Older People

• For integrated care, intermediate care services will be provided by a core team of professionals including speech and language therapists§ Intermediate care services will always include a programme of active rehabilitation involving contribution from therapies including speech and language therapy.
• There should be a specialist old age multidisciplinary team, which will include speech and language therapists as core members in all general hospitals.
• The evidence indicates that early, expert and intensive rehabilitation in a hospital stroke unit improves the long-term outcome for patients. Rehabilitation will vary according to needs but might include speech and language therapy for patients with communication, swallowing difficulties or for nutritional advice if texture modification is required.
• Managing stroke patients in hospital will mean establishing specialist stroke team led by a clinician with expertise in stroke. Stroke teams should include speech and language therapists.
• The specialist mental heath service for older people should also have agreed working and referral arrangements with speech and language therapists.
• Stroke patients and their carers will participate in a multidisciplinary programme of secondary prevention and rehabilitation.
• Recovery from stroke can continue over a long time and rehabilitation should continue until it is clear that maximum recovery has been achieved.
• Early interventions are also required in communication, cognition, mood and activities of daily living.
• Specialist stroke services should provide advice to and train other professionals and service providers in all aspects of stroke care consistent with the responsibilities of the individual members. Training should include swallowing and nutritional needs and overcoming communication problems, roles undertaken by a speech and language therapist.