Speak Out Feb 2020 DIGITAL EDITION. pdf

Navigating a placement in aged care

Aged care

FOURTH YEAR SPEECH PATHOLOGY STUDENTS ZOE LAM, CLARE KOYAMA AND MIKAYLA HUTCHINGS REFLECT ON THE CHALLENGES, DIVERSITY OF EXPERIENCE AND THE REWARDS OF THEIR PLACEMENT IN AGED CARE.

Walking into the facility on our first day, we weren’t too sure what to expect. Despite our clinical educator’s best efforts to prepare us with a number of resources and the three of us spending weeks in the lead up to the placement reviewing our lecture notes, mixed reviews of aged care placements from our fellow students meant we felt quite anxious about beginning the experience. Being placed at two different facilities, we initially found it challenging to define our role and often wondered how we were going to support and add value to the existing services. With both facilities already being serviced by a private Speech Pathologist, we were conscious of needing to add a complementary service to what was already in place. Thankfully, with the helpful guidance of our clinical educator, who has an extensive background in working with adults with communication disorders, it became apparent we were going to have the most positive impact by focussing our resources on communication. We quickly discovered that our placement and our role within the facilities was going to be just as diverse as the needs and wants of the residents and families we were working with. We came across an array of different medical diagnoses and communication disorders and were saddened to learn that so many of our residents felt lonely and socially isolated. With multiple residents thanking us for talking to them and one resident even saying, “no one here talks to you much, do they?”, we learned that most of the residents really just appreciated our time and ability to have a conversation with them. Every resident we interacted with presented uniquely, which meant we were continuously learning and challenging ourselves by putting our theoretical knowledge and clinical skills to the test. The ongoing support we received from the university coupled with their open, back and forth communication with us facilitated the success of our placement immensely. Even though the university provided us with a number of formal assessments and therapy resources, more often than not we used our own, modified informal communication assessments to determine our resident’s communicative strengths and inform our management plans. In hindsight, given their diverse presentation, we have discussed that by using the resident’s personal items (such as photos, photo books and other memorabilia) to prompt a conversation, we were able to ensure a more meaningful interaction. This flexibility was also crucial to developing a strong, long-term rapport with the residents, as we met with most of them regularly throughout our placement.

Subsequent therapy was guided by the evidence base, maintenance focussed and informed by our resident’s communication goals. We offered 1:1 therapy for voice, language and speech, and implemented communication partner strategies to support the resident’s understanding and ability to better contribute to decisions regarding their care. At one facility, we also offered a communication group, where a small number of residents were encouraged to participate in conversations about topics such as their family, hobbies and careers. The feedback we received from the residents following these groups was extremely positive, with one man expressing, “that was exactly what I needed”. Our ability to add these extra services to the facilities meant that for the most part, our presence was welcomed and well accepted. We worked closely with leisure coordinators and jumped at opportunities to participate in all things communication. We accompanied many residents to leisure activities, such as Bingo and Craft, and encouraged their participation and social engagement. We even in-serviced a number of residents and were surprised to receive a handful of self-referrals for communication and mealtime concerns.

A large portion of our placement was dedicated to delivering education to other students and aged care staff, and advocating for speech pathology. We conducted surveys to determine which resources staff would benefit most from and held multiple in- services which outlined the role of speech pathology and general communication (for example, message strategies) and mealtime strategies. We also made brochures, card tags and handouts for the facility’s welcome packs in response to the survey’s results. To measure the outcomes of our in-service, we conducted a pre-

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February 2020 www.speechpathologyaustralia.org.au

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