“But my speech is fine.”
This is often one of the first responses patients and their families in a rehabilitation hospital have when a speech therapist enters the room, indicating a thanks but no thanks to our services before we even have an opportunity to explain our role.
To say a speech therapist’s job in a rehabilitation hospital is misunderstood is an understatement. In fact, research indicates that 85% of people have never heard the term “aphasia,” and only 9% of people have heard of aphasia and can identify it as a language disorder.
It is also no surprise that patients with cognitive-communicative impairments are under-identified, and half of all stroke survivors with excellent physical recovery continue to have cognitive impairments and participation limitations two years post stroke. From a swallowing standpoint, it is estimated that up to 6 million older adults could be considered at risk for dysphagia.
Despite these concerning statistics, explaining a speech therapist’s role in the rehabilitation hospital setting and advocating for the importance of these services to patients, family members and other allied health professionals is an ongoing struggle.
What is Inpatient Rehabilitation
Inpatient rehabilitation provides a hospital level of care and intensive therapy to help patients recovering from an illness or injury, often following an acute hospital stay.
Unlike skilled nursing facilities, a rehabilitation hospital has 24-hour nursing care and frequent physician visits. Patients receive three hours of therapy a day, five days a week from at least two of the three disciplines: physical, occupational and speech therapy.
The speech therapist is an integral part of the care team, which also includes a physician, nurses, pharmacists, dietitians, and physical and occupational therapists. This multi-disciplinary team meets regularly to set unique goals for each patient to help them regain their highest level of independence.
The Importance of the SLP
A speech therapist in the rehabilitation hospital setting plays a unique role in assisting patients in many different areas which, if left untreated, can cause significant problems.
For example, the presence of a communication disorder is linked to higher rates of medical errors, reduced accessibility to healthcare and decreased satisfaction and autonomy with services provided.
Cognitive impairments have also contributed to higher rates of hospital readmission and poor overall health outcomes, increased fall risk and higher rates of mortality. Cognition also has a huge impact on activity participation and quality of life.
Communication disorders such as apragmatism can have serious effects on a person’s relationships and social interactions, including a loss of friends and negative change to family relationships.
If a patient has trouble swallowing, untreated dysphagia can have a whole sequel of negative side effects, including malnutrition, dehydration and increased risk for falls.
The Role of the SLP in the Rehabilitation Hospital Setting
The speech therapist’s job in the rehabilitation hospital setting is to provide exceptional, effective and efficient therapy that kicks into gear as soon as the patient arrives.
Speech therapists have a tremendous role in improving patient outcomes, decreasing healthcare utilization, reducing hospital readmission rates, increasing patient self-management, confidence, autonomy and—most importantly—enhancing the quality of life of our patients.
The role of the SLP in the inpatient rehabilitation setting involves understanding medical diagnoses, evaluation and treatment of speech, language, cognition, pragmatics and swallowing disorders. This is accomplished by setting appropriate patient-centered goals, building quick rapport, providing detailed and functional training/education sessions, and facilitating discharge planning.
In addition to the more traditional role, SLPs can also add significant value to tasks, topics and trainings that are not technically considered speech related but are well within an SLP’s scope of practice.
In the inpatient rehabilitation setting, SLPs are pushed to think outside the box to help patients with medication management, counseling, coaching, empowerment, self-management training, understanding of medical-related information, planning for offsite appointments, pain management, mobility, and even bowel and bladder retraining.
These tasks require a significant cognitive and communicative load, requiring effective verbal output, understanding of instructions and information provided, recall and implementation of strategies, self-monitoring, problem solving, sequencing, and execution, to name a few.
SLPs need to address patients’ concerns and impairments, but first, patients and providers must understand the importance of the SLP’s role in the inpatient rehabilitation hospital.
SLPs can have a profound impact on patients and play an important role on the care team. Working with other disciplines, they can help patients get back to their daily lives and what matters most to them.
The content of this site is for informational purposes only and should not be taken as professional medical advice. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding any medical conditions or treatments.
