The “Counseling+” Roles of the Speech-Language Pathologist Serving Older Adults With Mild Cognitive Impairment and Dementia From Alzheimer's Disease

Abstract

Purpose Persons with dementia and mild cognitive impairment (MCI) are major consumers of services provided by speech-language pathologists (SLPs). These services include not only direct assessment and treatment of communication and swallowing but also counseling, collaboration, prevention, and wellness. These “counseling+” activities can be especially challenging for SLPs to deliver because of the lack of evidence, as well as the complex nature of Alzheimer's disease (AD) and other conditions that cause MCI and dementia. Method This tutorial is written by a speech-language pathologist, a neuropsychologist, and a geriatric psychiatrist to provide education, resources, and recommendations for SLPs delivering counseling+ activities to patients with MCI and dementia from AD and related disorders. Results and Conclusions We describe counseling+ activities across the continuum of care ranging from educating and conducting cognitive screenings with adults experiencing age-related cognitive decline to supporting end-of-life wishes. Because of their expertise in communication, SLPs can provide an array of important leading and supporting services to patients, their family, and other health care professionals on the care team, such as providing patients with appropriate feedback following a cognitive screening and helping caregivers identify the communicative intent of a responsive behavior. The demand for SLP services for patients with MCI and dementia will grow significantly over the next few decades, necessitating more systematic research and clinical evidence in this area.

The affective, behavioural, and cognitive reactions to a diagnosis of Primary Progressive Aphasia: A qualitative descriptive study

“…The Multifaceted Grief expressed in the affective, behavioural and cognitive reactions to questions regarding their diagnosis of Primary Progressive Aphasia demonstrated grief at losses that are vivid, real and exacerbated by the awareness of the experience. Studies that support these findings are evident in dementia and aphasia (Hoppe, 2019; Lanzi et al, 2021; Lee et al, 2014; Spreadbury & Kipps, 2019).…”

“…Details of what people with Primary Progressive Aphasia require to support them in their diagnosis highlight the desire to be informed about their future. Notably, the role of the speech pathologist as primary to the care team highlights the significance of integrating psychological care with speech pathology practice with this and similar clinical groups (Lanzi et al, 2021). Findings also highlight opportunities for speech pathologists and health professionals to formulate care pathways to better support people with Primary Progressive Aphasia.…”

Planificación terapéutica fonoaudiológica para el abordaje de usuarios adultos con dificultades comunicativas y/o lingüísticas de origen neurológico

“…El desarrollo de las habilidades conversacionales de la persona con trastorno neurocognitivo mayor (TNMa), busca que la persona pueda mantener la participación en instancias sociales. Para ello, se brindan herramientas a sus compañeros de comunicación, que les permitan generar instancias de comunicación, mejorar sus interacciones con el/ la usuario/a y mediar escenarios de contacto social (Lanzi et al, 2021). Los sistemas de comunicación aumentativa alternativa (SCAA) son una herramienta que se puede trabajar con las personas con TNMa, a partir de libros de memoria (Bourgeois et al, 2009).…”

Speech language pathologists’ self-report on counselling

“…A report by the American Speech Language Hearing Association (ASHA) while explaining the responsibilities of a counsellor, said that an SLP counsellor understands and interacts with emotional behaviours, feelings and challenges in people living with communication, swallowing and/or feeding disorders (7).…”