‘There’s this big fear around palliative care because it’s connected to death and dying’: A qualitative exploration of the perspectives of undergraduate students on the role of the speech and language therapist in palliative care

2022 ◽  
pp. 026921632110508
Author(s):  
Claire A Collins

Background: Speech and language therapy in palliative care is a developing discipline of clinical practice. Research literature has highlighted that undergraduate palliative care education in speech and language therapy is inconsistent and inadequate. However, limited research has been carried out to date in relation to student speech and language therapists and palliative care. Aim: To explore the role of speech and language therapists in palliative care from the perspective of speech and language therapy students in Ireland. Design: A qualitative descriptive research study was conducted, involving focus group interviews. Setting/participants: Purposive sampling was used to recruit 12 student speech and language therapists from one university site for this study. Undergraduate second, third and fourth year students were eligible for inclusion. Results: This study revealed that undergraduate student speech and language therapists collectively agree that there is a role for speech and language therapy in palliative care. Although students acknowledged that speech and language therapists can make a positive difference to patients’ lives, and academic lectures were positively received, insufficient exposure to palliative care has resulted in fear, uncertainty and a lack of confidence amongst student speech and language therapists. Conclusions: A greater emphasis on palliative care is needed in undergraduate speech and language therapy education to ensure confidence and competency development. An exploration of student speech and language therapists’ experiences in a specialist palliative care unit would be advantageous to determine the appropriateness of this setting for clinical placements.

Author(s):  
Tim Luckett ◽  
Katherine L.P. Reid

Palliative care is an emerging specialty within the field of speech and language therapy (SLT); the discipline is currently under-represented both in specialist services and the research literature. This belies the fact that many patients in the palliative phase suffer problems with swallowing (dysphagia) and communication, the core domains of SLT practice. This chapter provides an overview of difficulties encountered in these domains by people with life-limiting conditions together with common approaches to assessment and management. Assessment and management should be person-centred, integrated into multidisciplinary care, and seek to maintain function via minimal intervention for maximum gain. More research is needed to inform appropriately integrated, person-centred models of SLT provision that enable difficulties with communication and swallowing to be addressed alongside other symptoms and care needs. It seems likely that difficulties in these domains are currently under-identified and under-treated in many cases.


2019 ◽  
Vol 12 (5) ◽  
pp. e227629
Author(s):  
Ceri Childs ◽  
Sally K Archer

A 75-year-old person was referred to speech and language therapy for voice rehabilitation following diagnosis of unilateral vocal cord palsy, secondary to relapsed non-small-cell lung cancer. On assessment, the patient presented with moderate–severe dysphonia. In addition, they presented with moderate pharyngeal stage dysphagia with risk of silent aspiration, which was successfully managed using a simple head turn strategy. This presentation is not atypical for patients who have disease in the upper chest or mediastinum and an increase in awareness and anticipation of such symptoms, with timely referral to appropriate specialist services, could help prevent complications associated with dysphagia, such as aspiration pneumonia and worse quality of life.


2018 ◽  
Vol 119 (2) ◽  
pp. 621-630 ◽  
Author(s):  
Meret Branscheidt ◽  
Julia Hoppe ◽  
Pienie Zwitserlood ◽  
Gianpiero Liuzzi

One-third of stroke survivors worldwide suffer from aphasia. Speech and language therapy (SLT) is considered effective in treating aphasia, but because of time constraints, improvements are often limited. Noninvasive brain stimulation is a promising adjuvant strategy to facilitate SLT. However, stroke might render “classical” language regions ineffective as stimulation sites. Recent work showed the effectiveness of motor cortex stimulation together with intensive naming therapy to improve outcomes in aphasia (Meinzer et al. 2016). Although that study highlights the involvement of the motor cortex, the functional aspects by which it influences language remain unclear. In the present study, we focus on the role of motor cortex in language, investigating its functional involvement in access to specific lexico-semantic (object vs. action relatedness) information in poststroke aphasia. To this end, we tested effects of anodal transcranial direct current stimulation (tDCS) to the left motor cortex on lexical retrieval in 16 patients with poststroke aphasia in a sham-controlled, double-blind study design. Critical stimuli were action and object words, and pseudowords. Participants performed a lexical decision task, deciding whether stimuli were words or pseudowords. Anodal tDCS improved accuracy in lexical decision, especially for words with action-related content and for pseudowords with an “action-like” ending ( t15 = 2.65, P = 0.036), but not for words with object-related content and pseudowords with “object-like” characteristics. We show as a proof-of-principle that the motor cortex may play a specific role in access to lexico-semantic content. Thus motor-cortex stimulation may strengthen content-specific word-to-semantic concept associations during language treatment in poststroke aphasia. NEW & NOTEWORTHY The role of motor cortex (MC) in language processing has been debated in both health and disease. Recent work has suggested that MC stimulation together with speech and language therapy enhances outcomes in aphasia. We show that MC stimulation has a differential effect on object- and action-word processing in poststroke aphasia. We propose that MC stimulation may specifically strengthen word-to-semantic concept association in aphasia. Our results potentially provide a way to tailor therapies for language rehabilitation.


