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then be communicated to aged-care facility management and care staff, with speech pathologists taking the role of educationalist to raise awareness of opportunities to facilitate communication with residents with cognitive communication impairment. To achieve and sustain long-term change, current and future models of speech pathology service provision in residential aged care must be reviewed to better align with person-centred care. In doing so, the importance of effective communication in enabling meaningful life participation and facilitating subjective well- being must be highlighted. Conclusion As the population ages, the demand for speech pathology services in residential aged-care facilities will increase. As the majority of older people in residential aged-care facilities experience communication difficulty, greater attention is needed to determine how the speech pathology profession can optimise services to facilitate communication. Current speech pathology services targeting communication are limited and impacted by numerous barriers within and outside of the profession. The current data indicates that speech pathologists in this setting have a desire to increase the profile of communication management in residential aged care. Current aged-care legislation and reform is based on the principles of person-centred care and, thereby, provides a legislative platform on which to advocate for communication management in aged-care settings. As such, there is an opportunity for the profession to align itself with current aged-care legislation and reform, raise the profile of communication, and position the profession as a key player in the delivery of care to older people. References Ball, M. M., Whittington, F. J., Perkins, M. M., Patterson, V. L., Hollingsworth, C., King, S. V., & Combs, B. L. (2000). Quality of life in assisted living facilities: Viewpoints of residents. Journal of Applied Gerontology , 19 (3), 304–325. Bennett, M., Ward, E., Scarinci, N., & Waite, M. (2014). Perspectives on mealtime management in long-term aged care facilities in New South Wales, Australia: Insights from a cross disciplinary investigation. Journal of Nutrition in Gerontology and Geriatrics , 33 , 325–339. Carpiac-Claver, M. L., & Levy-Storms, L. (2007). In a manner of speaking: Communication between nurse aides and older adults in long-term care settings. Health Communication , 22 (1), 59–67. Casper, M. L. (2013). Speech-language pathology in the long-term care setting: It isn’t your Grandmother’s nursing home anymore. Seminars in Speech and Language , 34 (1), 29–36. Department of Health. (2012). Living longer living better . Canberra: Department of Health, Australia. Cruice, M., Worrall, L., Hickson, L., & Murison, R. (2003). Finding a focus for quality of life with aphasia: Social and emotional health, and psychological well-being. Aphasiology , 17 (4), 333–353. Hilari, K., & Byng, S. (2009). Health-related quality of life in people with severe aphasia. International Journal of Language & Communication Disorders , 44 (2), 193–205. Hoffart, N. (1991). A member check procedure to enhance rigor in naturalistic research. Western Journal of Nursing Research , 13 (4), 522–534. Hopper, T., Cleary, S., Oddson, B., Donnelly, M. J., & Elgar, S. (2007). Service delivery for older Canadians with dementia: A survey of speech-language pathologists.

communication. In doing so, speech pathologists may further highlight the link between communication and participation, and between communication, subjective well-being, and person-centred care. In addition, the profile of this client group both within the speech pathology profession and in the wider health service and political arena may be raised. Achieving service change for communication in residential aged care will, however, first require profession specific change. This Australian-based study supports prior international research (Hopper, Clearly, Oddson, Donnelly, & Elgar, 2007) indicating a degree of uncertainty and inconsistency among speech pathologists working in residential aged care. Key challenges include (a) inconsistency in perceptions about the importance and prioritisation of communication management in the setting and (b) uncertainty about the validity of assessment and intervention approaches with the client population, given the high prevalence of cognitive impairment and degenerative disease (Hopper et al., 2007). The current study also confirms the findings of previous studies indicating that the management of “swallowing” is the primary focus of speech pathology professional services in residential aged care (Bennett, Ward, Scarinci, & Waite, 2014; Casper, 2013; Hopper et al., 2007). Further factors discussed that may inhibit speech pathology services for communication in residential aged care included resource constraints, lack of awareness of aged-care facility staff about communication management and the role of speech pathologists in providing this care, and limited education for speech pathologists specific to providing communication management in aged-care settings. These barriers are consistent with barriers identified as also inhibiting speech pathology management of mealtime difficulties in Australian residential aged care (Bennett et al., 2014). The impact of these barriers on both communication and mealtime management suggests the need for wider consideration of speech pathology service provision in residential aged care, including further exploration of the perceptions of a larger cohort of speech pathologists working in the setting. Such exploration may better guide training for speech pathologists working with older people and in residential aged-care settings, and may further assist in clarifying the current position of the profession in providing aged-care services. Despite the challenges faced in working in residential aged-care settings, speech pathologists in the current study expressed a strong desire to expand communication management in the setting. To assist the majority of the resident population who experience communication difficulty as well as staff caring for these residents, and speech pathologists working in the setting, the profession must unite in advocating for the need for speech pathology services for communication in residential aged care. With current aged-care legislation and reform founded on the principles of person-centred care, there is current legislative support for communication management in the setting. To assist speech pathologists entering the profession and clinicians already working in the setting, pre- and post-qualification training relevant to residential aged care must ensure clinicians are aware of challenges inherent in working in aged-care settings, and strategies to address these (Bennett et al., 2014; Hopper et al., 2007). Training in the management of cognitive-communication impairment and appropriate expectations for treatment outcomes must also be prioritised. This knowledge must

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JCPSLP Volume 17, Number 2 2015

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