Speech Pathologist - Allied Health

Speech Pathologist

The Speech Pathologist's (SP) role in working with an older adult receiving palliative care at the end of life is the assessment, management and support for communication and swallowing difficulties that can arise. The approach is led by the individual’s symptoms with respect to communication, cognition and swallowing and their sense of what is important to them to co-create realistic goals and expectations across the end-of-life period.

Key points

The SP liaises within the interprofessional care team to promote best outcomes. SPs who work with older adults receiving palliative care at the end of life may contribute to care planning via:

  • assessment of communication
  • cognition and swallowing function to determine relevant management strategies and therapy needs / interventions.

When assessing therapy needs and appropriate therapeutic interventions , a broad range of tools may be used depending on the context, important to note these are not palliative care specific. In addition to routine assessment, a practitioner might also use

-  Quality of life measures (e.g. SWAL-QOL or SWAL-CARE)

The results of communication and swallow assessment will guide methods of treatment and care, such as:

  • Optimising the older individual’s ability to eat and drink in the safest, most comfortable way and to participate in mealtimes
  • Educating the individual, their carers and family on safe swallowing techniques, recommendations and possible trajectory with regard to ability to swallow and oral intake
  • Educating and collaborating with the individual and their family to support their ability to make informed choices and ensure a documented care plan when eating / drinking with acknowledged risk and advising on risk and benefits of feeding modes in cases of dysphagia (see Resources section of Toolkit)
  • May work with a pharmacist to provide assessment information to inform medication administration routes
    • The new SHPA Don't Rush to Crush Handbook available for aged care settings can be purchased via the Resources page in the toolkit
  • Helping to optimise the older individual’s ability to communicate, particularly to support their ability to participate in end of life decision making, communicate choices, needs and emotional states and maintain social and emotional closeness and relationships with family and friends, including through the use of augmentitave and alternative communication
  • Providing education and advice to communication partners (family, carers, health team etc) with regards to communication, cognition and swallowing function, and how to best support communication as a communication partner
  • Cognitive stimulation to improve or maintain communication function in people living with moderate to severe dementi
  • Assessing and supporting strategies to manage oral care and hygiene including excessive saliva production (drooling) and dry mouth (teaching the family on how to assist with this).
  • Tools and Resources
  • For Families
  • Further Learning
  • Publications
Assessment Tools

Speech Pathology Australia

Speech Pathology Australia (SPA) has several private practice guides and templates in member portal, as well as clinical records and record keeping / guide to report writing etc. You must be a financial member of SPA to access these resources.

In addition, SPA has a palliative care interest group which has a focus on encouraging research and creating resources for SPs working in palliative care, as well as establishing referral pathways and supporting SPs in their self-care when working in this area.

American Speech-Language-Hearing Association (ASHA)

The ASHA has a number of useful resources for end of life issues in speech pathology.

The Agency for Clinical Innovation

The NSW Agency for Clinical Innovation has the following video:

International Dysphagia Diet Standardisation Initiative
Patient information and posters on foods and liquids of appropriate texture; and may be useful to Speech Pathologists and Dietitians working with individuals with dysphagia, and their carers.
Short Course
Queensland Health Speech Pathology

Palliative and end-of-life care: the role of speech pathology

Supports speech pathology clinicians to gain theoretical and practical knowledge regarding informed choice and shared decision making in dysphagia management, particularly in palliative and end-of-life care settings.

Case Study

This case study looks at how a SP can work collaboratively with the allied health team in a Residential Aged Care Facility (RACF) (299kb pdf) to support Gregor, an 83 year old resident with a diagnosis of end-stage COPD and advanced dementia.


Luckett, T, & Reid, KL. (2021). Speech and language therapy in palliative care. Oxford Textbook of Palliative Medicine, 231.

Chandregowda A, Stierwalt JG, Clark HM. Facilitating End-of-Life Interaction Between Patients With Severe Communication Impairment and Their Families. (2021). Perspectives of the ASHA Special Interest Groups https://doi.org/10.1044/2021_PERSP-20-00282

Chahda L, Mathisen BA, Carey LB. The role of speech-language pathologists in adult palliative care. Int J Speech Lang Pathol. 2017 Feb;19(1):58-68. doi: 10.1080/17549507.2016.1241301.

Krikheli L, Carey LB, Erickson S, Carey-Sargeant CL, Ann Mathisen B. Recommendations for speech-language pathologists in paediatric palliative care teams (ReSP3CT): An international modified Delphi study. Int J Speech Lang Pathol. 2021 Oct;23(5):486-496. doi: 10.1080/17549507.2020.1866073.

Chahda L, Carey LB, Mathisen BA, Threats T. Speech-language pathologists and adult palliative care in Australia. Int J Speech Lang Pathol. 2021 Feb;23(1):57-69. doi: 10.1080/17549507.2020.1730966. Epub 2020 Mar 17. PMID: 32182437.

Krikheli L, Mathisen BA, Carey LB. Speech-language pathology in paediatric palliative care: A scoping review of role and practice. Int J Speech Lang Pathol. 2018 Oct;20(5):541-553. doi: 10.1080/17549507.2017.1337225. Epub 2017 Jun 30. PMID: 28665209.

Page updated 02 February 2024