Introduction/or rationale
Communication partner training (CPT) for families of people with dementia is key to speech pathology practice. However, few programs include informal carers with active training components, co-created content, and accessible resources.

Aim(s)
To co-create an accessible evidence-based CPT program for families of people with dementia, our study aims to understand the effectiveness of CPT for families of people with dementia and describe their characteristics, including creation, implementation, and outcome measures.

Methods
We conducted a systematic review following PRISMA guidelines. Six databases were searched using a search strategy based on CPT interventions or protocols for families of people with dementia. A narrative synthesis was conducted using the Intervention Taxonomy (ITAX), Template for Intervention Description and Replication (TiDieR), and the Behaviour Change Wheel. Quality assessment was completed using the JBI Critical Appraisal tools and the Mixed Methods Appraisal Tool (MMAT).

Results
32 of 3172 initial studies were included in the review. CPT for families showed mostly improvements in knowledge and a smaller amount of studies demonstrated increased skill use. Psychosocial measures showed mixed results. Intervention descriptions varied with few fulfilling all TiDieR/ITAX criteria. Five of 28 programs involved consumers during creation. Most programs were delivered in person, with one delivered online with significant variety in materials, duration, outcome measures (mostly self-report), and behaviour change strategies.

Conclusions
CPT programs for families of people with dementia may improve knowledge and use of communication strategies. Future programs should include online options, consumer involvement, and thorough intervention descriptions with materials for clinical implementation.

Keywords - systematic review, dementia, communication partner training, family, speech pathology, informal carers


Submission Statement: Reflecting on the state of current CPT programs via systematic review ensures we can respond to the needs and gaps in available CPT programs, and ensures future programs are respectful in the inclusion of people with dementia in their creation and implementation.

Introduction/or rationale

Many individuals who reside in Australian permanent residential aged care (RAC) have a diagnosis of dementia, with majority experiencing a type of communication disorder. The quality of care aged care staff provide when working with people with dementia has been flagged by the Royal Commission into Aged Care Quality and Safety as an area of concern needing significant improvement, with communication highlighted as an area requiring further focus. Existing literature has placed an emphasis on the need for staff to undertake dementia communication training.

Aim(s)

This study aimed to explore the preferences of RAC staff and management regarding method/delivery of communication training and their perceived barriers and facilitators to workplace training in RAC.

Methods

An exploratory cross-sectional online survey design was employed in this study. Participants were RAC staff and management throughout Australia, recruited through purposive and snowball sampling techniques. Quantitative data collected from closed-ended questions was analysed through SPSS for non-parametric descriptive statistics. An inductive content analysis was used for the two-open ended written participant responses.

Results

A sample of RAC workers in Australia were recruited (n=104), with most participants over 45 years old and female. Descriptive statistics revealed that majority of participants preferred training to be delivered face-to-face and to receive remuneration for participation. Content analysis of open-ended questions identified eleven themes regarding perceived barriers and facilitators for communication training in the workplace.

Conclusions

The findings from this study may inform the development and outcomes of future dementia communication training to RAC workers.

Keywords – dementia, communication training, residential aged care

Submission Statement: This study aimed to reflect upon the experiences of RAC workers regarding their preferences and perspectives for dementia communication training. Gaining an understanding of training barriers and facilitators and respecting their training preferences, will allow for an appropriate response in the development of suitable dementia communication training within RAC.

Introduction
Speech pathology (SP) in residential aged care is focused on dysphagia, with limited provision of communication support for residents, carers and staff. A main barrier to supporting people with their communication is a lack of current prevalence data on residents with communication impairment.

Aim(s)
To investigate the feasibility of screening the communicative function of residents in a residential aged care facility.

Methods
Residents of a facility in metropolitan Melbourne were approached to complete communication screening. The screening was completed by supervised speech pathology students utilising the following tools: Frenchay Aphasia Screening Test, Frenchay Dysarthria Assessment (2nd Edition), Montreal Cognitive Assessment and a shortened version of The Pragmatics Profile of Everyday Communication Skills in Adults. Descriptive statistics was used to describe the communication difficulties.

