Beyond Speech and Swallowing: Speech Language Pathology’s Role in Engagement in Senior Living Communities

By Renee Sovern

Speech-Language Pathologist

MA,CCC-SLP

Senior living residents with dementia require continual engagement. This may seem obvious. However, we as medical professionals must always ask ourselves if we’re executing the best forms of engagement. Doing so can give residents the best quality of life- one that they deserve.

Not sure exactly how to best engage this population? No worries, that is where a speech-language pathologist’s expertise comes into play.

Speech-language pathologists can play a pivotal role in the engagement of residents with dementia in a community. Their areas of expertise include evaluation and treatment of swallowing, cognitive, speech, and language deficits.

After an initial assessment is completed, the SLP is in touch with all members of the community’s healthcare team to relay results and recommendations, and develop a treatment plan. Together with the speech-language pathologist’s and the community’s knowledge and experience, the resident will be more fully engaged and have an improved quality of life.

SPEECH, COGNITION & SWALLOWING WITHIN ASSISTED LIVING

As mentioned above, the speech-language pathologist’s primary role within the assisted living is to manage speech, cognition, and swallowing function of the residents. By doing this, it helps residents remain as independent as possible while in collaboration with their family members or loved ones.

Speech-language pathologists train staff members on how to best interact with the residents. For example, teaching the caregivers to present choices to residents with dementia instead of asking open-ended questions.

“Would you like water or apple juice?” instead of, “What do you want to drink,” is a good example.

Another technique is to keep information and questions short and simple, and then waiting 90 seconds to allow residents enough time to process the information is strongly recommended. Speech-language pathologists can also train caregivers to use external aids, such as calendars to recall the day, year, and month.

“Memory books” are another key tool that speech-language pathologists use with residents and train caregivers to use for improved carryover.  Speech-language pathologists are not with the residents for the entire day, so it’s key that caregivers are carrying over the use of memory books if residents become confused/agitated to help reorient them to their environment.

Speech-language pathologists also play vital roles in the safety of swallowing for residents. Speech-language pathologists assess for problems such as signs and symptoms of aspiration difficulty chewing, pocketing food in the mouth, coughing and throat clearing, or choking when eating or drinking.

In addition, they also assess for best feeding environments for the residents. Once the assessment is complete, the SLP may recommend that a resident be placed on an altered diet in order to reduce their risk for aspiration pneumonia, choking, weight loss, malnutrition, and dehydration based on findings from that assessment.

Finally, the biggest role of the SLP in the assisted living is communication. The SLP is in constant communication with all staff members – from caregivers, kitchen staff, and executive directors to family members – to ensure everyone is on the same page and carryover to in turn ensure best quality of care.

ENGAGING OLDER ADULTS WITH DEMENTIA

Speech-language pathologists target specific goals, established during the plan of care, to improve residents’ quality of life and improve their functioning as independently as possible within the community. Some of these are everyday activities and others are tailored to the resident’s interests, hobbies– things that excite the resident and bring happiness.

While the people in this photo are a real FOX clinician and patient, they are not mentioned in this article.