This is a question a lot of speech-language pathologists may ask. An SLP may respond to this question with “I’m not an OT!” “That’s out of my scope of practice.” “I’m not trained to give someone a shower!” However, the only response should be “why not?”
A few weeks ago, I was put into this exact situation. I had a patient who I was seeing post-stroke and she was having some new difficulty with sequencing tasks and following safety precautions. Her OT came to me and asked for advice. This patient could recall safety precautions when discussing what she would do during various scenarios, but when she was actually performing the task it all went out the window. I was planning on doing a role-play scenario in which I would act out various situations and the patient was to verbalize each step I needed to take to perform various tasks. However, when I walked in the room my plan changed.
“Hi Mrs. X, I’m here for your speech therapy session!”
“Well, I’m sorry to tell you this but I can’t do anything until I get a shower. You will need to push back my session.”
I knew my schedule was full this day so rearranging my patients wasn’t an option and I really wasn’t wanting to upset my patient. So I then asked myself – “why can’t I help her with a shower?”
If I helped this patient with her shower, we would be targeting the exact goals I was already planning to work on (in a WAY more functional approach) and we would be making the patient happy. Win-win scenario!!!
So what did I do? Well first, I ran to my OT partner. I asked her all about her safety precautions, transfers, and any tips she had. I also made sure it wouldn’t interfere with any plans she had for the patient today. My OT partner informed me that this patient just needed supervision during the transfer from the wheelchair to the shower chair, but needed LOTS of verbal cues during the actual shower to complete all steps. Right up my alley. However, instead of providing the patient with verbal cues, I educated my patient to “Self-Talk” and tell ME every step she needed to complete. This helped keep her on track and focused during the shower. This also helped improve her independence and move toward her goal of a safe discharge home.
“Self-Talk” is a great tool for adults to use to improve their memory and task completion. It teaches the patient how to cue themself instead of relying on a communication partner for their cues. Talking out loud also improves memory retrieval to help with future tasks as well. Teaching my patient to self-talk not only significantly helped during this shower, but carried over to other functional ADLs as well.
Cognition plays a huge role in the day-to-day lives of our patients, and if they can’t perform their functional tasks because of a cognitive deficit then it is absolutely within the scope of an SLP to target this task. OT, PT, and SLP should work in harmony as an interdisciplinary team to do everything we can to get our patients home safely. So the next time you’re asked to complete any functional task with your patient – your answer should always be yes.