Title: Fostering Communication in CommunityBased Groups for Senior Citizens: Developing Graduate Students K
1Fostering Communication in Community-Based Groups
for Senior Citizens Developing Graduate
Students Knowledge and Skills
- American Speech Language Hearing Association 2008
Convention - Chicago
- Assistant Professor Christine Kosky, PhD CCC- SLP
- Communication Disorders
- Mercy College
- Dobbs Ferry, New York
2Learning Outcomes
- Describe the effects of normal aging on
communication skills - Identify the clinical skills that are needed to
communicate effectively with senior citizens - Identify activities that promote group
communication with senior citizens in
community-based centers.
3Demographic Information
- In the United States, the number of people over
85 years, who are most in need of help, will
reach at least seven million in 2020 and double
again when the baby boomers reach 85 years of age
2040 (National Institute of Aging, 1997) - Worral Hickson (2003) page 6
4- It is currently estimated in the United States
that 19 of the overall speech-language pathology
caseload and 33 of the overall audiology
caseload are older people - Worral Hickson,
(2003)
5- there will be an increasing number of older
population requiring audiology and
speech-language pathology services, and the
majority of these clients will be living alone. - By 2050, these caseloads are expected to
increase to 39 and 59 respectively - Worrell Hickson
(1991)
6KASA Standards Targeted
- Standard 111 B Demonstrate knowledge of the
basic human communication processes including
their biological, neurological, acoustic,
psychological, developmental, linguistic and
cultural bases. - Standard 111 C Demonstrate knowledge of
articulation and phonological disorders,
receptive and expressive language disorders,
cognitive and social aspects of communication and
later language development, voice and resonance
disorders, neurogenic disorders of speech, and
acquired receptive and expressive language
disorders. - Standard III-F Demonstrate knowledge of
processes used in research and the integration of
research principles into evidence-based clinical
practice. - Standard 1V B Possess skill in oral and
written or other forms of communication
sufficient for entry into professional practice.
7Normal Aging
- understanding normal aging is a pre requisite
to clinical work with, as well, as research of,
cognitively impaired elders. Such knowledge is
necessary to analytically separate the effects of
disease from those of aging, individual life
history, and environment. - Ryan
(1991)
8Effects of Normal Aging
- Age related impairments of the
- Auditory and vocal systems
- Word retrieval impairments,
- Language comprehension (including a decrease in
literacy skills) - Conversational discourse skills
9- Changes in the Auditory System
- a reduction in speech perception ability in
adverse or difficult listening conditions
10Changes in Laryngeal Function
- Reduced fundamental frequency for females,
increased fundamental frequency for males,
decreased vowel time, diminished vocal intensity,
increased jitter, shimmer, and vocal tremor, and
increased hoarseness - Worrall Hickson
(2003)
11Word Retrieval Impairment
- Lesser (1987) described the stages of word
retrieval impairment as semantic lexicon,
phonological lexicon, phonological lexicon,
phonological assembly, phonetic planning, and
articulation -
12Linguistic Impairments in Conversational Discourse
-
- - decreased efficiency, increased ambiguity,
increased degree of topic maintenance, decreased
cohesion, decreased rate, increased number of
words per clause, overall increase in words - Garcia Orange
(1996)
13Successful Aging
- Successful aging is defined as maintaining
physical health, avoiding disease, sustaining
good cognitive function, and having engagement
with other people and productive activities - Rave Kahn, (1998)
14-
- Activities, such as socializing helps senior
citizens feel competent and improves their
self-esteem. Social networks include - Neighbors
- Family
- Volunteer/Social organizations
-
Heller (1993)
15-
- Social relationships influence both health and
well-being throughout the lifespan with effects
for multiple dimensions of health -
- Attix Welsh-Bohmer, (2005)
16Prevention
- According to Kastenbaum (1987) a prevention
activity is a form of environmental modification
to reduce levels of loneliness and to increase
social usefulness, while at the same time
providing help to maintain and improve older
adult coping abilities - Prevention activities can be
- Group therapy (Community centered)
- Family centered
- Heller,
1993
17Communicative Benefits of Group Therapy
- Communication helps to increase
- Word retrieval rate
- Comprehension of complex messages/discourse
- Efficiency of expression during discourse
- Helps to provide appropriate respiratory support
for speech - More precise articulation
- Appropriate
