JCPSLP Vol 22 No 1 2020

data suggests most services are dysphagia related with communication, mealtime and environmental modifications largely underrepresented despite documented population needs (Jeng, 2015; Walker & Paliadelis, 2016). Reasons for this remain unclear. While espoused clinician values aligned with holistic care, in practice services were biomedically focused with client activities and participation largely unaddressed (Bennett, Cartwright, & Young, 2019; Bennett, Young, & Cartwright, 2019; Bennett et al., 2016; Bennett et al., 2015; Bennett et al., 2015a). The evident dissociation between best and actual practice would suggest a need for clinical guidelines that support clinicians and advocate for their services in the setting (Bennett, Cartwright, & Young, 2019; Chahda et al., 2017; Smith & Kenny, 2015). Current research points to a particularly vulnerable client population receiving sub-optimal SLP care. Despite their documented needs, research suggests RACF residents receive minimal SLP service which is largely biomedically focused. RACF speech-language pathologists report being restricted by limited referral scopes and funding allocations with reduced clinical support (Bennett, Cartwright, & Young, 2019; Bennett, Young, & Cartwright, 2019). This results in client needs not being holistically addressed by SLP services in a setting where reduced QOL, loneliness and depression are common concerns (Bennett et al., 2015a; Casper, 2013; Jeng, 2015; Theurer et al., 2015; Walker & Paliadelis, 2016). Available research on this topic is recent, reflecting a growing aged-care focus in Australia. Further research is needed across the range of factors identified. Specifically, clinical guidelines are needed to clarify and advocate for SLP services. Greater support and training is needed for the clinical skills and mental health needs of clinicians to ensure sustainable best-practice is achieved. Finally, research from the coalface to document the specialty skills of experienced speech-language pathologists working in gerontology and palliative care is needed to inform best practice. Acknowledgement The authors would like to acknowledge Mr Tim Eggleston, for his early assistance in developing the literature search strategy for this review. References Aged Care Workforce Strategy Taskforce (ACWST). (2018). A Matter of care: Australia’s aged care workforce strategy . Australia: Department of Health. Retrieved from https:// agedcare.health.gov.au/sites/default/files/ documents/09_2018/aged_care_workforce_strategy_ report.pdf Beer, C., Horner, B., Flicker, L., Scherer, S., Lautenschlager, N. T., Bretland, N., Flett, P., Schaper, F., & Almeida, O. P. (2011). A cluster-randomised trial of staff education to improve the quality of life of people with dementia living in residential care: The DIRECT study. Plos One , 6 (11), 1–11. doi:10.1371/journal.pone.0028155 Bennett, M., Cartwright, J., & Young, J. (2019). Is the speech-language pathology profession prepared for an ageing population? An Australian survey. International Journal of Speech-Language Pathology , 21 (2), 153–162. doi:10.1080/17549507.2017.1413135 Bennett, M. K., Ward, E. C., & Scarinci, N. A. (2016). Exploratory investigation of communication management in residential-aged care: A comparison of staff knowledge, documentation and observed resident-staff communication.

International Journal of Language & Communication Disorders , 51 (3), 296–309. doi:10.1111/1460-6984.12207 Bennett, M. K., Ward, E. C., & Scarinci, N. A. (2015). Mealtime management in Australian residential aged care: Comparison of documented, reported and observed care. International Journal of Speech-Language Pathology , 17 (5), 451–459. doi:10.3109/17549507.2014.987816 Bennett, M. K., Ward, E. C., Scarinci, N. A. & Waite, M. C. (2015a). Challenges to communication management in residential aged care. Journal of Clinical Practice in Speech- Language Pathology , 17 (2), 58–62. Retrieved from https:// www.speechpathologyaustralia.org.au/spaweb/Document_ Management/Restricted/JCPSLP.aspx Bennett, M. K., Ward, E. C., Scarinci, N. A., & Waite, M. C. (2015b). Service providers’ perceptions of working in residential aged care: A qualitative cross-sectional analysis. Ageing & Society , 35 (9), 1989–2010. doi:10.1017/ s0144686x14000853 Bennett, M., Young, J., & Cartwright, J. (2019). Evidence- based care for older people: Where are we now and where to in the future? Speech, Language and Hearing , 22 (1), 16–24. doi:10.1080/2050571X.2018.1538198 Bourgeois, M., Brush, J., Douglas, N., Khayum, R., & Rogalski, E. (2016). Will you still need me when I’m 64, or 84, or 104?: The importance of speech-language pathologists in promoting the quality of life of aging adults in the United States into the future. Seminars in Speech and Language , 37 (3), 185–200. doi:10.1055/s-0036-1583544 Brush, J. A., & Calkins, M. P. (2008). Environmental interventions and dementia: Enhancing mealtimes in group dining rooms. ASHA Leader , 13 (8), 24–25. doi:10.1044/ leader.FTR4.13082008.24 Burke, D. M., & Shafto, M. A. (2008). Language and aging. In F. I. M. Craik & T. A. Salthouse (Eds.), The Handbook of Aging and Cognition (3rd ed.) (373–443). New York, NY: Psychology Press. Cartwright, J., & Oliver, E. (2015). What’s the evidence?. Journal of Clinical Practice in Speech-Language Pathology , 17 (2), 94–97. Casper, M. L. (2013). Speech-language pathology in the long-term care setting: It isn’t your grandmother’s nursing home anymore. Seminars in Speech & Language , 34 (1), 29–36. doi:10.1055/s-0033-1337392 Chahda, L., Mathisen, B. A., & Carey, L. B. (2017). The role of speech-language pathologists in adult palliative care. International Journal of Speech-Language Pathology , 19 (1), 58–68. doi:10.1080/17549507.2016.1241301 Douglas, N., Brush, J., & Bourgeois, M. (2018). Person- centered, skilled services using a Montessori approach for persons with dementia. Seminars in Speech and Language , 39 (3), 223–230. doi:10.1055/s-0038-1660781. Etherton-Beer, C., Venturato, L., & Horner, B. (2013). Organisational culture in residential aged care facilities: A cross-sectional observational study. Plos One , 8 (3), 1–7. doi:10.1371/journal.pone.0058002 Green, B. N., Johnson, C. D., & Adams, A. (2006). Writing narrative literature reviews for peer-reviewed journals: Secrets of the trade. Journal of Chiropractic Medicine , 5 (3), 101–117. doi:10.1016/S0899- 3467(07)60142-6 Hopper, T. L. (2003). “They’re just going to get worse anyway”: Perspectives on rehabilitation for nursing home residents with dementia. Journal of Communication Disorders , 36 (5), 345–426. doi: 10.1016/S0021- 9924(03)00050-9

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JCPSLP Volume 22, Number 1 2020

Journal of Clinical Practice in Speech-Language Pathology