Recognizing Better Hearing and Speech Month

Liz Hill and Tracey Ulterino

In recognition of Better Hearing and Speech Month, we took a few minutes to talk with our speech language pathologists here at St. John’s Home. Both Tracey Ulterino and Liz Hill explain why they chose the profession and how working with the older adult population has impacted their lives.

What led you down the path to becoming a speech language pathologist?

Liz Hill: My mom was a special education teacher and I originally I went to school for OT. The college that I went to had a type of internship every year. My first semester I was able to go into a school setting and I worked with an OT who also worked with a speech language pathologist. I worked with them together and I liked what the speech language pathologist was doing better. I like the communication aspect. I switched majors and transferred to a different college. On campus, I had a good mix of kids and adults. I liked working with the adults the most.

Tracey Ulterino: Before I was a speech language pathologist I was an actress. At one point I decided I wanted to transition into something more stable. I wanted to use the skills I had developed as an actress. I had a lot of voice lessons and speech training. I did not really know much about the field, but the kind of connections speech provides and working 1:1 with people is what intrigued me. Communication is fundamental in life so seeing it from the medical perspective was really interesting as well.

What drew you to the older population?

Liz Hill: With the clinic on campus I liked working with adults better. We had a lot of stroke patients. My first placement in grad school was in a nursing home in rehab. It is nice because there are two different sides of it. The rehab side involves safety, swallowing, and getting them back to being independent as safely as possible. The long-term care aspect involves more relationship building with the residents where you can see what changes they have, what goals need to be addressed, etc.

Tracey Ulterino: I think when people get to this stage of their lives sometimes even small things can have a really big impact. I think that can be really rewarding when you realize that something small that you might have done made an impact on their quality of life. You can build a really strong relationship because you become someone that they see every day. You get to be a person that gets to know them and understand their lives and hear the things that matter to them and learn from their experiences.

Liz Hill: It is nice to hear their stories. I think everyone has a different story. They really like to talk about their lives. They have lived through so much.

What is the biggest challenge that you face?

Tracey Ulterino: Everybody has their role here and everyone’s objective is good patient care. I think sometimes collaboration is not always as good as it could be with communication.

Liz Hill: Without the business aspect of it, with this population as they age you do not always see the progress that you hope for. So sometimes it is hard.

Tracey Ulterino: It can be hard. Earlier this week I had to tell someone that I thought they needed 24/7 care. There are times that you tell people that you do not think they can go home and that is hard.

What would staff members be surprised by?

Liz Hill: We pretty much maintain a full caseload. Not everyone knows about all the services we can provide as speech therapists. People do not always know the signs and symptoms to look out for, such as with swallowing.

Tracey Ulterino: Sometimes when we do cognitive evaluations, we can also be an important person in developing behavior care plans or what someone’s communication abilities are. I think there are a lot of times when they do not really understand that even someone with more advanced dementia can be benefited by the education or strategies that we can provide families with.

How do you know that you have done your job successfully?

Liz Hill: It depends on what you are treating.

Tracey Ulterino: It is different with patients who are more able. Some patients can tell you how they feel. Other times, there are patients who do not have the cognitive ability to give you that information.

Liz Hill: Yeah. Sometimes we work with people who do not have the insight into their impairments and when there is that disconnect they do not understand why they are getting therapy so sometimes we do not see as much progress with those patients.

Tracey Ulterino: It is very different for each person. There is not just one type of dementia. Each person has strengths and weaknesses. It is about assessing those strengths and weaknesses in each person to maximize their abilities.

Liz Hill: But it is good when they know that they have impairments. Some of patients will say they cannot remember or that they are having trouble communicating. When they are aware of those deficits and they are motivated to participate it makes it much easier and we see more progress in those therapy sessions.

What is the most rewarding part of your job?

Liz Hill: It is nice when you see progress being made. When nursing staff, therapists, and patients are all on the same page and as a group we can come up with an approach to make that patient’s quality of life better.

Tracey Ulterino: I had a patient just recently who came to us and she progressed in a couple of weeks. That is not something we do every day, but it is nice to see that happen. She is a very highly able person so she was able to participate and engage in therapy.

Liz Hill: Seeing a lot of gains is nice. But also another way, if someone is having some difficulty swallowing and you can educate them on what aspiration is and what dysphasia is and teach them strategies. Even if you can decrease their signs of aspiration by doing a diet modification, sometimes they are grateful for that.

Tracey Ulterino: I think speech therapy has a lot of unseen areas. People do not really understand swallowing difficulties. I think a lot of our residents themselves and certainly a lot of staff members have a hard time understanding really what swallowing impairments are and how different they can be and how we can do a lot of different things to improve their swallowing. Speech pathology is a hard discipline because everyone knows what PT is. I think because people see us doing more with the swallowing and cognitive side. I think what I like about the profession is that we get to do so many things within the job role.

Liz Hill: We have a good mixture.

Tracey Ulterino: Yeah, the brain is so fascinating.

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