- Topic maintenance
- Rate of speech
- Number of words per utterances
- Pitch
- Vocal quality
18- Groups are
- Valuable for interaction
- People listen, talk, laugh, meet new people and
can be motivated to maintain their communication - Reminiscence has been found to be a significant
factor in successful aging and the enhancement of
quality of life in older people - Reminiscence is a process involving people
recollecting, reflecting on and recreating
events, feelings, incidents, happenings, either
individually or collectively -
- Worrall
Hickson (2003)
19Cognitive Benefits of Group Therapy
- Psychological support
- Generalization of communication skills
- Helps individuals cope with feelings of
loneliness, depression, and hopelessness - Sense of worth belonging
- Support acceptance
- Establishing expected level of performance
- Consistent communication with peers
- Reverse cognitive decline
-
Zarit Zarit (2002)
20ASHA The Role of Speech-Language Pathologists
(SLPs)
- the provision of speech, language, and hearing
services to older people is critical to the
maintenance of quality of life -
- ASHA, 1988
p.84
21Student Learning Outcomes
- Demonstrate group leadership skills
- Utilize appropriate opening and closing of a
group/communication activity session - Provide appropriate choices of materials/topics
that of interest to the group - Demonstrate familiarity with the reading material
by researching the topic before the group
activity
22- Give appropriate responses to participants
questions about the written material/topic - Recognize the appropriate time(s) to change a
topic - Facilitate topic change smoothly
- Request record participants topic choices for
the next session
23- Recognize participants nonverbal and verbal
communication - Recognize a participants desire to communicate
- Reproduce a participants contribution so that
other participants can hear the message - Utilize appropriate prosody when communicating
with the participants - Utilize appropriate fluency and prosody when
reading aloud
24- Rephrase a participants contribution so that
other participants can comprehend the message - Utilize appropriate communication models and/or
prompts to facilitate communication in the group -
- Demonstrate appropriate collaborate skills with
other (student) clinicians and professionals/staff
at centers for senior citizens
25- Demonstrate appropriate listening skills
- Demonstrate empathy and sensitivity
- Create appropriate communication goals for
individual members of the group - Collect appropriate data
-
- Demonstrate appropriate writing and editing of
session plans and SOAP notes - Accept an individuals right to join or not join
in a communication activity -
26- Accept an individuals opinion
- Demonstrate understanding that each participant
is a unique individual - Demonstrate ease and confidence when engaged in
conversation with senior citizens - Demonstrate critical thinking and reflection
skills during weekly supervisory conferences - Demonstrate understanding of the nature of a
professional relationship
27Communication Activities/Discussion Groups
- Three locations in Lower Westchester County,
New York - Two Discussion groups (a) Village-based center
with a nutrition program - (b) independent living facility
- Communication activities Village-based club
for senior citizens
28Method
- Group Discussions
- Self- selected
- Participants are primarily women
- Participants choose discussion topics
- Small group discussion (6 8 participants) in a
center and a large group discussion (20
participants) in another center - Student clinicians take turns leading the group
and facilitating communication
29Learning Outcomes Group Communication
- Group dynamics
- Participative listening
- Opening closing a session
30Reflection
- At first the seniors took a little bit of
coaxing to join the discussion group. Once the
participants and clinicians introduced
themselves, and the article was read,
conversation flowed easily
31Reflection
- The discussions taught me how to firmly take
command of a group scenario all the while
respecting each persons turn to speak, thoughts
and opinions. I learned a great deal by listening
to the input that each individual had to share on
any topic and I shared my thoughts and feelings
with them as well
32Reflection
- The student clinicians learned to collaborate
for this group therapy and improved their
abilities to work together, manage time, share
interests, and express concerns
33Data Collection
- Clinicians developed a data collection form
to track individual participants communication
skills - Alteri, L., Burch, A., Carnevale, J.,
Unterberger, B., and Kosky, C
34Reflection
- We as (student) clinicians decided to monitor
each of the participants abilities to
demonstrate a particular skill. The skills we
focused on were topic maintenance, listening,
yielding to others, eye contact, initiating, and
interrupting.
