Speech-Language Pathology (SLP) in Palliative Care (PalCare) is a new and developing area of specialty which aims to provide appropriate SLP practice within palliative and end-of-life care services. While the profession of speech-language pathology/speech therapy has been in existence since the turn of the 20th Century, and palliative care has been practiced for centuries (in one form or another), nevertheless, the combination of the two disciplinary areas intersecting has often been intermittent and highly dependent upon a specific institutional context, rather than being systematically endorsed by any government regulations or professional association clinical practice guidelines (CPGs).
Speech-Language Pathology in Palliative Care Special Interest Group has a primary focus upon ten major areas in order to support SLPs in Palliative Care and redress the lack of SLP CPGs in Palliative Care:Chahda et al (2020)
Encouraging, developing and/or conducting ongoing research and creating resources for SLPs working in Palliative Care.
Educating health professions about the role of SLPs in PalCare.
Establishing referral procedures for SLP intervention within PalCare.
Integrating PalCare within SLP tertiary education.
Promoting the education, consultation, supervision and mentoring of SLPs new to PalCare.
Incorporating SLP observations and interventions into the overall multi-disciplinary/palliative care team goals.
Focussing PalCare assessment and therapy to include both cognitive-communication and swallowing interventions.
Integration of SLPs as a part of a practical, consultative and holistic PalCare approach.
Encouraging professional self-care consideration for SLPs working in PalCare.
Based upon the findings of an increasing number of researchers [for example see the reviews of Chahda et al (2017) and Krikheli et al (2018) there is clearly a need for further research and increased scope of practice accompanied by the development of SLP clinical practice guidelines so as to enhance the multidisciplinary and holistic collaboration of SLPs within Palliative Care / End of LIfe Care contexts.
(1) CURRENT RESEARCH (2022-2024)
"Identifing facilitators and barriers to successful speech pathology student placements in the palliative care setting"
To achieve the objective foci of SLPs within Palliative Care (as noted above) the formation of the 'Speech-Language Pathology and Palliative Care Special Interest Group' (SLP-PalCare-SIG) has been listed by Speech Pathology Australia (SPA) and currently involves representatives from a number of universities and clinical practices. There is no fee to be a member of the SLP-PalCare-SIG. Please email the secretary if you are interested in joining.
To achieve the objective foci of SLPs within Palliative Care (as noted above) the formation of the 'Speech-Language Pathology and Palliative Care Special Interest Group' (SLP-PalCare-SIG) has been listed by Speech Pathology Australia (SPA) and currently involves representatives from a number of universities and clinical practices. There is no fee to be a member of the SLP-PalCare-SIG. Please email the secretary if you are interested in joining.
SLP-PalCare-SIG Members (Alphabetical by Surname):
[Chairperson] Professor. Bernice Mathisen (University of Southern Queensland, AU: Bernice.Mathisen@usq.edu.au)
[Secretary] Associate Professor (Adj) Lindsay Carey (Palliative Care Unit: La Trobe University, AU: Lindsay.Carey@latrobe.edu.au)
Dr. Valerie Adams (Food Solutions Diet Consultants, Queensland, AU: valerie@foodsolutions.com.au).
**ISLP Award (2022): Congratulations to Dr. Laura Chahda (Victoria University) who was presented with the Taylor & Francis / International Journal of Speech, Language and Hearing Best Publication Award for her research into Adult Palliative Care and SLPs in Australia. If you would like to read the article please see the link below:
Chahda, L., Carey, L. B., Mathisen, B. A., & Threats, T. (2021). Speech-language pathologists and adult palliative care in Australia. International Journal of Speech-Language Pathology, 23(1), 57-69. https://doi.org/10.1080/17549507.2020.1730966
**JCPSLP Award (2023): Congratulations to Dr. Laura Chahda (Victoria University), Dr. Halely Dell'Oro (Victoria University), Jemma Skeat (Deakin University) and Megan Keage (University Melbourne) who were presented with the JCPSLP research publication award for their article:
Chahda, L., Dell’Oro, H., Skeat, J. & Keage, M. (2022). Learning at end of Life Preparedness of speech language pathology graduates to work in palliative care. Journal of Clinical Practice in Speech-Language Pathology. 24 (2), 77-79. [JCPSLP article available via SPA or author; see also Chahda et al 2024 - References below]
Mathisen, B.A. & Threats, T. (2018). Speech-Language Pathology and Spiritual Care. In Carey, L.B. & Mathisen, B.A. (2018). Spiritual Care for Allied Health Practice: A person-centered approach. London: Jessica Kingsley Press. https://www.jkp.com/aus/spiritual-care-for-allied-health-practice.html
Carey, L.B. & Mathisen, B.A. (2018). Spiritual Care for Allied Health Practice: A person-centered approach. London: Jessica Kingsley Press. https://www.jkp.com/aus/spiritual-care-for-allied-health-practice.htm[This book is free to all SPA-PalCare-SIG members; please contact the Secretary for your free copy]
Chahda, L., Carey, L. B., Mathisen, B. A., & Threats, T. (2020). Speech-language pathologists and adult palliative care in Australia. International Journal of Speech-Language Pathology, 23 (1), 57-69.
