For speech pathologists, palliative care is about consulting with and educating the patient and family about their priorities and preferences in managing possible communication and swallowing difficulties. Together, they are able to develop strategies to minimise the impact of symptoms on the patient’s comfort, participation in and quality of life.
The speech pathologist is an essential team member in the area of communication, both for patients with diagnosed communication impairments and for those who are having difficulties communicating due to fatigue, pain or medication. Their role is to assist the patient to express themselves, make their own decisions, maintain relationships, take part in social activities and fulfill their end-of-life goals. This requires the speech pathologist to work closely with the patient and their family or carers, to establish goals and to respond quickly to functional changes. It also involves close consultation with other team members, especially social work, to support the patient in engaging in key discussions.
When working with swallowing difficulties in palliative care, the main aim is to promote positive mealtime experiences. This can include education about potential changes to the swallow function and associated risks to the patient. The speech pathologist can make recommendations for diet modifications or for eating or drinking strategies to optimise comfort. The speech pathologist is involved in realistic discussions about patient preferences and sometimes also in supporting family and friends to focus on providing care in ways other than food or drink intake.