Speech pathology contact

8.9 People with aphasia and their family, friends and carers should have access to a contact person (e.g., a stroke coordinator or speech pathologist) for any queries post-discharge, and should know how to self-refer to appropriate speech pathology services after discharge if they feel further rehabilitation is required.

Reference: Crocker et al., 2021: Cochrane review (not restricted to aphasia); Ford et al., 2018: Scoping review of 21 qualitative studies; O’Callaghan et al., 2009: Narrative review; Pindus et al., 2018: Systematic review of 51 qualitative studies; Shaddan & Agan, 2004: Theoretical review; Worrall et al., 2013: Discussion paper; Wray & Clarke, 2017: Systematic review of 32 qualitative studies

NHMRC level of evidence: Qual.

Rationale: Aphasia can be a life-altering condition and often leaves people with ongoing functional impairments. It is often not until people with aphasia are discharged from hospital-based stages of care and experience everyday life with aphasia (including its effects on relationships with family and friends, identity, and social situations), that the impact of aphasia becomes apparent (Ford et al., 2018; Shadden & Agan, 2004; Worrall et al., 2013; Wray & Clarke, 2017). It is often at this time that people with communication impairments request services (O'Callaghan et al., 2009); however, accessing services post-discharge can be difficult, as stroke survivors and their carers often do not have the knowledge or skills to re-engage with healthcare services (Pindus et al., 2018).

On discharge, speech pathologists should ensure that clients are aware of the services available to them and know how to access them. Clients should also have access to a relevant contact person for any queries post-discharge, as their information needs may change, particularly during the first year, with adjustment, self-reliance, and self-management increasing over time (Pindus et al., 2018). It has been suggested that active information provision (with healthcare providers actively engaging to ensure information needs are met) may be more useful in this context than passive information provision (e.g., leaving leaflets in waiting areas), particularly for stroke survivors themselves (Crocker et al., 2021).

References:

1. Crocker, T. F., Brown, L., Lam, N., Wray, F., Knapp, P., & Forster, A. (2021). Information provision for stroke survivors and their carers. Cochrane Database of Systematic Reviews (11). DOI: 10.1002/14651858.CD001919.pub4
2. Ford, A., Douglas, J. and O’Halloran, R. (2018). The experience of close personal relationships from the perspective of people with aphasia: Thematic analysis of the literature. Aphasiology, 32 (4), 367-393. DOI: 10.1017/BrImp.2021.12
3. O'Callaghan, A. M., McAllister, L., & Wilson, L. (2009). Sixteen years on: has quality of care for rural and non-compensable traumatic brain injury clients improved? The Australian Journal of Rural Health, 17(3), 119-123. doi: 10.1111/j.1440-1584.2009.01054.x
4. Pindus, D.M., Mullis, R., Lim, L., Wellwood, I., Rundell, A.V., Abd Aziz, N.A., & Mant, J. (2018). Stroke survivors’ and informal caregivers’ experiences of primary care and community healthcare services: A systematic review and meta-ethnography. PLoS ONE, 13(2), 30192533. DOI: 10.1371/journal.pone.0192533
5. Shadden, B.B., & Agan, J.P. (2004). Renegotiation of identity: The social context of aphasia support groups. Topics in Language Disorders, 24(3), 174-186. DOI: 10.1097/00011363-200407000-00005
6. Worrall, L. E., Howe, T., O'Callaghan, A., Hill, A. J., Rose, M., Wallace, S. J., . . . Rohde, A. (2013). The World Report on Disability as a blueprint for international, national, and local aphasia services. International Journal of  Speech-language Pathology, 15(1), 106-112. doi: 10.3109/17549507.2012.721004
7. Wray, F. & Clarke, D. (2017). Longer-term needs of stroke survivors with communication difficulties living in the community: A systematic review and thematic synthesis of qualitative studies. BMJ Open, 7(e017944). DOI: 10.1136/bmjopen-2017-017944