Summary of the Clinical Practice Guideline

Article Citation

RACGP Aged Care Clinical Guide (Silver Book)

Royal Australian College of General Practitioners. (2019).
Australia: Royal Australian College of General Practitioners
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Article Details

Description

This guideline from the Royal Australian College of General Practitioners provides recommendations regarding the care of patients 65 and older as they age. This summary highlights recommendations within the scope of audiology and speech-language pathology.

Recommendations from This Guideline

What are Recommendations?

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Assessment

Older adults should have a regular audiological review for possible hearing impairment that includes an examination of the ear and maintenance of hearing aids as appropriate. Regular audiology assessment may also address balance disorders and fall prevention.

Keywords: Disorders of the Ear, Comorbid Disorders and Diseases, Hearing Aids, Follow-Up/Timing, Audiometric Testing, Follow-Up/Timing, Hearing Loss, Presbycusis, Otoscopy

Service Delivery

Older adults should have a regular audiological review for possible hearing impairment that includes an examination of the ear and maintenance of hearing aids as appropriate. Regular audiology assessment may also address balance disorders and fall prevention.

Keywords: Disorders of the Ear, Comorbid Disorders and Diseases, Hearing Aids, Follow-Up/Timing, Audiometric Testing, Follow-Up/Timing, Hearing Loss, Presbycusis, Otoscopy

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Assessment

When assessing cognition in older adults, the Rowland Universal Dementia Assessment Scale (RUDAS) has been validated for culturally and linguistically diverse (CLD) populations, while the Mini-Mental State Examination (MMSE) is "Western-centric" and may not provide productive information for CLD individuals.

Keywords: Cognitive-Communication, Cognition, Dementia

Treatment

For older adults who are bilingual or who have a hearing impairment or dementia, counseling and education may be provided with the help of an interpreter. If preferred by the patient, a family member may act as an interpreter after that individual is respectfully educated on the interpreter's role and a back-up plan for a professional interpreter, if needed, is established.

Keywords: Provider (SLP/Caregiver), Communication Modalities, Deaf/Sign Language, Caregiver, Provider, Linguistic Diversity, Multilingual, Counseling and Education, Dementia, Education/Counseling, Hearing Loss, Aural Rehabilitation

Service Delivery

For older adults who are bilingual or who have a hearing impairment or dementia, counseling and education may be provided with the help of an interpreter. If preferred by the patient, a family member may act as an interpreter after that individual is respectfully educated on the interpreter's role and a back-up plan for a professional interpreter, if needed, is established.

Keywords: Provider (SLP/Caregiver), Communication Modalities, Deaf/Sign Language, Caregiver, Provider, Linguistic Diversity, Multilingual, Counseling and Education, Dementia, Education/Counseling, Hearing Loss, Aural Rehabilitation

Go to Map

Assessment

When assessing cognition in older adults, the Rowland Universal Dementia Assessment Scale (RUDAS) has been validated for culturally and linguistically diverse (CLD) populations, while the Mini-Mental State Examination (MMSE) is "Western-centric" and may not provide productive information for CLD individuals.

Keywords: Cognitive-Communication, Cognition, Dementia

For older adults with dementia, cognitive function may be assessed by the patient's multidisciplinary team. Functional capacity should be reviewed regularly. See the Collaboration and multidisciplinary team-based care section of the Silver Book - Part B for detailed description of optimal care considerations.

Keywords: Provider (SLP/Caregiver), Timing, Adults, Cognitive-Communication, Dementia

Treatment

For older adults who are bilingual or who have a hearing impairment or dementia, counseling and education may be provided with the help of an interpreter. If preferred by the patient, a family member may act as an interpreter after that individual is respectfully educated on the interpreter's role and a back-up plan for a professional interpreter, if needed, is established.

Keywords: Provider (SLP/Caregiver), Communication Modalities, Deaf/Sign Language, Caregiver, Provider, Linguistic Diversity, Multilingual, Counseling and Education, Dementia, Education/Counseling, Hearing Loss, Aural Rehabilitation

Service Delivery

For older adults with dementia, cognitive function may be assessed by the patient's multidisciplinary team. Functional capacity should be reviewed regularly. See the Collaboration and multidisciplinary team-based care section of the Silver Book - Part B for detailed description of optimal care considerations.