Results
Eighty-nine percent (25/28) residents participated. Almost all residents (96%, 24/25) presented with communication difficulty in at least one domain. The main domain of difficulty was cognition (96%, 23/25), followed by language (65%, 15/23). Sixty percent (15/25) presented with impairment across multiple domains. Less than 80% residents presented with hearing impairment.

Conclusions
Communication screening of residents in aged care is feasible and would provide vital prevalence data to support staffing reform in the sector if completed on a wider scale. Supporting residents with communication would enable a preventative and reablement approach to supporting older people in aged care.

Keywords
Communication; Aged care; residential aged care, Cognition, language.

Submission statement:

This project evolved from reflection on previous work, which showed that speech pathology intervention in aged care is focused on dysphagia. A barrier in providing communication support is lack of robust data describing the prevalence of communication impairment in aged care. Respecting the need for reform, we responded by addressing this critical knowledge gap.

Introduction/rationale: Oral care is effective in the prevention of oral diseases and infections, however there is a gap between research evidence and the provision of oral care in practice.
Aim(s): To evaluate current oral care practices in an acute aged care hospital setting, and staff perceptions of the barriers and enablers to delivery of evidence-based oral care practices.
Methods: A mixed methods study comprised of retrospective file audit and cross-sectional survey was conducted within the acute aged care unit at St Vincent’s Hospital, Sydney. Medical records of patients aged 65 years and over, admitted to the ward over six months were retrospectively audited. A clinician survey (allied health, nursing and medical staff) was conducted between March and May 2022. The Capability, Opportunity, Motivation, Behaviour (COM-B) questionnaire was used to explore perceptions of the delivery of oral care practices. Results were analysed using descriptive statistics.
Results: Patient file audits (n=206) revealed 13.6% (n=28) of patients had oral care completed, despite 23% (n=47) of patients being recommended to receive oral care. A total of 31 staff surveys were included for analysis. The majority of staff reported they do not have the physical or social opportunities to provide oral care i.e., adequate resources, time and social support, however, they were motivated and reported they have the required knowledge and skills to provide oral care.
Conclusions: There is a need for implementation strategies to enable interprofessional response to improve the delivery of evidence-based oral care practices and optimise patient outcomes.
Keywords: Oral care, Ageing, Dysphagia, Acute Care, Evidence-Based Practice, Implementation Science
Submission statement: The results of this study challenge clinicians to reflect on oral care practices in their practice and workplace. Clinicians are prompted to respond by considering interprofessional practice and how they themselves, can diligently provide, document, and train others in evidence-based oral care practices.

Introduction: Diet and fluid modification is one compensatory management strategy that speech pathologists may recommend for people diagnosed with dysphagia. However, the preparation of texture-modified foods and thickened liquids is not without its challenges. Failure to correctly modify and prepare a person’s diet could result in increased morbidity and mortality.
Aim(s): To examine the feasibility of using augmented reality (AR) to train student speech pathologists to modify fluids within IDDSI standards.

Methods: Student speech pathologists trialled AR training in a semi-randomised AB design mixed methods case series. Participants thickened and tested a fluid using commercially available thickener, following the manufacturer instructions and printed IDDSI testing guidelines (traditional method), and using the AR Microsoft® HoloLens2® instructional guide. Participants were observed in their adherence to thickening and testing methods, and rated usability of both training approaches.

Results: Four participants with prior knowledge of the IDDSI framework completed the training. Two reported prior experience thickening and testing fluids. On average, participants accurately completed more steps in the thickening and testing procedures when using AR than without. Three participants thickened fluids to match the target, as measured by a blind rater, when using the traditional method, while only two achieved success using AR.

