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WRHA Long Term Care Speech-Language Pathology Services

Speech Language Pathology WRHA Long Term Care Program provides services to 36 long term care homes with approximately 5038 beds within the WRHA. Services include swallowing and communication assessment, consultation and education for residents, facilities and families.


  • Clinical swallowing assessment within the resident’s LTC facility
  • Instrumental swallowing assessment (i.e., Video fluoroscopic swallowing study – VFSS) which is available with SLP recommendation and with physician diagnostic imaging requisition order
  • Education for residents/family/staff.  SLP provides counseling and education to residents, families and team members regarding the nature and management of a resident’s swallowing disorder, associated risks, available interventions and anticipated outcomes.
  • Conversation regarding end-of-life and quality of life related to the progression of swallowing difficulties and how they may impact decision making
  • Management of swallowing, including diet texture modifications and resident-specific safe-feeding and swallowing strategies
  • Collaboration with other disciplines (e.g., RD, OT, nursing, Dental, GI)

Referral Criteria:

  • Any signs/symptoms of possible swallowing difficulty on meal observation screening (MOS) or reported by staff/family/resident
  • Choking event – urgent referral
  • Significant change in swallowing, absent swallow or query NPO status – urgent referral
  • Recurrent chest infections
  • Admitted with tube feed
  • Continuation of care from acute care for follow-up of swallowing recommendations and re-assessment for any possible changes
  • Potential for diet texture upgrades – includes residents admitted on most restrictive diet textures (e.g., pureed diet, thickened fluids)
  • Family could benefit from education related to swallowing difficulties, associated risks, available interventions, end-of life swallowing and anticipated outcomes


Direct treatment for communication impairments is not available. Our focus is on assessment of functional abilities and providing recommendations and limited training in the use of strategies to facilitate residents’ communication with staff and family.

Referral Criteria:

  • Sudden change in communication (speech, language or cognitive-linguistic communication)
  • Possible benefit from augmentative-alternative communication – initial assessment may lead to further referral to Communication Devices Program
  • Possible benefit from SLP therapy – LTC SLP can provide brief assessment to determine candidacy for therapy and provide information regarding how to access public or private SLP therapy
  • Family/staff could benefit from education regarding communication strategies for individual residents

Any member of the medical team may refer for swallowing assessments or communication assessments.

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