JCPSLP Vol 23 No 3

Creative clinical education

Speech-language pathology management for culturally and linguistically diverse patients with COVID-19: A single-case report Franziska Newman, Thomas Wilson, and Merridy Moore

The purpose of this case report is to describe speech-language pathology (SLP) intervention in tracheostomy management, communication and swallowing disorders with a culturally and linguistically diverse (CALD) patient diagnosed with COVID-19. This retrospective case study is of a 75-year- old male requiring extensive and adapted SLP input during the COVID-19 pandemic. Electronic medical records were reviewed to examine SLP care during the early stages of the COVID-19 pandemic, adjusting to infection containment guidelines and providing culturally competent care in this context. This paper emphasises the adaptability of speech-language pathologists (SLPs) in responding to the rapidly evolving infection control guidelines, and the specific challenges in supporting patients from culturally and linguistically diverse backgrounds during the COVID-19 pandemic. SLPs provide a core role across the continuum of care from the intensive care unit (ICU) to rehabilitation during the COVID-19 pandemic, supporting restoration of quality of life, recovery from deficits and returning to independent living. C OVID-19 is a novel disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and was declared a global pandemic by the World Health Organization on the 11th of March 2020 (World Health Organization, 2020). As of the 4th of September 2021, there have been over 219 million reported cases and 4.5 million associated deaths worldwide (John Hopkins University and Medicine, 2021). The societal impact and the degree in which the COVID-19 pandemic has affected both individuals and communities has varied significantly around the globe. This variance, as with many global health issues, can largely be attributed to geographical circumstance and socioeconomic differences between nations. While Australia has been relatively spared of the disease in the global

context and is well-positioned in the aforementioned metrics to manage the impact of COVID-19, the inequities of this pandemic on several minority sub-groups remains a concern. In Australia, these sub-groups include indigenous communities, pregnant women, the immunocompromised, and those that are culturally and linguistically diverse (CALD) (Belsky et al., 2021; Boushra et al., 2021; Power et al., 2020; Wilder, 2020). The majority of Australian cases have been concentrated in regions with large CALD populations, particularly in Western and Northern Melbourne and Western Sydney (NSW Government, 2021; Victoria Government, 2021). The community of Western Melbourne, where our tertiary hospital is located, speaks over 110 different languages and dialects, with up to 45.1% of households speaking a non-English language at home (Australian Bureau of Statistics, 2017; Western Health, 2020). At the time of writing (September 2021), Australia is facing a surge in cases of the Delta variant, a highly contagious strain of COVID-19 with rates of infection higher than that of 2020 in some locations (The Australian Government, 2021). Since the time of data collection, evidence has emerged suggesting that patients from CALD backgrounds have a higher mortality rate and suffer greater severity of the disease (Richards-Belle et al., 2020). Recommendations for communicating COVID-19 related information to CALD communities have also been established; however, despite this, CALD populations remain among the highest with COVID-19 infection in Australia (Wild et al., 2021). In the initial stages of the pandemic, little was known about COVID-19 and its impact on speech-language pathology (SLP) practice. In the hospital setting, the core role of speech-language pathologists (SLPs) includes assessment and management of communication and swallowing disorders, as well as tracheostomy management as an advanced area of practice (Speech Pathology Australia, 2013). While this was assumed to remain unchanged during the pandemic, there were many uncertainties surrounding SLP service delivery due to the lack of clarity regarding the extent to which SLP clinical practice increases risk of aerosol generation and related exposure to the virus. With new and changing health information emerging daily, much of the early focus was on communicating current research, information and consensus guidelines as they became available from international professional societies and associations (Speech Pathology Australia, 2020; Vergara et al., 2020). As the impact of COVID-19 has varied across the

THIS ARTICLE HAS BEEN PEER- REVIEWED LANGUAGE PATHOLOGY TRACHEOSTOMY KEYWORDS COVID-19 DYSPHAGIA REHABILITATION SPEECH-

Franziska Newman (top), Thomas Wilson (centre) and Merridy Moore

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JCPSLP Volume 23, Number 3 2021

Journal of Clinical Practice in Speech-Language Pathology