Speech therapy in palliative care and comfort feeding: Current practice and way ahead

Abstract

Background. Speech therapy is important in palliative care and endof-life care of the geriatric population. Comfort feeding is an option for such patients, but there is no guideline for its operational and clinical practice. Thus, we surveyed the opinions of speech therapists on their role, clinical practice, and future development to formulate preliminary recommendations in dysphagia management and comfort feeding in patients on palliative care. Methods. An online survey of speech therapists in Hong Kong was conducted between February and March 2018. The survey comprised 14 questions to assess speech therapists’ understanding of palliative care, their current practice in comfort feeding, and their views on future development. Results. Of 70 speech therapists invited, 38 (54%) completed the survey. 89% of participants reported to have provided care to patients with dementia. The most common service provided was feeding and swallowing management (100%), followed by education to patients, their family and/or the multidisciplinary team regarding communication and swallowing difficulties (88.2%). There were diverse opinions on the practice of comfort feeding among speech therapists. Thus, 92.1% of participants agreed a need of development of practice guideline for palliative care. Conclusions. The practice of comfort feeding varies among different speech therapists, particularly in the frequency of follow-up and the recommendation on liquid consistency. To improve the standard of care for patients receiving palliative care or end-of-life care, development of an evidence-based guideline for comfort feeding is recommended.