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IntroductionAccording to Frost (2001, as cited in Pollens, 2004), there is a growing trend to utilise allied health interventions in palliative care, including speech pathology, physical therapy and occupational therapy. In a review of the literature, many authors recognised the prevalence of communication and swallowing impairment in palliative care caseloads (e.g. Kristjanson, Toye & Dawson, 2003; Stringer, 1999; O'Brien, Welsh & Dunn, 1998). However, there is little literature regarding speech pathology intervention with this population (Pollens, 2004). Santiago-Palma and Payne (2001) proposed that the lack of research in rehabilitative intervention for patients with terminal cancer reflects the attitude that rehabilitation for such patients is futile and inappropriate. The lack of research surrounding specific palliative care interventions may also be due to the nature of the palliative care setting (Riley, & Ross, 2005; Salt, & Robertson, 1998). See ETHICS AND RESEARCH section of this website.Several authors have outlined the role of the speech pathologist in palliative care (Pollens, 2004; Eckman, & Roe, 2005) in an effort to increase awareness among health care professionals. There remains a lack of information in the literature regarding the nature and source of referrals to speech pathology in palliative care, and the types of referrals made by speech pathologists in palliative care. The nature of referrals*The majority of palliative care referrals made to speech pathology are regarding the assessment and management of dysphagia. Speech pathologists also receive referrals for the assessment and management of speech, cognition, language, oral care, secretion management and hearing deficits.The source of referrals*Speech pathologists working in palliative care receive referrals from medical staff and nursing staff. Referrals are also received from other allied health professionals, including social workers, and ward support staff or patient services attendants.Referrals to other health care professionalsPotter (1979) discusses the importance of making appropriate referrals to "specific health service personnel such as physicians, psychologists, psychiatrists, social workers, and nurses" (p. 500) in order to address the psychological/emotional needs of terminally ill patients and their families. Palliative Care Australia (PCA; 2003) also affirms that health care professionals must be able to refer clients to specialist palliative care services where necessary.Common referrals made by speech pathologists to other health professionals have included* those made to dieticians, neuropsychology, medical staff, social work and pastoral care. Other referrals which may be necessary include those to physiotherapy, occupational therapy, otolaryngology and radiology (for videofluoroscopic study of swallow)*. In cases where speech pathologists report rarely making referrals to other health professionals*, it may be indicative that all the necessary team members are already involved with the client's care. ReferencesEckman, S., & Roe, E. (2005). Speech and language therapists in palliative care: what do we have to offer? International Journal of Palliative Nursing, 11, 179-181. Kristjanson, L., Toye, C., & Dawson, S. (2003). New dimensions in palliative care: a palliative approach to neurodegenerative diseases and final illness in older people. Medical Journal of Australia, 179, S41-S43. O'Brien, T., Welsh, J., & Dunn, F. (1998). ABC of palliative care: Non-malignant conditions. British Medical Journal, 316(7127), 286-289. Palliative Care Australia (PCA) (2003). Palliative care service provision in Australia: A planning guide. Retrieved June 10, 2005, from http://www.pallcare.org.au/Portals/9/docs/publications/Planning%20guide2003.pdf Pollens, R. (2004). Role of the Speech-Language Pathologist in Palliative Hospice Care. Journal of Palliative Medicine, 7, 694-702. Potter, R., Schneiderman, C., & Gibson, G. (1979). Understanding death, dying, and the critically ill: a concern for Speech-Language Pathologists. Journal of Communication Disorders, 12, 495-502. Riley, J., & Ross, J. (2005). Research into care at the end of life. The Lancet, 365(9461), 735-737. Salt, N., & Robertson, S. (1998). A hidden client group? Communication impairment in hospice patients. International Journal of Language and Communication Disorders, 33, 96-101. Santiago-Palma, J., & Payne, R. (2001). Palliative care and rehabilitation. Cancer, 92(4 Suppl), 1049-1052. Stringer, S. (1999). Managing dysphagia in palliative care. Professional Nurse, 14(7), 489-492. | ||||||||||||||||||||||||||||||||||
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