Chahda, L., Dell’Oro, H., Skeat, J. & Keage, M. (2022). Learning at end of Life Preparedness of speech language pathology graduates to work in palliative care. Journal of Clinical Practice in Speech-Language Pathology. 24 (2), 77-79. [JCPSLP article available via SPA or author].
Chahda, Laura; Dell'Oro, Hayley; Skeat, Jemma; McVilly, Isobel; Lobo, Sarisha; Vu, Maya; et al. (2024). End-of-Life Learning: Exploratory Insights for Enhancing Successful Tertiary Speech Pathology Placements in Australian Palliative Care. Australian Jounal of Clinical Education, 13, 113-132. https://doi.org/10.53300/001c.123457
Collins, C.A. (2022). There’s this big fear around palliative care because it’s connected to death and dying’: A qualitative exploration of the perspectives of undergraduate students on the role of the speech and language therapist in palliative care. Palliative Medicine. 36(1), 171 –180. https://doi.org/10.1177/02692163211050818
DeZeeuw, K., & Lalonde Myers, E. (2020). The Role of Speech-Language Pathologists in Medical Assistance in Dying: Canadian Experience to Inform Clinical Practice. Canadian Journal of Speech-Language Pathology & Audiology, 44(2).https://cjslpa.ca/detail.php?ID=1259&lang=en
Feeney, R., Willmott, L., Wilson, J., & White, B. (2023). Legal issues in end-of-life care for speech-language pathologists and social workers: A scoping review. International Journal of Speech-Language Pathology, 26 (2), 244-256.. https://doi.org/10.1080/17549507.2023.2205061
Fong, R., Tsai, C., Wong, H., Yiu, O., & Luk, J. K. H. (2019). Speech therapy in palliative care and comfort feeding: Current practice and way ahead. Asian Journal of Gerontolology and Geriatrics, 142, 61-68. https://doi.org/10.12809/ajgg-2018-330-oa
Hanna, E., & Joel, A. (2005). End-of-Life Decision Making, Quality of Life, Enteral Feeding, and the Speech-Language Pathologist. Perspectives on Swallowing and Swallowing Disorders (Dysphagia), 14(3), 13-18. https://pubs.asha.org/doi/full/10.1044/sasd14.3.13
Hawksley, R., Ludlow, F., Buttimer, H., & Bloch, S. (2017). Communication disorders in palliative care: Investigating the views, attitudes and beliefs of speech and language therapists. International Journal of Palliative Nursing, 23, 543–551. doi: 10.12968/ijpn.2017.23.11.543.
Gravier, S. (2019). Palliative care and how evidence supports speech pathologists who care people at end of life. Speech Pathology AustraliaSpeak Out. June, p. 20-21.
Kelly, K., Cumming, S., Corry, A., Gilsenan, K., Tamone, C., Vella, K., & Bogaardt, H. (2016). The role of speech-language pathologists in palliative care: Where are we now? A review of the literature. Progress in Palliative Care, 24(6), 315-323.
Kelly, K., Cumming, S., Kenny, B., Smith-Merry, J., & Bogaardt, H. (2018). Getting comfortable with “comfort feeding”: An exploration of legal and ethical aspects of the Australian speech-language pathologist’s role in palliative dysphagia care. International Journal of Speech-Language Pathology, 20(3), 371-379.
Sharp & Stead (2024) End of Life Care & SLPsKrikheli, L., Mathisen, B. A., & Carey, L. B. (2018). Speech–language pathology in paediatric palliative care: A scoping review of role and practice. International Journal of Speech-Language Pathology, 20(5), 541-553.
