18 August 2021

Colleen Francis, a Speech Language Pathologist, describes her journey of discovery about palliative care and her thoughts on the valuable role Speech Language Therapists can play within the palliative care and children’s palliative care team.

As Speech Therapy students we were taught that we play a role throughout a person’s life, from birth to adulthood in a number of ways, through speech, communication, literacy, language, feeding and swallowing (many people are surprised by the last two!). We also learnt that our role could extend to the palliative care journey as well. It would make sense, as communication and feeding professionals, that we would be needed at a time when clients and their families need to be able to communicate needs and ideas, and access safe feeding. The part that never really settled in for me at the time of studying was that palliative care is not only appropriate for adults. When I took a job working at a school 11 years ago, being part of a learner’s final chapters wasn’t even a thought, until it happened.

Although I have never formally been part of a Palliative Care Team for any of my learners, I was privileged to play a small supportive personal role in the life of a young man, who along with his mother, touched my heart forever. There was a chance that he may have needed my professional skills near the end, but thankfully he was able to communicate as before until his final moments. This experience and others lead me to realise that as a therapist, I need to be able to assist at any time and be professionally and personally present and productive even in the most difficult moments.

“This experience and others lead me to realise that as a therapist, I need to be able to assist at any time and be professionally and personally present and productive even in the most difficult moments.”

Another step in my journey was the introduction to the organisation Paedspal Cape Town, when another learner was able to benefit from the skills and care of their incredible team. Dr Tracy called our school to let us know one of our other learners was palliative, news we were not aware of. Her kindness in reaching out allowed so many of us to say good bye and allowed her classmates a chance to make her a video and to write her letters of support and love. Just in time. This moment reminded me that Palliative care is more than just medical, it’s a chance to prepare, share and connect patients to those who they love most. The fact that someone in a care team made sure those precious moments happened was so inspirational.

I also witnessed, mostly from afar unfortunately, the journey my Gran went on over a number of years while she was essentially under palliative care. Her strength and resilience were incredible. The staff supporting her made sure that her basic needs were met, that she was happy and comfortable and that her family could be with her. She had both communication and feeding difficulties in her final years but was able to be communicated with, cared for, loved, fed and kept safe throughout this time. What an incredible blessing it was to have the time to say goodbye, the time to prepare and share the journey in some way. My own diagnosis of a rare disease in 2017 and my introduction to the wider Rare Disease community has also opened my eyes to the many ways palliative care can play a vital role in the quality of someone’s life throughout and not just in final days or months.

“My own diagnosis of a rare disease in 2017 and my introduction to the wider Rare Disease community has also opened my eyes to the many ways palliative care can play a vital role in the quality of someone’s life throughout and not just in final days or months.”

All of these experiences and a few more highlighted a need for me to make sure that should I be called up to play a role again professionally or personally in this field that I would be ready. Myself and some colleagues were even in the process of developing our understanding of palliative care and reached out to Paedspal for support. Unfortunately, shortly after our first planning meeting, COVID-19 became a reality and our teams’ plans had to change temporarily. We do still though make provision for our learners with life-limiting conditions, ensuring they are referred for support, regularly checked up on and we teach valuable skills such as using assistive technology should the need arise. Despite all the challenges of the last year, I still find myself, now more than ever, wanting to learn further about this role I could play. Thanks to the PatchSA Facebook page, I found an online option to do so in the courses offered by the Patch Academy.

Despite all the challenges of the last year, I still find myself, now more than ever, wanting to learn further about this role I could play. I found an online option to do so in the courses offered by the Patch Academy.

I have completed one course so far on Teamwork, Managing Conflict and Self Care and really enjoyed it. The content of this course in particular was so relevant to any team and professional role, so it really resonated with me, even with my limited experience in palliative care. It also made me think of my own profession and the role we can play in the team. A Speech Therapist on a care team could play an important role in assisting clients/patients to communicate to the best of their abilities anything they want to say (not just request basic needs) through any means of communication – including Augmentative and Alternative Communication (A.A.C), to ensure safe feeding methods are used as needed and to even assist fellow team members in developing communication strategies with patients who may have limited or lost speech. I’m sure there are many other valuable insights and skills a speech therapist could bring to the team. I look forward to developing my skills further in order to do just that. One way will definitely be to do more of the courses offered by PatchSA!

You can visit and learn more about the Patch Academy here.

About the author
Colleen is a Speech Language Pathologist who graduated from UCT in 2008. After her community service working in a number of hospitals, clinics, schools, care centres and doing home visits for the Frances Baard Health district in Kimberley in 2009 she returned to the Western Cape. Since 2010 she has been part of a wonderful interdisciplinary team at Tembaletu LSEN in Gugulethu, working with learners with physical impairments in both mainstream and practical curriculum streams at the school. She has also worked part time for a private practice focusing on A.A.C. for a short while. She is interested in most aspects of speech therapy, especially maximising functional communication and literacy skills to help learners learn and communicate with their families and communities.