The role of Speech-Language Pathologists in palliative care: Exploring the issues and reaching consensus

Katherine Kelly1

1South Western Sydney Local Health District, Campbelltown, Australia

Background: The role of SLPs in palliative and EOL care is still not well defined, not always understood by other professions, and sometimes not even by SLPs themselves (Hawksley et al., 2017; O’Reilly & Walshe, 2015). The outcome can be a self-sustaining cycle of role uncertainty, untimely referrals, limited impacts on patient outcomes, service under-utilisation and under-development (Hawksley et al., 2017). Many SLPs recognise that they can bring value to comprehensive multidisciplinary palliative and EOL care (Hawksley et al., 2017; O’Reilly & Walshe, 2015; (Pascoe, Breen, & Cocks, 2018), and the importance of practice guidelines as a basis for education, research, outcome measurement and service development has been highlighted (Chahda et al., 2017; Collis & Bloch, 2012).

Purpose: Definition of key expectations of the role and best practice of speech-language pathologists (SLPs) in palliative and end-of-life (EOL) care, from the perspective of practicing SLPs.

Method:  A two-round e-Delphi consensus methodology was used. Round 1 was exploratory and gathered feedback on participants’ activities and opinions regarding provision of palliative care. During Round 2, participants rated their agreement with 28 statements generated from Round 1 responses and the literature reviewed as background for this study.

Results: Consensus was reached for all statements during Round 2, eliminating the need for a third round.

Conclusion: The consensus statements generated by this study begin to formally define the SLP role in palliative and EOL care. The statements provide a framework for development of practice guidelines, standards against which services can be evaluated and support promotion of the SLP role to patients and multidisciplinary colleagues. Further research in this area can test, challenge and further refine the statements, and the body of knowledge in this area can evolve with the changing nature of SLP practice in palliative and EOL care.


Katherine is a practicing Speech Pathologist in South Western Sydney Local Health District, and is a PhD candidate with the University of Sydney. Her areas of clinical interest include head and neck oncology and palliative care. She is the chair of the Palliative Care Working Party for Speech Pathology in South Western Sydney Local Health District. She has lead the group in completing the program of research being presented upon here.

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