Krikheli, L., Carey, L. B., Mathisen, B. A., Erickson, S., & Carey-Sargeant, C. (2018). Recommendations for Speech-Language Pathologists in Paediatric Palliative Care Teams (ReSP3CT): A modified Delphi study protocol. BMJ Supportive & Palliative Care, Online First, 1-7. doi:10.1136/bmjspcare-2018-001667
Krikheli, L., Carey, L. B., Erickson, S., Carey‐Sargeant, C. L., & Mathisen, B. A. (2020). Recommendations for Speech-Language Pathologists in Paediatric Palliative Care (ReSP3CT): An International Modified Delphi Study. International Journal of Speech Language Pathology, Online: : https://doi.org/10.1080/17549507.2020.1866073
Krikheli, L., Erickson, S., Carey, L. B., Carey‐Sargeant, C. L., & Mathisen, B. A. (2020). Perspectives of speech and language therapists in paediatric palliative care: An international exploratory study. International Journal of Language & Communication Disorders. Online:https://doi.org/10.1111/1460-6984.12539
Krikheli, L., Erickson, S., Carey, L. B., Carey‐Sargeant, C. L., & Mathisen, B. A. (2020). Speech-Language Pathologists in Pediatric Palliative Care: An International Study of Perceptions and Experiences. American Journal of Speech-Language Pathology, 30(1), 150-168:https://doi.org/10.1044/2020_AJSLP-20-00090
Lamont, R., Stead, A., Smidt, A. (2022). AAC for people with motor neurone disease in pallative and end-of-life care. Journal of Clinical Practice in Speech Langauge Pathology, 24 (2), 80-83.
Mahendra, N., & Alonso, M. (2020). Knowledge of palliative care and advance directives among speech–language pathology students. Topics in Language Disorders, 40(3), 248-263. doi: 10.1097/TLD.0000000000000224
Mathisen, B., Carey, L. B., Carey-Sargeant, C. L., Webb, G., Millar, C., & Krikheli, L. (2015). Religion, spirituality and speech-language pathology: A viewpoint for ensuring patient-centred holistic care. Journal of Religion and Health, 54(6), 2309–2323.
Mathisen, B.A. & Threats, T. (2018). Speech-Language Pathology and Spiritual Care. In Carey, L.B. & Mathisen, B.A. (2020). Spiritual Care for Allied Health Practice: A person-centered approach. London: Jessica Kingsley Press. https://www.jkp.com/aus/spiritual-care-for-allied-health-practice.html
Mathisen, B.A., Yates, P., Crofts, P. (2010). Palliative care curriculum for speech-language pathology students. International Journal of Language and Communication Disorders. 46 (3), 273–285. https://doi.org/10.3109/13682822.2010.495739
Martins, S., & Castro Alves, S. (2017). Speech Therapy in Palliative Care—Portuguese Perspective. Journal of Palliative Medicine, 20(1), 7-7. https://doi.org/10.1089/jpm.2016.0407
Nagdee, N., & Manuel de Andrade, V. (2022). ‘I don't really know where I stand because I don't know if I took something away from her’: Moral injury in South African Speech–Language Therapists and Audiologists due to patient death and dying. International Journal of Language & Communication Disorders. Published online: https://doi.org/10.1111/1460-6984.12765
O'Reilly, A.C. & Walshe, M. (2015). Perspectives on the role of the speech and language therapist in palliative care: An international survey. Palliative Medicine, 29(8), 756-761. https://doi.org/10.1177/0269216315575678
Pascoe, A., Breen, L.J., & Cocks, N. (2018). What is needed to prepare speech pathologists to work in palliative care?. International Journal of Language and Communication Disorders, 53(3), 542-549. https://doi.org/10.1111/1460-6984.12367
Pollens, R., Chahda, L., Freeman-Sanderson, A., Lalonde Myers, E., & Mathison, B. (2021). Supporting Crucial Conversations: Speech–Language Pathology Intervention in Palliative End-of-Life Care. Journal of Palliative Medicine, 24(7), 969-970. https://doi.org/10.1089/jpm.2021.0134
Pollens, R. (2020). Facilitating Client Ability to Communicate in Palliative End-of-Life Care: Impact of Speech-Language Pathologists. Topics in Language Disorders, 40 (3) , 264-277. https://doi.org/10.1097/TLD.0000000000000220
Pollens, R. (2012). Integrating speech-language pathology services in palliative end-of-life care. Topics in Language Disorders, 32, 137–148. doi:10.1097/TLD.0b013e3182543533.
Pollens, R. (2004). Role of the speech-language pathologist in palliative hospice care. Journal of Palliative Medicine, 7, 694–702. doi:10.1089/jpm.2004.7.694.
Stead, A., Dirks, K., Fryer, M., & Wong, S. (2020). Training Future Speech–Language Pathologists for Work in End-of-Life and Palliative Care. Topics in Language Disorders, 40(3), 233-247. doi: 10.1097/TLD.0000000000000219
Stead, A., Haynie, S., & Vinson, M. (2023). Teaching End-of-Life Care in Speech-Language Pathology: A Tutorial. Teaching and Learning in Communication Sciences & Disorders, 7(1) Article 4. https://ir.library.illinoisstate.edu/tlcsd/vol7/iss1/4
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