Diabetic children and foot care: are we heading in the right direction?

This study investigated parents' knowledge and understanding of foot care for their child with diabetes mellitus (Type I). Thirty parents of diabetic children in four out-patient clinics within the same trust (not the author's place of work) were asked to complete a questionnaire. There was a clear lack of parental knowledge concerning the children's foot care. Only 40 per cent of the children had had their feet examined by a healthcare professional since diagnosis; a recommendation in the Diabetes UK guidelines (2000). Only sixty-three per cent of families had ever received any foot care advice, which is consistent with the results of a study by Barnett et al in 1995. Parents wanted more verbal and written foot care advice. More emphasis needs to be placed on foot care education and regular foot examinations are essential if foot ulcers and limb amputations are to be prevented in later life.     

Speech and language therapists in palliative care: what do we have to offer?

Speech and language therapists (SLTs) are specialists in the management of communication and swallowing disorders (dysphagia); however, few are members of acute and community specialist palliative care teams in the UK. Although numbers of SLTs working in palliative care are increasing, there is a need for education and research to support service development and promote understanding of their role. This profile piece outlines what SLTs have to offer patients with palliative care needs and describes how their role in palliative care is increasing in the UK.     

Information in dementia care: sense making and a public health direction for the UK?

Providing information is a core focus of policy and practice in dementia care. Information is a vehicle through which people can be enabled or disabled, so it is essential that we ensure that information is available in a way that is accessible and relevant for people with dementia and that it enables personal aspiration and collective identity to be advanced in a way that is to the benefit of those living with dementia. People with dementia need information to support autonomy in making decisions and in acting on those decisions. Information must be provided in a way that is appropriate to the individual and to achieve that requires knowledge of the needs of that individual. However, maintaining autonomy includes, but involves much more than, the provision of information - others need to listen and hear their views and be prepared to act on them. As professionals, we must be aware that the (dementia) information we provide may disrupt the biographical narrative that people with dementia value. Thus, a person-centred approach encourages the sharing of knowledge and information. The (mis)use of information also impacts on the way that society disables, discriminates and applies barriers against people with disability.     

The role of speech-language pathologists in palliative care: Where are we now? A review of the literature

Introduction: Dysphagia and communication changes are common in life-limiting conditions and Speech-Language Pathology (SLP) involvement to facilitate effective communication, eating and drinking contributes to the goals of comprehensive palliative care.

Aim: To examine the existing literature around the role of SLPs in palliative care to define the best practice role for SLPs in this area, identify current services and interventions provided by SLPs to patients with life-limiting conditions, assess for potential gaps between best practice in the literature and everyday SLP practice and opportunities for improvement.

Methods: The methods used were electronic literature searches within MEDLINE, EMBASE and CINAHL, and manual searching. Papers were classified according to type. Meta-analysis was not appropriate due to the nature of the papers, and so a narrative exploration of themes was conducted.

Results: Thirty-two papers were included (eight research, twenty-four non-research).

Discussion: Specific roles for SLPs in dysphagia, communication, and holistic professional practice were identified. There is insufficient research to determine whether this is reflected in everyday SLP practice. Potential challenges to providing services include the impact of working with people who are dying, limited professional preparation, ongoing education constraints, and legal and ethical considerations. Further research into SLP activities with patients with life-limiting conditions is required to explore the valuable contributions already being made by SLPs to the care of patients with life-limiting illnesses and to identify opportunities to develop and improve evidence-based services in this area.