Communication is possible by writing, until that skill is lost. The living nightmare is the throat. The ability to swallow grows progressively worse. Water goes down the windpipe and results in choking. Food goes wrong, also resulting in choking.
Liquids are as likely to come out the nose as make it to the stomach.
He was diagnosed in November 1989. By March his speech was almost completely unintelligible. By June he had to write everything. No matter how slowly he spoke, it was mush. By Christmas of 1989, Dad was coughing quite a lot while eating.