Special Interest Group 15 - Gerontology

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Clinical Practice Considerations: COVID-19, Word Retrieval, and Tinnitus
Format(s): SIG Perspectives
Three clinical practice considerations are reviewed within, including communication with patients/families in the face of the COVID-19 pandemic, identification of word finding errors in normally aging individuals, and how to address severe tinnitus. The first article points out that communication demands have changed during the pandemic, with increased need for communication about the virus and necessary precautions; however, mask use and social distancing have had a negative impact on everyone’s communication, especially those with communication disorders. COVID-19 specific precautions have included restriction of visitors in hospitals and nursing homes, quarantining, mask wearing, social distancing. Those with communication disorders experience specific circumstances that put them at a disadvantage as a result of these measures, to the extent that some disability rights groups argued that these policies may be violating acts and policies that are in place specifically to protect these individuals. This article goes on to explore, within the context of the COVID-19 pandemic, the importance of clear patient–provider communication, the impact of culture on communication, and using clear terminology. The second article sought to develop clinical practice by examining variations in performance on different verbal tasks completed by typically aging adults without neurological impairment who self-identified as either having or not having word-retrieval difficulties that frequently affected their lifestyle. The authors studied fifty-seven healthy adults between the ages of 54 and 71, by separating them into one group without selfidentified word retrieval difficulties and one group with self-identified word retrieval difficulties. Formal and informal assessment measures were used to objectively identify word-finding difficulties. The final article addresses the problem of tinnitus, which is broken down into two forms: bothersome and nonbothersome. Treatment is typically initiated when it becomes bothersome to the person experiencing it. The author reviews risk factors for developing tinnitus. In this specific instance, tinnitus was reported following a procedure that was intended to reduce vertigo. The patient opted to manage her tinnitus with pharmaceuticals, sound therapy, and education in the form of Tinnitus Retraining Therapy. The author describes the evaluation and treatment of each component in great detail. The result was a significant improvement in symptoms and the patient’s quality of life and functional abilities.
Social Considerations: Exercise and Engagement, Communicative Participation
Format(s): SIG Perspectives
This Perspectives activity contains three articles, all with emphasis on social considerations in the elderly, with emphases on risk factors for dementia and treatment of Parkinson’s Disease. The first article seeks to describe the validity and reliability of the Fun and Social Engagement Evaluation (FUSE). The authors explain that this is an important topic because lack of physical activity and low social engagement are risk factors for dementia and could impact the rate of decline associated with dementia. Furthermore, physical inactivity has been identified by the World Health Organization as a leading risk factor for global mortality. Nursing home residents were evaluated using the FUSE during “Bingocize” sessions; the program combines a bingo-like game and physical activity and is scaled for differing cognitive and physical levels of ability. Results indicate that the FUSE is a valid and reliable method to measure engagement, and this is important because this measure can be recommended to nursing homes to measure engagement, as well as used in future research. The second article attempts to determine which of a variety of factors were associated with communicative participation and measured this based on the social network size of an individual. The author feels that this is important because social isolation is linked to cognitive decline and depression, both of which are risk factors for developing dementia. This study builds on previous research related to social participation and communication as predictors of successful health outcomes. Two research questions are addressed: What numbers of communication partners exist in the self-reported social network of older adults? And what factors are included in a model for predicting the social network size of older adults? They studied 337 seniors in Central Arkansas by collecting interviews and conducting standardized assessments. Results indicate that cognition and education are factors that are related to communicative participation. The results of this study, along with additional literature on this topic, suggest that there is benefit in recognizing a decrease in communicative participation and the role that cognitive decline may play in restricting communicative participation. The final article describes the program developed at Long Island University Brooklyn, which is multidisciplinary in nature, in contrast to previous treatment models which have traditionally focused on a monodisciplinary approach. In the past decade, there has been a shift from monodisciplinary models and research to a multidisciplinary approach, which is more effective in holistically treating the multifaceted effects of Parkinson’s Disease (PD), resulting in better outcomes and social participation for individuals with PD. The article describes use of the Fitness for PD exercise program twice per week for ten weeks, targeting strength, balance, agility, stretching, and aerobic exercises. Students at the university are engaged in taking vitals, facilitating resistance training, and enhancing safety; students and participants find benefit in working together. One hour Speech Clinic for PD sessions are conducted after each fitness class, including voice evaluations and therapy focusing on maximizing voice production and improving breathing patterns. The first half of sessions are conducted in game format, which encourages interpersonal interactions and collaboration and facilitates carryover into conversational contexts. Sessions incorporate Motor Learning Principles, LSVT LOUD, and respiratory exercises. The second half of sessions are conducted in whole-group format and speech practice in small groups.