Conclusions: Training students to accurately thicken fluids is a complex task and the use of technology shows potential as a teaching tool. Students need further training and support to achieve accuracy. Further research is needed to extend and verify results with more participants of varied disciplines and experience.

Keywords: Dysphagia, IDDSI, student training, technology, augmented reality

Submission Statement: Reflections on challenges in student training and the need for accuracy in practice informed the development of a new approach leveraging emerging technologies. The implementation of technology was responsive to student needs and interests, and the need for new approaches in a growing and evolving profession.

Introduction:
As part of a Victorian state-wide focus on partnering in healthcare, our health service was selected as a site to implement a shared decision-making (SDM) framework into clinical practice and Eating and Drinking with acknowledged risk (EDAR) was prioritised. With the recent release of Speech Pathology Australia’s (SPA) practice guidelines, this was an opportunity to standardise processes to support SDM for patients with dysphagia.

Aims:
To compare current clinical practice in EDAR management against practice guidelines.
To implement a robust shared decision-making framework to support consumers’ preferences for oral intake.

Method: A Continuous Improvement framework was used to review current EDAR practices within the subacute setting at a tertiary hospital. A retrospective audit of patient files was completed and descriptive statistics used to identify gaps against SPA’s EDAR practice guidelines and Safer Care Victoria’s shared decision-making proposal. Benchmarking of metro hospitals was used to inform the development of resources to support the next steps of implementation of a shared decision-making framework into dysphagia clinical practice.

Results: Findings indicated minimal documented evidence of SDM discussions and variable adherence to practice guideline recommendations. A suite of tailored SDM resources were developed to support clinicians and consumers to make an informed EDAR decision and trialled. Results and key learnings of the implementation will be presented.

Conclusion: A robust SDM framework will provide structure for clinicians discussing EDAR and enable the consumer to make an informed decision. This ensures that clinical practice is aligned with the current evidence-base whilst providing person-centred care through shared decision-making.

Key words: shared decision-making, dysphagia, clinical practice, choice, risk, feeding.

Submission statement: This project embodies the conference theme of ‘Reflect, Respect, Respond’ through reflecting on current practice gaps, respecting the wishes of consumers whilst supporting clinicians, and responding by creating a framework to ensure consumers are supported to make this decision and our practice aligns with the current evidence base.

Introduction: Frailty is a complex, multidimensional syndrome characterised by physiological decline, and contributing to poorer health outcomes. However, consensus is lacking on how to clinically recognise and manage frailty across different medical and allied-health professionals, resulting in poorly coordinated care.

Aims: To explore perspectives of speech-language pathologists (SLPs) about frailty including: enablers and barriers to frailty prevention and management; multidisciplinary teamwork within frailty care; and opportunities for improvements in frailty prevention and management.

Methods: An exploratory qualitative descriptive design was adopted. Seven Australian SLPs from public and private sectors working within acute, rehabilitation, and geriatric wards, and community settings were recruited using purposive sampling. Individual semi-structured online interviews were conducted and recorded via Microsoft Teams. Data were analysed using a qualitative descriptive approach to develop themes.

Results: Three major themes were created: (1) SLPs understand the clinical manifestation of frailty but do not use explicit language to describe it; (2) SLPs’ knowledge and awareness of frailty impacts how they provide services within this population; and (3) SLPs do not currently have an established identity within the frailty field but do have a role within the multidisciplinary team in caring for frail individuals. The themes were overlapping and influenced one another.

Conclusion: More research is required to be able to present formal recommendations regarding frailty management to SLPs but may include increased education of SLPs themselves about frailty and awareness of SLPs’ role within the multidisciplinary team. This may assist in improving service provision to and health outcomes for frail individuals.

Keywords: Frailty; oral-frailty; SLP-role; multidisciplinary-team

Submission Statement: We reflect on the current practices of speech-language pathologists working with the frail population and identify opportunities for improvements, as our role is not well defined. By respecting our older, frail clients, and understanding they have specific and individualised care needs, our discipline can respond appropriately to these needs.