1996 ◽  
Vol 20 (9) ◽  
pp. 524-526
Author(s):  
N. J. Muir

Speech and language therapy is a small profession. It only reached its golden jubilee year in 1995 and misleadingly, remains for many highly associated with the elocution training in which the profession had its genesis. In the last few years the greatest developments have been in the area of cognitive neuropsychological and functional (pragmatic) models for the assessment and management of language and communication. It is the premise of this article that speech and language therapists are likely to prove flexible and valuable members of the multidisciplinary team, with the ability to contribute a further dimension to care planning – that of specific clinical input to the wide range of language, speech and communication impairments associated with the major mental illnesses (Gravell & France, 1991).


Revista CEFAC ◽  
2017 ◽  
Vol 19 (6) ◽  
pp. 879-888
Author(s):  
Carmen Lucianna Miranda e Silva ◽  
Camila Bertoncelo ◽  
Ana Paula Brandão Barros ◽  
Marina Padovani

ABSTRACT The aim of this study was to integrative review of publications concerning the role of speech and language therapists in regards to communication strategies in palliative care, as well as the characterization of the types of communication used in these cases. The search was conducted in the databases SciELO, LILACS and PubMed from 2001 to 2016. The studies selected included abstracts or full articles addressing aspects of communication in palliative care, especially those related to speech and language therapy, with an emphasis on communication. Ten articles focused on communication, and published after 2004, were selected, half being literature reviews, two, case reports, two others, quantitative exploratory studies, and one, a qualitative exploratory study, with only 3 specifically describing the communication strategies used by speech and language therapists in patients in palliative care. The descriptors found were: palliative care, communication, speech and language therapy, quality of life, dysphagia, swallowing and elderly. Four of the ten articles showed the importance of patients communication in palliative care. When described, it is up to the speech and language therapist to provide family support, evaluate the patient, favore patient-family and patient-team intervention, manage and intervene in communication and swallowing. Finally, the most used communication strategies were non-verbal communication, communication board, electronic equipment, verbal communication and speech valve. The analysis of the characterization of the communication in palliative care over the past 15 years allowed concluding that the attention to communication is recent and is only described in a few reports, includes non-verbal communication in different ways as the most frequent resource, but provides oral communication as an important factor for maintaining dignity and comfort in this scenario. Speech and language therapist are the main interlocutors for the maintenance, mediation and adaptation of communication, within the multidisciplinary team as well as among patients, their family and the care team.


Author(s):  
Yune S. Lee ◽  
Corene Thaut ◽  
Charlene Santoni

This chapter examines the connection between music and speech, and points out areas of intersection relative to the mechanisms guiding their practice, application, and execution. This work also investigates the role of neurologic music therapy as a developmental, remedial, and rehabilitative protocol in the area of speech and language. In order to operationalize findings, the chapter is divided into sections by speech and language disorder: dysarthria, apraxia of speech, aphasia, fluency, sensory deficits, voice disorders, and dyslexia. Literature is provided hereafter outlining the premise for music prescription relative to the aforementioned areas, as well as areas of speech and language therapy wherein music discernibly exists as a fundamental construct in various therapeutic protocols; the practice of singing being a main area of concentration. The review provides an overview of related research and outlines areas in preliminary stages of investigation.


