Background Aphasia is an acquired disorder of language and can be caused by conditions including stroke, brain tumour, head injury and dementia (Royal College of Speech & Language Therapists, 2019). Due to the nature of these conditions, it is likely that people with aphasia will access palliative care (Hawksley, Ludlow, Buttimer & Bloch, 2017).
Speech and language therapists (SLTs) are well placed as ‘communication experts’ to support patients with aphasia to communicate. Although the role of SLTs in palliative care is well documented (Chahda, Mathisen & Carey, 2017) the literature suggests that SLTs are not usually integrated within a hospice MDT (Pollens, 2004).
Aim To identify views of hospice staff on their interactions with patients with aphasia.
Do staff have an understanding of SLT and do they feel SLTs have a role in palliative care?
Do staff feel confident in interacting with patients with aphasia and/or do they feel that service improvements need to be made to improve these interactions?
Methods A qualitative descriptive exploratory design (Sandelowski, 2000). Four doctors and four nurses working in hospices in Yorkshire were interviewed using a semi-structured interview guide. Hospices which identified that they commonly care for patients with aphasia were included. A purposive sampling strategy was adopted. Data were analysed using thematic analysis (Tesch, 1990).
Results The following themes emerged:
Knowledge of and attitudes towards speech and language therapy;
Knowledge and awareness of supporting people with communication impairments;
Palliative care in the hospice;
Using family to support;
Directions for change.
Differences were apparent between the two hospices in the frequency of referrals to SLT. Staff had skills in caring for patients with communication impairments but some spoke of a desire for further training and closer links to SLT.
Conclusions Findings from this study and the literature suggest limited specialist communication support for patients accessing palliative care. Clinicians are encouraged to reflect upon the approach in their own setting to consider if changes could be implemented.