Keywords: Provider (SLP/Caregiver), Timing, Adults, Cognitive-Communication, Dementia

For older adults who are bilingual or who have a hearing impairment or dementia, counseling and education may be provided with the help of an interpreter. If preferred by the patient, a family member may act as an interpreter after that individual is respectfully educated on the interpreter's role and a back-up plan for a professional interpreter, if needed, is established.

Keywords: Provider (SLP/Caregiver), Communication Modalities, Deaf/Sign Language, Caregiver, Provider, Linguistic Diversity, Multilingual, Counseling and Education, Dementia, Education/Counseling, Hearing Loss, Aural Rehabilitation

Go to Map

Assessment

Older adults should have a regular audiological review for possible hearing impairment that includes an examination of the ear and maintenance of hearing aids as appropriate. Regular audiology assessment may also address balance disorders and fall prevention.

Keywords: Disorders of the Ear, Comorbid Disorders and Diseases, Hearing Aids, Follow-Up/Timing, Audiometric Testing, Follow-Up/Timing, Hearing Loss, Presbycusis, Otoscopy

Treatment

For older adults who are bilingual or who have a hearing impairment or dementia, counseling and education may be provided with the help of an interpreter. If preferred by the patient, a family member may act as an interpreter after that individual is respectfully educated on the interpreter's role and a back-up plan for a professional interpreter, if needed, is established.

Keywords: Provider (SLP/Caregiver), Communication Modalities, Deaf/Sign Language, Caregiver, Provider, Linguistic Diversity, Multilingual, Counseling and Education, Dementia, Education/Counseling, Hearing Loss, Aural Rehabilitation

Older adults should be recommended strategies to preserve hearing function and prevent hearing loss.

Keywords: Disorders of the Ear, Prevention of Hearing Loss/Occupational Noise Exposure, Counseling and Education, Presbycusis, Aural Rehabilitation

Service Delivery

For older adults who are bilingual or who have a hearing impairment or dementia, counseling and education may be provided with the help of an interpreter. If preferred by the patient, a family member may act as an interpreter after that individual is respectfully educated on the interpreter's role and a back-up plan for a professional interpreter, if needed, is established.

Keywords: Provider (SLP/Caregiver), Communication Modalities, Deaf/Sign Language, Caregiver, Provider, Linguistic Diversity, Multilingual, Counseling and Education, Dementia, Education/Counseling, Hearing Loss, Aural Rehabilitation

Older adults should have a regular audiological review for possible hearing impairment that includes an examination of the ear and maintenance of hearing aids as appropriate. Regular audiology assessment may also address balance disorders and fall prevention.

Keywords: Disorders of the Ear, Comorbid Disorders and Diseases, Hearing Aids, Follow-Up/Timing, Audiometric Testing, Follow-Up/Timing, Hearing Loss, Presbycusis, Otoscopy

Go to Map

Assessment

For older adults with dementia, cognitive function may be assessed by the patient's multidisciplinary team. Functional capacity should be reviewed regularly. See the Collaboration and multidisciplinary team-based care section of the Silver Book - Part B for detailed description of optimal care considerations.

Keywords: Provider (SLP/Caregiver), Timing, Adults, Cognitive-Communication, Dementia

Service Delivery

For older adults with dementia, cognitive function may be assessed by the patient's multidisciplinary team. Functional capacity should be reviewed regularly. See the Collaboration and multidisciplinary team-based care section of the Silver Book - Part B for detailed description of optimal care considerations.

Keywords: Provider (SLP/Caregiver), Timing, Adults, Cognitive-Communication, Dementia

For older adults experiencing frailty and developing end-of-life goals, a team of health professionals (e.g., speech therapist, physiotherapist, nutritionist, dentist) should be involved early in discussions. For older individuals with stroke or neurodegenerative disorders (e.g., multiple sclerosis, Parkinson's disease, Alzheimer's disease, Huntington's disease, amyotrophic lateral sclerosis, motor neuron disease), healthcare providers should work proactively to monitor general health and maintain mobility and independence. See the Collaboration and multidisciplinary team-based care section of the Silver Book - Part B for detailed description of optimal care considerations.

Keywords: Timing, Adults, Amyotrophic Lateral Sclerosis, Dementia, Huntington’s Disease, Multiple Sclerosis, Parkinson’s Disease, Stroke

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