EDMONTON - There was a time when Warren Steffes couldn't tell you about his two grandsons, his walls of family photos or his impressive collection of John Deere tractor models that line his apartment shelves.That time was two years ago, when the 72-year-old widower suffered a stroke. Upon waking from a coma after 19 days, "I couldn't speak at all," he says. "But today, I've got more to say. It's really good."
Like Steffes, hundreds of Alberta adults with dementia, stroke-related impairments and other neurological disorders are regaining the ability to communicate effectively thanks to a program offered within the city's continuing care environments.
Speech-language Pathology Consulting Services - provided through a partnership between Alberta Health Services (AHS) and the Faculty of Rehabilitation Medicine at the University of Alberta - supports adults in long-term care, a supportive-living facility or in home care who have communication impairments of varying severity. For some, memory loss makes conversation difficult and frustrating; others have lost the ability to speak altogether.
"When people lose the ability to communicate, it takes a huge emotional toll on them and their families, and it makes the job more difficult for caregivers," says AHS speech-language pathologist Rhonda Kajner. "This program benefits Albertans with communication needs by giving them confidence and increasing their independence. It really helps their quality of life and participation with family and community."
The program has helped more than 250 adults, mostly seniors, since 2009.
"In the past, some had the attitude that if you can't communicate well, it's not life and death, you're not going to die, so we don't have to worry about it," says Tammy Hopper, an associate professor in the Department of Speech Pathology and Audiology at the University of Alberta.
"But in reality, a lack of ability to communicate meaningfully with somebody else really results in social isolation and depression. The individual may think: 'I can't understand what you say, so I'm going back to bed.' It certainly is a quality-of-life issue."
Ensuring people with special needs receive support is one of the goals outlined in the 5-Year Health Action Plan, jointly developed by AHS and the Government of Alberta and supported by the province's stable, 5-year funding.
The service employs four AHS speech-language pathologists (SLPs), each of whom supervises two postgraduate SLP students, creating a pool of a dozen SLPs who work with patients and their families for typically one to three months, depending on need.
SLPs use a variety of techniques to aid communication, whether the individual needs to learn vocal techniques to speak more clearly or memory strategies to choose the right words.
They've also conducted about 50 information sessions attended by more than 500 health-care professionals and faculty staff, giving them the tools they need to identify communication disorders, especially in the early stages.
"Without staff training and education, communication disorders, particularly those of dementia, may go unrecognized," says Hopper. "People with dementia are always getting worse but there are things we can do at each stage to maximize communication."
Steffes is grateful he can once again speak to his daughter, grandsons and siblings after his stroke left him with an ongoing struggle to get sounds in the right order and find words when speaking.
SLP Sophie Kollias visited Steffes at his supportive-living apartment, supervised his speech therapy and educated family and facility staff to his communication needs.
"When we worked with him last summer, he struggled to find many different words, including the word 'stroke,'" says Kollias. "Since then, Warren has applied the strategies he learned in therapy and he's able to get his message out with greater ease now."
For that, the retired mechanic is grateful. "I can talk much more now with my grandsons. I talked to my sister last night for an hour on the phone."
Prior to this service, adults in continuing care could only access SLP services as an outpatient in a clinical setting, an option often hindered by transportation and chronic health issues.
This two-to-one supervision model fills an important need for practicum opportunities, gives quality clinical experience to students, and helps to ensure more SLPs will be working with Albertans in the future. At present, it's the only program of its kind in Alberta.
The U of A has benefited from 11 full-time and 35 part-time SLP student placements in the Seniors Health portfolio of AHS.
"I'm excited for people in continuing care to have access to this," says Hopper. "I feel we are making a difference in the lives of Alberta seniors."
About the University of Alberta Faculty of Rehabilitation Medicine
As the only free standing faculty of rehabilitation in Canada, the University of Alberta Faculty of Rehabilitation Medicine balances its activities among learning, discovery and citizenship (including clinical practice). A research leader in musculoskeletal health, spinal cord injuries and common spinal disorders (back pain), the Faculty of Rehabilitation Medicine aims to improve the quality of life of citizens in our community. The three departments, Occupational Therapy (OT), Physical Therapy (PT) and Speech Pathology and Audiology (SPA) offer professional entry programs. The Faculty offers thesis-based MSc and PhD programs in Rehabilitation Science, attracting students from a variety of disciplines including OT, PT, SLP, psychology, physical education, medicine and engineering.