Source: www.lhsc.on.ca
Author: London Health Sciences Centre

A Speech Language Pathologist (S-LP) assesses and manages swallowing and communication. Since these activities are performed by the same set of muscles, an S-LP is able to provide support for both functions.

Communication functions include speech, voice, language, and cognitive-communication. S-LPs support expressive abilities (verbal and non-verbal communication) as well as receptive abilities (understanding what other people are saying). We provide low-tech and high-tech communication aids when appropriate, or refer to community services to support as needed.

For swallowing, S-LPs help patients with the ability to consume solids and liquids safely and efficiently when experiencing difficulties with the muscles that support this function.

“We focus on the quality of life of the patient and do our best to optimize and maximize their abilities in swallowing or communication or both,” explains Suzie Fox, Speech Language Pathologist at London Health Sciences Centre (LHSC). “We work with the patient and take into account their values and wishes so they are able to get the most out of what they eat and drink and how they communicate once they return home.”

How can someone lose communication and swallowing functions?
A number of conditions may impact swallowing or communication because of changes to our muscles for speaking/eating or the respiratory system.

Some examples include:

  • Neurological conditions: stroke, brain injury or tumours, or neuromuscular diseases.
  • Medical conditions: dementia, COPD, congestive heart failure.
  • Surgery: head and neck, esophageal, orthopedic, facial and head trauma, transplant.
  • Cancer: head and neck cancer, brain cancer, impact of cancer treatments.
  • An ICU admission where an individual may have been intubated.

How do SLPs help patients with their communication and swallowing?
First, an SLP will assess a patient’s ability to efficiently and safely swallow, or assess their communication. They will then make recommendations and provide consultation and treatment if appropriate at the acute care level, or make referrals to the appropriate outpatient or community resources.

Recommendations and treatments are dependent on the patient’s needs and can vary between patients. Ultimately, S-LPs do their best to optimize functioning to ensure safe discharge and prevent readmission.

SLPs also:

  • Make recommendations for the medical team to take into consideration during assessment and treatment.
  • Provide strategies and modifications to rehabilitation of swallowing and communication functions.
  • Make referrals to inpatient rehabilitation programs, outpatient programs, or community services for continued support.
  • Work with SLPs in the community and liaise within the hospital team (e.g., with occupational therapists, physiotherapists, dietitians, etc.) so patients’ abilities to communicate and feed themselves continue to improve.

S-LPs help patients to socialize in a way meaningful to them once again. “S-LPs help with eating and drinking and with communicating – these are primary ways in which we all socialize with one another,” Suzie says. “We eat meals together, get a coffee with a friend, and talk with one another to build and maintain connections. S-LPs support and enable a person’s participation in their own life and that is incredibly rewarding.”

Interdisciplinary teamwork
SLPs also work as part of an interdisciplinary team that works together for the benefit of the patient.

“For example, if a patient requires food with altered textures to help with swallowing, such as minced or pureed solids or thickened liquids, an S-LP will work with a dietitian to find ways to maximize their nutrition. If a patient needs support with the function of feeding themselves at home, an S-LP will work with an occupational therapist to look at how the patient can improve their function and make any necessary modifications with devices,” explains Suzie.

“It’s rewarding to be a speech language pathologist because we get to see the progress a person makes in their ability to speak and communicate with loved ones. There is nothing more touching than someone saying ‘I love you’ to their family again when they haven’t been able to,” Suzie shares. “It’s wonderful to see someone have the ability to eat or drink something they enjoy again and to see them be able to return to a level of functioning they had before.”