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“But My Speech Is Fine...”: Expanding the Speech-Language Pathologist’s Role in Nursing Home Dementia Care
Natalie Douglas. Innovation in Aging, 2025-12-01
Topic: Risk, prevention and care in population studies
Abstract Speech-language pathologists are uniquely positioned to support communication and person-centered care for people living with dementia in nursing homes. A recent feasibility study demonstrated that Dementia Collaborative Coaching can be implemented by speech-language pathologists to train certified nursing assistants in communication strategies within usual care workflows. In that study, four speech-language pathologists implemented coaching with 10 nursing assistants and 15 residents across 90 sessions, achieving 64% fidelity and significant reductions in behavioral distress, as measured by the Cohen-Mansfield Agitation Inventory, t(14) = 10.51, p < .001, d = 2.76. This presentation builds upon those findings by adapting Dementia Collaborative Coaching for a nursing home in southwestern Louisiana, located in one of the most socioeconomically disadvantaged regions in the United States, ranking in the 9th decile on the Area Deprivation Index. Adaptations included reducing session frequency to improve feasibility, training multiple nursing assistants per resident to ensure continuity across shifts, and incorporating culturally responsive materials tailored to the linguistic and social diversity of the region. Speech-language pathologists developed relationships with nursing assistants, modeled skilled communication strategies, and fostered a collaborative learning environment to integrate communication-focused care into daily routines. Preliminary findings suggest these adaptations improved nursing assistant engagement, consistency in strategy use, and resident interaction quality. This study highlights how speech-language pathologists can modify evidence-based interventions to fit resource-limited nursing homes while maintaining fidelity and impact.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Douglas, N. (2025). “But My Speech Is Fine...”: Expanding the Speech-Language Pathologist’s Role in Nursing Home Dementia Care. Innovation in Aging. https://doi.org/10.1093/geroni/igaf122.173
Vancouver
Douglas N. “But My Speech Is Fine...”: Expanding the Speech-Language Pathologist’s Role in Nursing Home Dementia Care. Innovation in Aging. 2025. doi:10.1093/geroni/igaf122.173.
BibTeX
@article{douglas2025-a56a60ff,
author = {Douglas, Natalie},
title = {{“But My Speech Is Fine...”: Expanding the Speech-Language Pathologist’s Role in Nursing Home Dementia Care}},
journal = {Innovation in Aging},
year = {2025},
doi = {10.1093/geroni/igaf122.173},
url = {https://doi.org/10.1093/geroni/igaf122.173}
}
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Key findings
- A recent feasibility study demonstrated that Dementia Collaborative Coaching can be implemented by speech-language pathologists to train certified nursing assistants in communication strategies within usual care workflows.
- In that study, four speech-language pathologists implemented coaching with 10 nursing assistants and 15 residents across 90 sessions, achieving 64% fidelity and significant reductions in behavioral distress, as measured by the Cohen-Mansfield Agitation Inventory, t(14) = 10.51, p < .001, d = 2.76.
Why it matters
A prior feasibility study found that speech-language pathologists could train nursing assistants in communication strategies, with significant reductions in behavioral distress among residents. This work is about improving communication and care in nursing homes, not about treating, curing, or preventing Alzheimer's disease itself.
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Study details
- Evidence strengthLow
How this study scored 26/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Innovation in Aging) |
| Journal's citation record | 0 / 4 | Innovation in Aging: journal h-index 48 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Natalie Douglas: h-index 15 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | University of Louisiana at Lafayette: institution h-index 223 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Total | 26 / 100 | — |
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