Perceptions of speech-language pathologists and family members of terminally ill veterans regarding the effectiveness of therapy

Objective. To examine satisfaction with speech-language therapy services provided to terminally ill veterans from the perspective of family members of the veterans, and to determine whether there is agreement between family members' and SLPs perceptions of the therapy. Design. A retrospective analysis of speech-language therapy services provided to terminally ill veterans. A questionnaire was designed for the study and used in face-to-face interviews with family members of veterans and the SLPs who provided therapy to the veterans. Setting. Six VA hospitals speech-language therapy departments and the homes of family members. Subjects. Eleven family members of deceased veterans who received speech-language therapy services within the 18 months prior to interviews and the 9 SLP's who provided the therapy to the veterans. Measurements. Interview data were analyzed using Chi Square statistics, paired t-tests, and logistic regression analysis. Results . There was significant agreement between SLPs and family members' responses to the following questions: What was the patient's medical diagnosis? What type of communication disorder did the patient exhibit? Were goals discussed with the patient? Why was therapy discontinued? Did therapy have a positive impact on the patient's quality of life? SLP's reported significant improvement in patients' communication status after therapy as compared to at the initiation of therapy. Both family members and SLP's rated benefits of therapy as high (mean rating = 4 on a scale of 1–5). All (100%) SLP's and family members said the therapy had a positive impact on the patients' quality of life, and all rated the impact as high (mean = 4.36 on a scale of 1–5). There was not agreement on questions related to the goals of therapy and family involvement in therapy.; Conclusions. Family members were aware of the patients' medical diagnosis, the type of communication disorder for which the patient was receiving therapy, whether goals were discussed with the patient, and why therapy was discontinued. SLP's reported significant improvement in communication status as a result of therapy, but family members did not. However, both SLP's and family members felt patients benefited from therapy, and believed that therapy had a positive impact on the patients' quality of life.