Moreover, the ability to communicate may fluctuate during the day, depending on the medication schedule and whether the individual is ‘on’ or ‘off’. Such fluctuations can be very confusing to others.

A lack of self-expression can dent your confidence to interact with others. In some people, this could lead to depression, so it is important that family and friends are aware of your difficulties and encourage you to continue socialising.