Special Interest Group 15 - Gerontology

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Addressing Current Demands in Geriatric Care: COVID-19 and the Workforce
Format(s): SIG Perspectives
Four articles are contained within that address current demands in geriatric care, including impacts of the COVID-19 pandemic and the shifting demographics reflecting an aging population. First, Thomas et al. analyze eight interviews with caregivers of those with amyotrophic lateral sclerosis (ALS). Authors conclude positive and negative themes that were specific to the pandemic and make suggestions that could result in improved perception of medical support and lower feelings of burden for ALS caregivers. Next, Stead et al. investigate practice patterns, experiences, and changes in referrals to medically based SLPs as a result of the COVID-19 pandemic. Authors analyze results of a survey of 208 SLPs and determine themes related to COVID-19 precautions, patient flow, patient characteristics, and mental health (staff, families, and patients). This incredibly detailed article uses three research questions to guide review and discussion, including what changes SLPs had seen in their caseloads since the onset of COVID-19; inquiry into experiences with COVID precautions; and inquiry into the impact that COVID has had on patients, caregivers, and practice overall. Then, Heape examines the effect of social isolation and loneliness as a result of the pandemic, specifically in the especially vulnerable geriatric population. The author reviews existing research on social isolation and loneliness in the aging population, discusses current demographic data on the gaining population, considers principles of bioethics, and examines social determinants of health. She reveals a link between social isolation, loneliness, and negative outcomes, and suggests strategies to mitigate the negative effects of social isolation. Finally, Watson et al. address the need for practice-ready geriatric health professionals as a result of unprecedented population growth of persons aged 65 years and older. The authors review 20 SLP student perceptions after visiting a senior mentor’s home in interprofessional practice teams of 3-4 over three semesters and completing assignments aimed at growing skills in geriatric collaborative care. Authors determine that moderate positive effects were observed in perceptions of interprofessional knowledge, attitudes, and skills. The results include discussion of predominantly positive attitudes toward older persons, an appreciation for the elderly, increased knowledge and skills in geriatric care, and an interest in working with older persons in the future.
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
This course examines three progressive cultural topics as they relate to speech-language pathology and audiology: ageism among CSD graduate students; institutional, symbolic, and individual systems of oppression; and the interaction between social determinants and health disparities.
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.

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