Author(s):  
Emma Gregory ◽  
Judy Clegg ◽  
Helen Cameron

The COVID-19 pandemic has impacted significantly on the provision of speech and language therapy education. In this commentary, we consider the impact of unprecedented uncertainty and disruption on the student experience. Changes made within both university and practice-based learning environments have resulted in the continuation of high-quality learning experiences enabling students to continue or complete their programmes. However, studying in uncertain times has been destabilising for students having the potential to impact on the more nuanced aspects of clinical and professional development (e.g., self-efficacy, confidence, and professional identity formation). We reflect on collaborative efforts to support students with navigating uncertainty and change and to facilitate their ongoing personal, professional and clinical development in a holistic way. There is a need for empirical research into the experiences of student speech and language therapists who have studied or are continuing to study in the context of COVID-19. Such research will help inform university and practice-based educators as well as SLT managers about the ongoing needs of this population. Dealing with uncertainty should be considered within university-based curriculum development as well as induction and supervisory systems within the workplace.


2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Lisa Sheridan ◽  
Cathy McHale ◽  
Joshi Dookhy ◽  
Tara Coughlan ◽  
Desmond O'Neill ◽  
...  

Abstract Background Speech and Language Therapy (SLT) is recognised as having a unique role in contributing to the overall neuropsychological assessment of people living with dementia and cognitive impairment. The role of the SLT within a memory clinic has become more widely understood. It is now recognised that speech and language characteristics are reported to be amongst the most reliable behavioural markers for distinguishing amongst different dementia subtypes, and specific analysis of a language production and delivery facilitates timely and more accurate diagnosis. Methods Patients with a language predominant presentation or those with subjective complaints of speech/language difficulties were referred for SLT assessment through the tertiary memory assessment and support service from January 2018 – March 2019. Assessment of speech and language skills, and overall cognitive communications skills were reviewed, and this information was used to aid with differential diagnosis and contribute to the person’s overall cognitive profile. The SLT attends weekly memory service interdisciplinary consensus diagnosis conference. Data was collected on these patients to observe the profiles of those patients referred to SLT. Results 22 patients were seen for full SLT assessment during this period, 13 women, 9 men; mean age 69.5 (range 48- 80). Diagnoses include: AD (32%), FTD behavioural variant (14%), Primary Progressive Aphasia (14%), Non-amnestic MCI (18%), Amnestic MCI (14%), Other neurological disorder (8%). 68% of these patients required ongoing SLT intervention for their cognitive communication difficulties following diagnosis. Conclusion SLTs fulfil an integral role in supporting both the diagnostic and post-diagnostic care pathways of people living with dementia and cognitive impairment attending memory services. SLTs have a unique role and skillset in identifying the specific nature of language difficulties for a person with dementia or cognitive impairment and in reducing the impact of the communication difficulties for the person and for their family members.


Dementia ◽  
2018 ◽  
Vol 19 (5) ◽  
pp. 1349-1363 ◽  
Author(s):  
Anna Volkmer ◽  
Aimee Spector ◽  
Jason D Warren ◽  
Suzanne Beeke

Objective To assess the extent of UK speech and language therapy engagement in assessment and management of primary progressive aphasia, determine the factors contributing to any shortfall and explore a gap in the research literature on current speech and language therapy practices with people with primary progressive aphasia. Methods A 37-item, pilot-tested survey was distributed electronically via clinical networks and through the Royal College of Speech and Language Therapists. Survey items included questions on intervention approaches, referral numbers and demographics, referral sources and access to services. Results One hundred and five speech and language therapists completed the survey. Over the previous 24 months, respondents reported seeing a total of 353 people with primary progressive aphasia (an average of 3.27 per speech and language therapist). Neurologists were the most commonly reported referrers to speech and language therapy (22.5%). Seventy-eight percent of respondents reported that people with primary progressive aphasia experienced barriers to accessing speech and language therapy. Key barriers were a lack of referrer awareness of a speech and language therapist’s role, and restrictive eligibility criteria for services. Conclusions This study highlighted inequities in access to speech and language therapy for people with primary progressive aphasia. The medical and speech and language therapy professions need to develop appropriate care pathways for people with primary progressive aphasia. Speech and language therapists have a duty to develop a relevant evidence base for speech and language interventions for people with primary progressive aphasia.


Sign in / Sign up

Export Citation Format

Share Document