Communicative Accessibility in Aphasia: An Investigation of the Interactional Context of Long-Term Care Facilities Purpose The purpose of this study was to examine the ability of persons with aphasia to access interaction and be included in social encounters in long-term care facilities (LTCFs). Method Four persons with aphasia were the focus of this investigation. A qualitative research approach using ethnographic methods was ... Research Article
Newly Published
Research Article  |   September 10, 2018
Communicative Accessibility in Aphasia: An Investigation of the Interactional Context of Long-Term Care Facilities
 
Author Affiliations & Notes
  • Jamie H. Azios
    Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX
  • Jack S. Damico
    Department of Communicative Disorders, University of Louisiana at Lafayette
  • Nancye Roussel
    Department of Communicative Disorders, University of Louisiana at Lafayette
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Jamie H. Azios: jhartwell@lamar.edu
  • Editor-in-Chief: Julie Barkmeier-Kraemer
    Editor-in-Chief: Julie Barkmeier-Kraemer×
  • Editor: Anastasia Raymer
    Editor: Anastasia Raymer×
Article Information
Professional Issues & Training / Language Disorders / Aphasia / Newly Published / Research Article
Research Article   |   September 10, 2018
Communicative Accessibility in Aphasia: An Investigation of the Interactional Context of Long-Term Care Facilities
American Journal of Speech-Language Pathology, Newly Published. doi:10.1044/2018_AJSLP-17-0099
History: Received July 3, 2017 , Revised December 8, 2017 , Accepted June 4, 2018
 
American Journal of Speech-Language Pathology, Newly Published. doi:10.1044/2018_AJSLP-17-0099
History: Received July 3, 2017; Revised December 8, 2017; Accepted June 4, 2018

Purpose The purpose of this study was to examine the ability of persons with aphasia to access interaction and be included in social encounters in long-term care facilities (LTCFs).

Method Four persons with aphasia were the focus of this investigation. A qualitative research approach using ethnographic methods was used to conduct participant observation, semistructured interviews, and artifact analysis. Expanded field notes from observations, transcribed interviews, and artifacts were then coded to identify patterns in the data.

Results The interactional context of LTCFs negatively influenced the ability of persons with aphasia to communicate with others and develop meaningful relationships. Three major themes emerged from the data detailing the contextual elements leading to communication accessibility and inclusion: (a) lack of support, (b) social hierarchy, and (c) focus on performance.

Conclusions Findings highlighted several barriers in LTCFs that worked to discourage persons with aphasia from living social and expressive lives. Specific obstacles included a misunderstanding of aphasia and its influence on communicative exchanges and performance-oriented environment that overlooked psychosocial needs. Speech-language pathologists have an important role for advocacy in LTCFs. Clinical implications for assessment and treatment in institutions are discussed.

Acknowledgments
We would like to thank the participants who openly shared their lives and stories with us. Also, we are thankful for the residents and staff in the LTCFs for their assistance and cooperation.
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