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Stroke and Neurology

The speech and language therapy team for stroke and neurology work primarily on Wisley ward to provide assessment and rehabilitation for patients with communication, cognitive, and swallowing difficulties arising from strokes and other neurological conditions (e.g. brain injury). 

How is someone's swallow affected after a stroke or neurological event?

A stroke or neurological event can cause difficulties with eating and drinking (dysphagia) as a result of damage to the nerves and/or muscles involved in swallowing.

Usually, if food or fluid enters the airway (aspiration), it would cause an instant cough response, but a stroke can reduce sensation and a person may not show any outward signs of difficulty with eating and drinking (silent aspiration).

For further details on dysphagia, please refer to the Adult Acute Inpatient Service.

How can communication be affected following a stroke or neurological event?

A number of areas in the brain are responsible for communication, so damage to the brain as a result of a stroke or neurological condition can cause various difficulties depending on the areas of the brain affected. The main types of communication difficulty are:

  • Aphasia – this refers to difficulties with understanding and/or using spoken and written language. For example, the person may find it difficult to understand what people are saying to them, have problems with reading or writing or struggle to find words and put sentences together. 
  • Dysarthria – this means difficulty with producing speech because of weakness or incoordination of muscles used for speech (i.e. in your face, lips, tongue or throat). This can result in speech that sounds slurred. 
  • Apraxia of Speech – this refers to difficulties planning and coordinating the movement of speech muscles. This can make someone’s speech effortful or difficult to understand.

How are communication difficulties assessed?

The speech and language therapist will carry out a number of assessments for a detailed analysis of an individual’s speech and language.

This will determine areas of strength and areas which contribute to a breakdown in communication, requiring more support. 

Following the assessment, the speech and language therapist can create a tailored management plan which looks to either rehabilitate and/or compensate for any communication deficits.

What does rehabilitation involve?

The speech and language therapist may:

  • Help to educate the person and their family about what has happened.
  • Provide communication charts or strategies to support any immediate communicative needs (e.g. making simple choices).
  • Provide advice to staff and family members about how best to communicate with the individual.
  • Provide intensive therapy targeting the person’s specific communication difficulties and help the individual to rebuild confidence by practicing communication in functional, everyday situations.

The speech and language therapist will also spend time with the individual to establish personalised therapy goals to optimise recovery.

They will work closely with the individual and their family, as well as the multidisciplinary team to ensure rehabilitative and compensatory strategies are consistent and meaningful.

The speech and language therapist can also help in assessing an individual’s capacity to make decisions regarding their care and can support communication to facilitate decision making.

 

How can someone be referred?

If the individual is admitted to the ward from another acute hospital and has already been seen by speech and language therapy, the Royal Surrey team will typically receive a referral/handover from the relevant hospital team.

At any time, nursing staff/members of the multidisciplinary team on the ward can refer patients to speech and language therapy if any concerns arise regarding their swallowing or communication during their admission.

What happens when I leave hospital?

Regular discussions around progress in rehabilitation and plans for discharge will be undertaken with the individual, their family and members of the multidisciplinary team. 

The speech and language therapist will write a report detailing the progress made during an individual’s hospital stay and will organise onward referral to community speech and language therapy if further support is required for communication or swallowing. 

Contact us

Telephone: 01483 571 122 

Extension: 4680 

Royal Surrey Charity