1. TBI & Degenerative Conditions

2. Traumatic Brain Injury (TBI) http://www.youtube.com/watch?v=c-W_o-pMDXQ

3. TBI TBI affects 186,000 people per year (Headway 2009) TBI can affect all areas of life TBI can affect: learning ability, attention, memory, language, voice, fluency, speech and swallowing Cognitive-communication disorders: cognitive difficulties and their effect on language processing, language use and communication behaviour (RCSLT, 2006) TBI can greatly impact on an individuals social communication and therefore effect relationships

4. ‘Don’t cut me out!’ Access to vital support services is being reduced due to funding cuts “…making it harder for brain injury survivors to access the help and support they need...lead independent lives ”. Communications Manager at Headway Early assessment in the acute setting to enable early identification of intervention for communication and swallowing needs Goal orientated rehabilitation by a coordinated interdisciplinary team Well planned and flexible discharge to community living to improve longer term outcome and self management (RCSLT, 2006) SLT value

5. The National Service Framework for long term neurological conditions. (March, 2005) To improve the treatment and long term support of people with neurological conditions by 2015. 11 quality standards - health and social care 3 qualities most relevant to individuals with TBI (Headway) - person-centred service - community rehabilitation and support - supporting families and carers

6. Dementia Approximately 800,000 people are diagnosed with the condition today Prediction: - increase to 1 million by 2021 - 1.7 million by 2051 1 in 25 over 65 1 in 6 over 80 Only 43% receive diagnosis (Alzheimer’s Society 2014)

7. Dementia http://www.telegraph.co.uk/health/10511920/A-cure-for- dementia-could-be-found-within-twelve-years-David- Cameron-has-said.html http://www.telegraph.co.uk/health/10511920/A-cure-for- dementia-could-be-found-within-twelve-years-David- Cameron-has-said.html

8. Dementia 80% of people living in care homes have a form of dementia (Alzheimer’s Society 2013) Global action – there is “no solution to the dementia crisis without research” (G8 summit) Carers are vitally important (NICE) – funding is needed to adapt care homes, train carers and adapt wards to be facilitating communication (Defeating dementia campaign)

9. Communication is key For individuals to maintain a quality of life – communication is important The RCSLT Dementia Campaign: Early intervention to monitor changes over time Help relatives and carers communicate with individuals with dementia more successfully and for longer Funding will allow training days to be set up to train individuals in communication strategies Feeding assessments – allow them to keep their independence concerning eating and drinking

10. Parkinson’s Disease 1 in 500 people suffer with Parkinson’s disease 127,000 currently have Parkinson’s in the UK Stem cell research – working towards a cure – new funding March 2014 (Britain and Israel) Palliative care needed at all phases of the condition (Parkinson’s UK 2013) 90% of individuals with diagnosed Parkinson’s experience dissatisfaction with how they communicate (Miller, et al, 2010)

11. Parkinson’s Disease Lee Silverman Voice Therapy has been shown to be effective in improving communication in individuals with the condition The majority of individuals with Parkinson’s found SLT had a positive effect, helping breathing, speech rate, loudness and confidence, as well as strategies to help swallowing (Miller, et al, 2010)

12. Motor Neurone Disease Majority of people aged 50-70 years Incidence – 2 people in every 100, 000 Prevalence – 7 people in every 100,000 (MNDA 2014) Incidence of motor neurone disease is increasing as people live longer and more accurate diagnosis No cure – manage symptoms to improve quality of life

13. Motor neurone disease Standards of care developed by MND association – work together to maintain these standards MND Year of Care Pathway to help the NHS and Social Services improve the provision of services for people with MND SLT input – dysphagia and dysarthria – important for individuals to still be able to communicate with friends and family (Resource manual for commissioning and planning services for SLCN– dysarthria, RCSLT 2009)

14. Multiple Sclerosis (MS) 20-50 years old Incidence: 4 per 100,000 (MS Society 2006, cited in RCSLT 2006) Prevalence: 144 per 100,000 (MS Society 2006, cited in RCSLT 2006 )

15. MS Challenges as an organisation and SLT clinician variable condition: Relapse/ remission Slow progressive increase in symptoms. Prognosis unpredictable SLT role in rehabilitation (NSF)

16. A case for speech and language therapy and MS ‘Key element of successful home care’ (The National Service Framework for Long-term Conditions, 2005. Department of Health) Recommendations (NICE Guidelines on MS): Dysphagia Communication: Dysarthria AAC Advice and training for circle of support LOCAL IMPLEMENTATION POINTS: which speech and language therapist should see people with dysarthria who may assess for and recommend augmentative equipment and adaptive technology to communication funding arrangements for augmentative aids to communication (AACs).

17. We need your funding!!

18. Useful links https://www.headway.org.uk/home.aspx https://www.headway.org.uk/news/dont-cut-me-out.aspx https://www.gov.uk/government/publications/quality- standards-for-supporting-people-with-long-term-conditions https://www.gov.uk/government/publications/quality- standards-for-supporting-people-with-long-term-conditions http://www.alzheimers.org.uk/ http://www.rcslt.org/governments/docs/dementiacampaign_ bulletinmay2013 http://www.rcslt.org/governments/docs/dementiacampaign_ bulletinmay2013 http://www.mssociety.org.uk/sites/default/files/Documents/ Governance%20docs/Misc%20resources/Annual%20report%2 0and%20accounts%202006.pdf http://www.mssociety.org.uk/sites/default/files/Documents/ Governance%20docs/Misc%20resources/Annual%20report%2 0and%20accounts%202006.pdf http://www.rcslt.org/docs/free- pub/TBI_reading_list_Feb_07__2_.pdf http://www.rcslt.org/docs/free- pub/TBI_reading_list_Feb_07__2_.pdf http://www.nice.org.uk/

19. References Miller, N., Noble, E., Jones, D., Deane, K. H. O., Gibb, C. (2010). Survey of speech and language therapy provision for people with Parkinson’s disease in the United Kingdom: patients’ and carers’ perspectives. International Journal of Language and Communication Disorders, Online 23 June 2010 Motor neurone disease association (2014). Brief guide to MND. Retrieved March 17 th, from http://www.mndassociation.org/what-is- mnd/Brief+guide+to+MND.htmhttp://www.mndassociation.org/what-is- mnd/Brief+guide+to+MND.htm Parkinson’s UK (2013). NICE guidelines for Parkinson’s. Retrieved March, 12, 2014, from http://www.parkinsons.org.uk/content/nice-guideline-parkinsonshttp://www.parkinsons.org.uk/content/nice-guideline-parkinsons RCSLT (2006). Communicating quality 3. London: RCSLT. RCSLT (2009). RCSLT resource manual for commissioning and planning services for SLCN; dysarthria. Retrieved 14 th March, 2014, from http://www.rcslt.org/speech_and_language_therapy/commissioning/dysarthria _plus_intro http://www.rcslt.org/speech_and_language_therapy/commissioning/dysarthria _plus_intro RCSLT (2009). RCSLT resource manual for commissioning and planning services for SLCN; TBI. http://www.rcslt.org/speech_and_language_therapy/commissioning/brain_injur y_intro http://www.rcslt.org/speech_and_language_therapy/commissioning/brain_injur y_intro http://www.nice.org.uk/nicemedia/live/14355/66330/66330.pdf