35- Communication Activities
- Variety of communication activities that
involve both student clinicians and participants.
E.g., - - Guest speakers nutrition, local history
- - Flower arranging, house plants
- - Cross word puzzles and word games
- - Recipes cooking demonstrations
- Students working with Club organizers
-
36Masters Project
-
- Attitudes of Senior Citizens and Their
Comfort Level in Various Communication
Activities - Graduate Students Maggie Hales Odasia
Mallory
37Research Questions
- Are communication activities designed for
community-based senior citizens beneficial? - What are community-based senior citizens self
perceptions concerning their own communication?
38Methods
- Led and facilitated a discussion group in a
village center for senior citizens and
facilitated communication activities in a club
for senior citizens in another village - Developed a questionnaire that was trialed
revised based on a small group of participants
feedback
39Questionnaire
- 3 point scale (1 agree, 2 neither agree or
disagree, 3 disagree) - Asked participants 11 questions regarding their
attitudes and comfort level with their
communication skills - Supplemental questions for participants to check
off pertaining to - - Age, living conditions, level of education,
past working experience, interests, communication
partners reasons for attending the group
40Initial Results
- Unable to compare scores from the two centers due
to difference in group size at each of the sites - Independent T-tests were to analyze the data
- Significant correlation between comfort with
communication and hearing level - Moderate correlation between the total number of
communication partners the quantity of
communication topics
41Reflection
- when I thought about a field like
speech-language pathology and the senior citizen
population I automatically thought about the
senior population already presenting with some
type of speech, language, or swallowing disorder,
as a result of stroke, illness, injury of the
aging process. However, after spending afternoons
with this lively, active, and opinionated bunch
of seniors, I not only acquired a different
outlook on the seniors that attended the center,
but is also gave me a sense of empathy when
dealing with future clients from the senior
citizens population.
42Reflection
- My experience working with senior citizens
at the ______Center was life changing Ive
gained wisdom and knowledge from each one of the
senior citizens. I do love my grandmother dearly
and this experience has made me recognize the
significance of our knowledge.
43References
- American Speech Language Hearing Association
Healthy people 2010 Health objectives for the
nation and roles of speech language pathologists,
and speech language scientists -
- Attix, D.K. Walsh Bohmer, K.A. (2005)
Geriatric neuropsychology assessment
intervention New York Guildford Press - Garcia Orange (1996) in Worral, L.E. Hickson,
L.M. (2003) Communication Disability in Aging
From prevention to intervention Thompson Delmar - Graham, M.S. Avent, J., (2004) A discipline
wide approach to group treatment Topics in
Language Disorders, 24, (3), 225 238 - Heller, K. (1993) Prevention activities for older
adults Social structures personal competencies
that maintain useful roles Journal of Counseling
Development (92) 124 130
44- Hickson, L.M. Worrall, L.E. (2003)
Communication Disability in Aging New York Delmar
Learning - Lesser (1997) in Worral, L.E. Hickson, L.M.
(2003) Communication Disability in Aging From
prevention to intervention Thompson Delmar - Ryan, E.B. Normal Aging and Language in Dementia
and Communication (1991) Ed. Lubinski, R. BC
Decker - Shipley, K.G. Roseberry_McKibbin, C. (2006)
Interviewing and Counseling in Communicative
Disorders Pro Ed - Worral, L.E. Hickson, L.M. (2003) Communication
Disability in Aging From prevention to
intervention Thompson Delmar -
- Zarit Zarit (2002) Mental disorders in older
adults Fundamentals of assessment treatment
Guildford -