S.A.L.T. stands for Speech and Language Therapist
What is the role of the Speech and Language Therapist?
The role of the Speech and Language Therapist is to assess and treat speech, language, communication, cognitive (higher level thinking) and swallowing problems. This involves closely working with other multidisciplinary team members such as nurses, doctors, dietitians and occupational therapists. They have expertise in assessing, diagnosing and managing patients with disorders of communication and/or swallowing including patients with a variety of Voice disorders.
What can cause a communication/swallowing problem?
Head and neck cancer.
Motor Neurone Disease.
Progressive and degenerative conditions.
What are typical communication problems?
Common communication problems found in hospital settings are Dysphasia and Dysarthria.
Dysphasia (also known as aphasia) is difficulty in using and understanding spoken and written language. Dysphasia can result from damage to various regions of the brain resulting from disease, direct trauma or stroke. A person who has dysphasia may know what they want to say but can’t find the words. It may be hard for them to understand what others are saying, even if their hearing and thought processes are not affected. Therapy can help people recognise words or find other ways to communicate, like using gestures, word-and-picture charts, symbols or computers.
Dysarthria is when a stroke or a neurological condition affects the muscles in the face for example lips, tongue, making it difficult to form words. Therapy can help people to strengthen the facial muscles to help improve the clarity of their speech. Alternative methods of communication for example word-and-picture charts may be used in severe cases.
What swallowing problems are typical?
Some people have difficulties with either diet or fluids (dysphagia). Coughing, choking and sounding chesty after swallowing are some of the symptoms of dysphagia. These can be caused by muscle weakness or an obstruction in the food pipe.
What happens if someone has difficulties swallowing?
Speech and Language Therapists also work with people who experience swallowing and eating problems and a swallow test is one of the first hospital assessments. If people have any difficulties swallowing, they will be seen by a Speech and Language Therapist, who can assess the problem and work out a diet that is easy and safe to eat. Some people may need to have their food puréed and their drinks thickened. The Speech and Language Therapist will also advise on the most appropriate postures for example sitting upright when eating/drinking to help prevent food and drink from going into their windpipe (this is called aspiration). A dietitian will make sure the diet has all the right nutrients.
In some cases, if a person cannot eat by mouth, special feeding techniques might be used. For example, Nasogastric (NG) feeding is when a tube is passed up the nose and down the throat to get food into the stomach. If the swallowing problems do not resolve, then a longer term option could be offered for instance Percutaneous Endoscopic Gastrostomy (PEG) which is a feeding tube that goes into the stomach directly through the abdominal wall.
When will I be discharged from Speech and Language Therapy services?
If people continue to have communication or swallowing problems when they are discharged from hospital, they can be referred to a Community Speech and Language Therapist in their area for a follow up appointment. The Speech and Language Therapist will discharge when (Speech and Language therapy) intervention, is no longer wanted or needed or in some cases, when therapy can no longer improve peoples difficulties.
If you (or your relative) is in hospital as an inpatient they can be referred to Speech & Language Therapy by a member of the ward team.
If family members have any concerns about their relative’s swallowing or communication they should report this to the nurse or doctor in charge of their relatives care.
After Discharge from Hospital
There are a number of ways in which you can carry on working on your communication on/or swallowing after you have left hospital.
Your SALT will discuss the best way forward for you before you are discharged.
This might be:
- home visits
- outpatient appointments at a Day Hospital
- home visits/outpatient appointments with a community healthcare team.
You may be able to contact them yourself for communication and cognition difficulties.
WHERE IS THE CARE SAY:
This team were only involved after a complaint to the GP. They were crucial in helping us access supplements that my mum could tolerate to help nutrition to heal her pressure sore wounds that we would otherwise not have known about and would not have been told about. One supplement was called Calogen, find out about it please. If your loved one cannot tolerate drinks like Fresubin etc, ask for something else, and keep asking. Ask for this team to be involved if your person is having trouble eating and drinking, there may be a reason and no-one is picking it up.