Speech-language pathology in Australian residential aged-care facilities

This narrative literature review aimed to identify the speech-language pathology (SLP) service profile in Australian residential aged-care facilities (RACFs) and service level factors influencing SLP service delivery in that setting. A rigorous and step-wise systematic database search was augmented with manual searches of grey literature related to aged-care policy and professional guidelines. Thematic analysis was applied to twenty-six included articles. Despite RACFs being complex service settings where a range of multi-morbidities impact communication and swallowing function for residents, results showed there is limited research investigating SLP services delivered in RACFs. There is a particular dearth of research in the Australian setting where the aged care sector has undergone significant public scrutiny in recent times. Major themes arising from the research included: the current role of speech-language pathologists in this setting and factors influencing the provision of best-practice. Sub-themes related to best practice barriers included: poor understanding of SLP scope of practice in RACFs; limited SLP roles in practice; potential impact of “ageism”; communication access and quality issues; and a lack of recognition of RACFs as a clinical specialty site for speech-language pathologists. This research revealed that Speech-language pathologists have a limited range of practice within RACFs despite significant need across both communication and swallowing disorders. RACFs should be recognised as a specialist SLP setting requiring unique clinician support, education and training. Barriers to service expansion need to be addressed to ensure that residents living in RACFs have access to the holistic, patient-centred care they have a right to receive.