Quality of Life in Communication Among the Elderly
Format(s): SIG Perspectives
Three articles have been grouped, all centering around quality of life: at end of life, following a stroke, and among individuals with voice disorders. In “Facilitating End-of-Life Interaction Between Patients With Severe Communication Impairment and Their Families,” the authors acknowledge the work that has been done previously and recently in outlining the role of the speech-language pathologist in dysphagia and communication at end of life. One case study is presented, which describes an end-of-life scenario following a stroke. Post–case study review, the authors include reflections, counseling points for clinicians related to the case study, and counseling points in the form of a handout that could be used as a resource for clinicians. Given that existing research on the impacts of stroke is primarily conducted within a 5-year period following the stroke, the authors of “Quality of Life Following Stroke: A Qualitative Study Across 30 Years” seek to understand the long-term effects. They draw data from 28 years of journals that were kept by the participant and conduct semistructured family interviews. The authors draw four themes from the data—family support, faith, personality, and journaling—as having influence over the participant’s long-term experience poststroke. Within the discussion, the authors examine the World Health Organization’s Quality of Life Factors and the participant’s experience through the lens of the resilience theory. Among aging individuals, voice disorders (including presbyphonia) are commonly reported—however, treated less proportionately. “Perceived Voice Disorders in Older Adults and Impact on Social Interactions” uses a cross-sectional investigation approach by examining the findings of three assessments on 332 community dwelling individuals aged 60 and older. The authors conclude that voice disorders increase with age and, conversely, social interactions requiring communication decrease among individuals with voice disorders. As a result, health-care professionals are encouraged to educate older individuals on how and why to seek management of a voice disorder by a speech-language pathologist or qualified medical professional.
Progressive Topics for Consideration: Ageism, Systems of Oppression in Geriatrics, and Health Disparities
Format(s): SIG Perspectives
Three progressive cultural topics are examined as they relate to speech-language pathology and audiology. Because negative feelings toward the elderly can result in adverse effects in healthcare settings, in “Ageism Among Graduate Students in Communication Sciences and Disorders: A Longitudinal Analysis,” Heape et al. tested 80 graduate students in speech-language pathology to determine the presence and level of ageism using the Fraboni Scale of Ageism. They conclude that positive impacts could be gained by development of graduate curriculum that encompasses all age groups, including the elderly. In “Systems of Oppression in Geriatric Clinical Service Delivery,” Kendall builds on previous work related to forms of oppression by defining institutional, symbolic, and individual systems of oppression. Additionally, she provides clinical examples specific to working in communication sciences disorders settings and suggestions as to how clinicians can disrupt oppression in the workplace. In “The Complexity of Health Disparities: More Than Just Black–White Differences,” Ellis and Jacobs bring health disparities back to light given the recent findings from 2020 indicating that Hispanic and African Americans are more than twice as likely to die from COVID-19 than White Americans. They provide definitions, review vulnerable populations and the interaction between social determinants and health disparities, and provide suggestions on how to achieve equity.
Dysphagia & Auditory Matters in Geriatric Speech-Language Pathology
Format(s): SIG Perspectives
These articles explore thickened liquids for oropharyngeal dysphagia, importance of patient selection, & balancing physical welfare/quality of life (QOL); QOL in patients/caregivers in recovery for swallowing disorders; audiologist knowledge of cognitive impairment/screening in outcomes/communication; and hearing screening for individuals who are diagnosed with dementia.
Dementia, Student Supervision,  and the Patient Driven Groupings Model
Format(s): SIG Perspectives
These Perspectives (SIG 15) articles discuss issues related to dementia care, student supervision, and the home health patient driven groupings model. Warren describes the rational for the development of a new payment system, how it will be changing, and what speech-language pathologists can do to be prepared and successfully navigate the transition. Davies explores the relating concepts of participation and communication in dementia care research and to propose future avenues of research within the field of communication disorders. Bice and Smith discuss current issues found in external clinical placements, their possible causes, and offers practical solutions for assisting students to benefit from their experiences.
An Intergenerational Cognitive Training Program
Format(s): SIG Perspectives
This Perspectives (SIG 15) article discusses the benefits and nuances of development of an intergenerational cognitive social media training program. The program supports the use of a cognitive social media training tool to promote intergenerational learning, communication, and stimulation, with parallel benefits for young and older adults.

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