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SALT makes a difference!

Speech and Language Therapists (SALT) have always had a key role to play in supporting any patient in a critical care environment, by supporting rehabilitation of their communication, swallowing disorders and respiratory management.

Therapists at Cwm Taf Morgannwg University Health Board are working tirelessly to ensure that people with Covid-19 receive as much support as possible, promoting people’s physical and mental well-being by using specialist skills to provide interventions and rehabilitation, both within and beyond intensive care units.

As the majority of the work therapists carry out are Aerosol Generating Procedures (AGP’s), they have to wear full PPE for swallowing assessments and services that are provided to patients with altered airways. Wearing full PPE impedes communication and part of the role has been to offer support and advice around maximising communication when wearing PPE and communication boards and charts have been produced for use in clinical environments.

When these patients become self-ventilating, therapists support their rehabilitation. Patients who have been supported with mechanical ventilation and/or subsequent tracheostomies are more at risk of developing muscle weakness which can affect their ability to swallow safely or sufficiently and their ability to communicate either because of voice problems or other communication problems related to their critical illness.

Mouth care is extremely important for these patients and therapists add immense value to this treatment and with oral care packs being provided to the wards.

Patients continue to have rehabilitation needs long after their acute episode of care and therapists working in community hospitals and outpatient services offer crucial support and intervention during this phase of recovery.

A dedicated Therapies Hub has been set up to ensure that there is support and intervention from therapy services for those in the community, and speech and language therapy intervention is key within this team.

Speech and Language Therapists are holistic in their management of these patients and take into consideration the psychological impact that their diagnosis, hospital stay and rehabilitation will have on them and their loved ones.

As well as those affected by Covid-19, the service continues to offer support to those patients with other acute illnesses who are admitted to hospital to try and ensure that they are seen and managed in a timely way often aiding hospital discharge and avoidance of complications, such as pneumonia.

Some stroke patients have contracted Covid-19 during their hospital admissions and the therapists continue to provide treatment and are also maximising communication opportunities by speaking with relatives on the telephone to keep them updated and facilitating Facetime with family and friends in order to ensure the wellbeing of patients and to reduce anxiety levels of their carers’.

Cancer Services also continue to be a priority for the health board and the dedicated Head and Neck Cancer SLT service has continued to provide the required treatment for those newly diagnosed patients living with head and neck cancer.

The Children’s Speech and Language Therapists maintain their support and advice to the families of children who would have usually attend face-to-face appointments or be seen in schools, and some have also been helping support in the adult team, with triage, contacting patients and making resources.

Vanessa Hayward, Head of Speech and Language Therapy, said: “I am immensely proud of my team who have been flexible in their approach to giving specialist value to the care of patients and families who are either suffering with Covid-19, other conditions or the effects of the lockdown. We will continue to do everything we can to adapt our service going forward so we can support children and adults with communication and swallowing difficulties.”