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Speech pathology should be routinely offered in aged care facilities, says therapist

Photo: Health Times Magazine
While many consider speech pathology to be a child-centric allied health service, the elderly may also benefit greatly from the service, despite accessibility being limited, particularly those living in aged care facilities.

“Speech Pathology is commonly used for the elderly as well as children, although the goals targeted in therapy may often differ somewhat,” says Certified Practising Speech Pathologist Rebecca Ivanyi.

“Speech Pathologists are employed in a range of sectors, such as hospitals and community health settings, to support the elderly by promoting social participation, independence in daily tasks and overall quality of life.”

Generally speaking, Speech Pathology is the assessment, diagnosis and treatment of communication difficulties and disorders. This can include difficulties with speech sounds, language, swallowing, voice, stuttering, social skills, literacy and more.
There are a range of conditions that are treated by Speech Pathologists, including developmental delays, learning disabilities, intellectual disability, language delays, speech sound disorders, voice disorders, swallowing difficulties and more.

Among the elderly, one of the most common conditions Speech Pathologists will treat in therapy is ‘dysphagia’.

Dysphagia involves a disruption in the swallowing process that impacts on a person’s ability to safely eat and drink, often arising as a result of a stroke or other type of Traumatic Brain Injury (TBI).

“It is the Speech Pathologist’s role to assess the nature and severity of the swallowing difficulty and make recommendations as to the type of diet on which the affected person should then be placed.

“If an affected person’s diet has not been amended based on the swallowing difficulties they are experiencing, they are at risk of aspiration, which is where food or liquid enters the airway or lungs.

“This can lead to further complications such as pneumonia, which poses particular risks for the elderly.”

Another common disability arising as a result of a stroke is ‘aphasia’, a neurological impairment which can affect the production and comprehension of language as well as the ability to read and write.

“Speech Pathologists may employ an impairment-based philosophy, the aim being to repair what is broken by completing exercises such as word-finding activities, comprehension and every day problem-solving tasks.

“Additionally, communication-based therapies may be used to enhance communication and provide strategies to caregivers in order to encourage support and participation.

“An example of this is ‘supported conversation’ which aims to enhance the communicative confidence of the relevant individual by using scaffolds, such as written keywords, hand drawings and detailed pictures.

“This may be aimed towards people who tend to know more than they are able to say and are often challenged in being able to express their feelings and opinions.”

Speech Pathology can also assist with conditions including language and swallowing difficulties relating to dementia, as well as voice difficulties emanating from Parkinson’s disease.

“Speech Pathologists will work with patients to diagnose, treat and manage these difficulties and provide strategies to improve these conditions.”

Just as is the case with children, the elderly are able to access Speech Pathology either through the private or public system, however cost is a significant barrier for many, particularly residents of aged care facilities.

By contrast, public Speech Pathology services are significantly more affordable, however there may be a significant wait involved in accessing services, which may not be a viable option for the person depending on the severity and nature of their condition.

“Aged care residents may be referred to Speech Pathology, however patients are typically prioritised based on potential immediate harm.

“Therefore, it is more likely that an aged care resident will be seen by a Speech Pathologist for a swallowing assessment to amend their diet if they are experiencing frequent coughing/choking episodes - particularly while eating and drinking - than it will be for a resident to receive therapy for a communication disorder such as aphasia.

“Government services are limited and therefore the access to Speech Pathology is not as easily available. Some facilities may employ private practices to employ Speech Pathologists on a referral basis.”

Ms Ivanyi believes Speech Pathologists should be routinely employed at aged care facilities.

“This would provide the elderly with appropriate strategies and communication modalities to adequately express themselves, and therefore reduce the risk of being mistreated, neglected or abused.

“Improved access to Speech Pathology services for the elderly would allow for more treatment and management rather than just assessment and recommendations.

“This would aid in setting up an effective communication system for those that require alternative modes of communication, such as low or high-tech communication devices, training of family members, caretakers and staff members as well as ongoing support as the patient’s needs change over time.

“I would like to see Speech Pathologists being routinely employed by aged care facilities in order to support the elderly in the long-term, rather than only providing short-term recommendations and strategies.”

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Nicole Madigan

Nicole Madigan is a widely published journalist with more than 15 years experience in the media and communications industries.

Specialising in health, business, property and finance, Nicole writes regularly for numerous high-profile newspapers, magazines and online publications.

Before moving into freelance writing almost a decade ago, Nicole was an on-air reporter with Channel Nine and a newspaper journalist with News Limited.

Nicole is also the Director of content and communications agency Stella Communications (www.stellacomms.com) and a children's author.