clinical focus
You obviously deal with a lot of older Australians , what are the general comments they make about life as a result of their inability to communicate ? I think any kind of communication disability is quite difficult to visualise . Unlike a physical disability , a communication disability isn ’ t necessarily that obvious to someone . We ’ re moving in a very verbal world and a very big world , so you get mail , you can get it on the phone , even currently , you ’ ve got lots of telehealth which was a huge twist in how we provide services brought about by COVID , which is really difficult for some people in the aged care sector .
So in terms of access to the community and completing everyday tasks , it can be quite isolating and become quite difficult when someone has difficulty in accessing reading information or being able to express themselves clearly when they go out to have lunch : it might be too noisy and they have difficulty keeping up with the conversation and finding the right words .
And that can make it difficult for them to have meaningful connections with others . And it can be quite isolating unless someone takes the time and puts in the energy to work with someone who has a communication disability .
I often associate speech pathology with younger people . Do people realise that speech therapy and speech pathology can be effective for older Australians ? I think it depends on who you talk to . I think speech pathology is increasingly being identified in its role within the aged care sector . There ’ s a difference between the community and residential aged care in terms of funding and access to speech pathologists , which is something that is being reviewed by the royal commission .
“
Just because someone might have difficulty recalling words or constructing a sentence … it doesn ’ t mean that ’ s the end .
I think particularly with the introduction of My Aged Care and the national standardised assessment form , I think that that ’ s been really good at being able to identify where the role of the speech pathologist may be in aged care . I think there ’ s a lot more prompts within that for assessments to really consider someone ’ s communication and the impact that might have on their everyday life , and the role of the speech pathologist in being able to work with someone . It does take a lot to educate the community around that role .
How much can be done for someone over an advanced stage ? There ’ s a lot , there are lots of people who are very young 65-year-olds and particularly in the community , if you look all the way through high level care needs and residential care – there ’ s a huge range of things that we work on and these are some clinical examples .
A gentleman was diagnosed with Alzheimer ’ s disease . Part of that involved loss of his language . He also became quite apathetic in his presentation , so he didn ’ t initiate as much conversation with others as well . And his ability to recall information was reduced .
We worked on a life story book with him so that he could really engage in a meaningful way with someone . Instead of relying on him being able to recall information , the information is there , it can be shared with someone . So it gave him the opportunity to really share part of himself and his identity , identifying that he is still a person despite the fact he does have a diagnosis of dementia , and really looked at the roles he could still fulfil within his life and included in that was communication partner training .
Take someone with Parkinson ’ s disease . Very early on in a diagnosis we usually do some voice therapy , which has really good evidence behind it . It is rehab to strengthen someone ’ s voice with the knowledge of an understanding of the neurobiology behind Parkinson ’ s disease . And then as that progresses , we look at other strategies and supports .
In the community , we have aphasia support groups for people who are living post-stroke with chronic language impairments . Part of that is having an opportunity to link in with people who understand what it ’ s like to live with a communication impairment .
For anyone out there , any older Australians who are reading this or any aged care homes who don ’ t currently use the services of a speech pathologist , what would you say to them ? Speech pathology definitely has a role quite diversely across the aged care sector , and anybody with the right help can learn to communicate with confidence .
I think we have a huge role in terms of behaviour support and creating meaningful experiences across the sector . Even though someone has been living with a communication disability chronically , it doesn ’ t necessarily mean that there isn ’ t anything that we can do to help .
Things progress , things change , evidence changes , technology changes ; there ’ s always new , upcoming things within the sector . So just because someone might have difficulty recalling words or constructing a sentence , or is having difficulty clearly not getting words , it doesn ’ t mean that that ’ s their diagnosis and that ’ s the end .
We ’ re definitely out there to provide strategies and support to build people ’ s opportunity to communicate with confidence . ■ agedcareinsite . com . au 21