AGED CARE & COMMUNITY SPEECH PATHOLOGY | LOQUI SPEECH PATHOLOGISTS SERVICE AGED CARE FACILITIES THROUGHOUT AUSTRALIA

Education

Speech Pathology Education

Loqui can provide up to date, evidence-based education and training to all facility staff whose performance directly influences individual resident’s quality care.  Talks and seminars can be presented to:

  • Nursing staff: Registered Nurses (RN), Assistants in Nursing (AIN) and
    Endorsed Enrolled Nurses (EEN).
  • Chefs, catering and kitchen staff.
  • Clinical and managerial staff.

Swallowing Disorders: Dysphagia

Approximately 50% of residents in aged care facilities present with swallowing difficulties (dysphagia) (SPA, 2014). As speech pathologists we recognise the important role that all residential aged care facility staff play in supporting swallowing needs of residents. This training provides staff with a clear understanding of impairments to the swallowing process seen in residents with dysphagia and a greater appreciation of the need for texture modified diets and thickened fluids for those residents. With this training, staff become better equipped to recognise swallowing difficulties and make appropriate referrals to the speech pathology team

Swallowing in Ageing

With general ageing there are natural changes that occur to the swallowing mechanism. Staff will benefit from an understanding of these changes, their impact on a resident’s safety, social emotional needs and wellbeing and the ways in which residents may require support from staff. This training outlines the phases of the swallow and the changes seen in geriatric populations. Facility staff will learn to identify if residents are experiencing difficulties with swallowing related to the general ageing process and are given practical strategies to support these residents.

Modified Textures and Thickened Fluids

Modification of food textures and thickening fluids are frequently used in the treatment of dysphagia (swallowing impairments). By altering the texture or consistency of food and fluids for a resident, speech pathologists are able to improve a resident’s swallow safety and decrease risk of aspiration or choking. Facility staff play a significant role in ensuring residents are on the correct diet/consistency and therefore benefit from specific training on the various modified texture diets and fluid consistencies recommended by speech pathologists. During this training, Loqui staff will explain the characteristics of each diet/consistency and provide practical strategies for making and presenting these foods/fluids.

Swallowing Safety and Improving Oral Intake

The safety of residents is the primary priority for all facility staff. Residents with dysphagia are placed at increased risk of aspiration, malnutrition and dehydration (Dietitians Association of Australia, 2010). Training will provide staff with an understanding of these and ways to ensure safe swallowing. Topics discussed include: modified diets and thickened fluids; optimal positioning for oral intake; supportive mealtime environments and ways to promote increased awareness and intake at all mealtimes.

Minimising Aspiration Risks

Aspiration pneumonia is when material such as saliva, food or fluid is inhaled into lungs, rather than ingested into the stomach, and causes inflammation and infection of the lungs. Residents with dysphagia can be at an increased risk for developing this condition. Aspiration risks can be minimised through use of swallowing strategies and/or the modification of fluids and foods; a speech pathologist can provide strategies suitable for specific residents following assessments. Staff can also assist by being familiar with safe feeding and making appropriate referrals to speech pathologists. This training outlines strategies and techniques that staff are able to implement within facilities and provides them with confidence in making correct referrals to speech pathologists for assessment.

Speech Pathology in Palliative Care

Speech pathologists work within the multidisciplinary team (with nursing staff, other allied health professionals, the medical team, residents and their families) to ensure residents and their families are well supported during the palliative care process. As part of our training we discuss ways to provide palliative care that respects each person’s personal preferences, dignity, spiritual needs and rights. Specifically we look at creating positive mealtime experiences and the concept of ‘comfort (or risk) feeding’. We also look at ways to support communication in the palliative phase. Our training is based on current evidence-based practice on end of life support and care.

What is a Texture B, minced and moist diet?

Texture modified diets are commonly used to support residents who may have swallowing difficulties (dysphagia). Of all three texture modifications, we find that Texture B (Minced & Moist) can be the most difficult to comprehend and create. Loqui Speech Pathology offers training to facilities on this topic; ensuring staff members have a clear understanding of the characteristics of a Texture B meal and the types of foods that are (and are not) included under this diet, and an appreciation for ways to improve the presentation of modified meals.

How to thicken fluids?

For some residents, thickened fluids are important to ensuring swallow safety and it is important that they receive the consistency that has been recommended for them. However, we know that thickening drinks to a mild, moderate or extremely thick consistency can be a challenge. We support staff by providing easy, hands-on training targeted at improving staff competence and confidence with thickening fluids to correct consistencies. We are familiar with a variety of thickening agents and will centre our training on whichever product your facility utilises.

Supportive Feeding Techniques and Strategies

There is a well-known link between malnutrition and a poorer quality of life and health outcomes (Dietitians Association of Australia, 2010) and, as such having staff well-trained in safe feeding techniques and strategies is paramount for aged care facilities. In our practical, hands-on training we discuss feeding techniques and strategies for improving safety of residents at mealtimes and increasing oral intake. Some topics discussed include: positioning of residents for oral intake, setting up a supportive mealtime environment, cup vs straw drinking, mouth cares and strategies for providing food/fluids to residents.

Communication disorders: Dysphasia, Dysarthria and Dysphonia.

Communication problems are common in residential aged care settings with approximately 95% of residents living with at least one communication disorder (Speech Pathology Australia, 2014). Communication impairment can significantly impact upon a resident’s quality of life. We provide staff with background understanding of different communication disorders (i.e. ‘dysphasia’ (language disorder), ‘dysarthria’ (speech disorder) and ‘dysphonia’ (voice disorder)) and typical presentations. We also provide practical examples of how to support these residents to communicate their needs, wishes and opinions in the aged care facility.

Communication in the Aged

We are passionate about quality of life for residents of aged care facilities and know that for some residents this is significantly impacted because of challenges with communication. As part of our training targeted at facilitating improved communication between staff and residents of aged care facilities, we can provide information about communication skills of aged populations and how these may change over time.   We find that nursing staff are often the key communication partners for residents and therefore they can particularly benefit from our practical strategies for increasing the effectiveness and efficiency of communication interactions with residents.

Should you require any further information on these topics, or if you would like information on any other areas of speech pathology aged care services, please contact Loqui.
REFERENCES

Speech Pathology Australia, 2014. Speech Pathologists working with older people. [Fact sheet]. http://www.speechpathologyaustralia.org.au/library/2013Factsheets/Factsheet_Speech_Pathologists_Working_With_Older_People.pdf

Dietitians Association of Australia, 2010. Residents in aged care facilities malnourished. [Media Release].  http://dmsweb.daa.asn.au/files/media%20releases/March_2010/MR-Aged%20Care%20Malnourished_March10.pdf