TBI & Degenerative Conditions

Traumatic Brain Injury (TBI)• http://www.youtube.com/watch?v=c-W_o-pMDXQ

TBI• TBI affects 186,000 people per year (Headway 2009)

• TBI can affect all areas of life

• TBI can affect: learning ability, attention, memory, language, voice, fluency, speech and swallowing

• Cognitive-communication disorders: cognitive difficulties and their effect on language processing, language use and communication behaviour (RCSLT, 2006)

• TBI can greatly impact on an individuals social communication and therefore effect relationships

‘Don’t cut me out!’• Access to vital support services is being reduced due to funding cuts

• “…making it harder for brain injury survivors to access the help and support they need...lead independent lives ”. Communications Manager at Headway

• Early assessment in the acute setting to enable early identification of intervention for communication and swallowing needs

• Goal orientated rehabilitation by a coordinated interdisciplinary team

• Well planned and flexible discharge to community living to improve longer term outcome and self management (RCSLT, 2006)

SLT value

The National Service Framework for long term neurological conditions. (March, 2005)

• To improve the treatment and long term support of people with neurological conditions by 2015.

• 11 quality standards - health and social care

• 3 qualities most relevant to individuals with TBI (Headway)• - person-centred service• - community rehabilitation and support• - supporting families and carers

Dementia• Approximately 800,000 people are diagnosed with the

condition today • Prediction:

- increase to 1 million by 2021- 1.7 million by 2051

1 in 25 over 651 in 6 over 80

Only 43% receive diagnosis

(Alzheimer’s Society 2014)

Dementia• http://www.telegraph.co.uk/health/10511920/A-cure-for-dem

entia-could-be-found-within-twelve-years-David-Cameron-has-said.html

Dementia

80% of people living in care homes have a form of dementia (Alzheimer’s Society 2013)

Global action – there is “no solution to the dementia crisis without research” (G8 summit)

Carers are vitally important (NICE) – funding is needed to adapt care homes, train carers and adapt wards to be facilitating communication (Defeating dementia campaign)

Communication is key• For individuals to maintain a quality of life – communication is

important• The RCSLT Dementia Campaign:

• Early intervention to monitor changes over time• Help relatives and carers communicate with individuals with

dementia more successfully and for longer• Funding will allow training days to be set up to train

individuals in communication strategies• Feeding assessments – allow them to keep their independence

concerning eating and drinking

Parkinson’s Disease• 1 in 500 people suffer with Parkinson’s disease• 127,000 currently have Parkinson’s in the UK

• Stem cell research – working towards a cure – new funding March 2014 (Britain and Israel)

• Palliative care needed at all phases of the condition (Parkinson’s UK 2013)

• 90% of individuals with diagnosed Parkinson’s experience dissatisfaction with how they communicate (Miller, et al, 2010)

Parkinson’s Disease• Lee Silverman Voice Therapy has been shown to be effective in

improving communication in individuals with the condition

• The majority of individuals with Parkinson’s found SLT had a positive effect, helping breathing, speech rate, loudness and confidence, as well as strategies to help swallowing (Miller, et al, 2010)

Motor Neurone Disease

• Majority of people aged 50-70 years• Incidence – 2 people in every 100, 000• Prevalence – 7 people in every 100,000

(MNDA 2014)

• Incidence of motor neurone disease is increasing as people live longer and more accurate diagnosis

• No cure – manage symptoms to improve quality of life

Motor neurone disease• Standards of care developed by MND association – work

together to maintain these standards

• MND Year of Care Pathway to help the NHS and Social Services improve the provision of services for people with MND

• SLT input – dysphagia and dysarthria – important for individuals to still be able to communicate with friends and family

(Resource manual for commissioning and planning services for SLCN– dysarthria, RCSLT 2009)

Multiple Sclerosis (MS)

• 20-50 years old • Incidence: 4 per 100,000 (MS Society 2006, cited in RCSLT

2006)

• Prevalence: 144 per 100,000 (MS Society 2006, cited in RCSLT 2006 )

MS

Challenges as an organisation and SLT clinician

• variable condition: Relapse/ remission Slow progressive increase in symptoms.

• Prognosis unpredictable

• SLT role in rehabilitation (NSF)

A case for speech and language therapy and MS • ‘Key element of successful home care’ (The National Service Framework for Long-term

Conditions, 2005. Department of Health)

Recommendations (NICE Guidelines on MS):

• Dysphagia

• Communication: Dysarthria

AAC Advice and training for circle of support

LOCAL IMPLEMENTATION POINTS:• which speech and language therapist should see people with dysarthria• who may assess for and recommend augmentative equipment and adaptive technology to• communication• funding arrangements for augmentative aids to communication (AACs).

We need your funding!!

Useful links• https://www.headway.org.uk/home.aspx• https://www.headway.org.uk/news/dont-cut-me-out.aspx• https://

www.gov.uk/government/publications/quality-standards-for-supporting-people-with-long-term-conditions

• http://www.alzheimers.org.uk/• http://

www.rcslt.org/governments/docs/dementiacampaign_bulletinmay2013

• http://www.mssociety.org.uk/sites/default/files/Documents/Governance%20docs/Misc%20resources/Annual%20report%20and%20accounts%202006.pdf

• http://www.rcslt.org/docs/free-pub/TBI_reading_list_Feb_07__2_.pdf

• http://www.nice.org.uk/

References• Miller, N., Noble, E., Jones, D., Deane, K. H. O., Gibb, C. (2010). Survey of speech

and language therapy provision for people with Parkinson’s disease in the United Kingdom: patients’ and carers’ perspectives. International Journal of Language and Communication Disorders, Online 23 June 2010

• Motor neurone disease association (2014). Brief guide to MND. Retrieved March 17th, from http://www.mndassociation.org/what-is-mnd/Brief+guide+to+MND.htm

• Parkinson’s UK (2013). NICE guidelines for Parkinson’s. Retrieved March, 12, 2014, from http://www.parkinsons.org.uk/content/nice-guideline-parkinsons

• RCSLT (2006). Communicating quality 3. London: RCSLT.• RCSLT (2009). RCSLT resource manual for commissioning and planning services for

SLCN; dysarthria. Retrieved 14th March, 2014, from http://www.rcslt.org/speech_and_language_therapy/commissioning/dysarthria_plus_intro

• RCSLT (2009). RCSLT resource manual for commissioning and planning services for SLCN; TBI. http://www.rcslt.org/speech_and_language_therapy/commissioning/brain_injury_intro

• http://www.nice.org.uk/nicemedia/live/14355/66330/66330.pdf