Speech-Language Pathology and Palliative Care
“At the recent UKSRG conference, I sat in on several interesting talks. One was given by Laura Chahda about Speech Therapists/ pathologists role in palliative care. It was something new to me and so I asked Laura to share some of her presentation.
You can find it below and hope you find it as interesting as I did”. Mathew Done. MD.
When a Sip Matters
When people think about speech therapists, probably one of the last things they might think of is palliative care (PC) supports.
But at the end of life, one of the most important things commonly see is individuals who (1) want to communicate with their loved ones and (2) want to enjoy eating and drinking.
Swallowing difficulties are common in people with life-limiting illness. For many people receiving PC, these changes can make something as simple as a sip of water uncomfortable, frightening, or exhausting.
This is where speech therapists play a unique role.
At the end of life, our focus often shifts away from rehabilitation and toward comfort and quality of life. Rather than trying to “fix” swallowing, we help people eat and drink in ways that feel safe, manageable, and meaningful to them.
This might involve adjustments to positioning, pacing, environment, fatigue management, and food and fluid textures. It also involves guiding conversations with families and care teams about goals, risks, and preferences around eating and drinking.
One strategy that sometimes becomes part of this conversation is thickened fluids.
Thickened drinks are commonly used in dysphagia management because a slightly thicker liquid can move more slowly through the mouth and throat and increase sensory awareness.
For some people, this can improve control during swallowing and reduce coughing, choking, or discomfort when drinking.
In PC, thickened fluids are not about rigid rules or restrictions. Instead, they are one tool among many that may help support comfort and participation in eating and drinking.
Comfort eating and drinking is often misunderstood as meaning someone should simply “have whatever they want.”
In reality, comfort often means reducing distress. If drinking thin fluids leads to repeated coughing, breathlessness, or anxiety, a slightly thicker drink may feel calmer and easier to manage.
For another person, maintaining familiar drinks and routines may matter most. These decisions are deeply personal and depend on the individual’s goals, preferences, and overall condition.
Speech therapists help individuals and families navigate these nuanced decisions.
Our role is to balance safety, comfort, autonomy, and quality of life—supporting individuals to continue enjoying food and drink in ways that align with what matters most to them.
Because at the end of life, a sip of water isn’t just hydration. It can be so much more than that, it is comfort, it is connection with their loved ones and sometimes, it’s one of the last simple pleasures a person wishes to hold onto.
Many of these ideas can be explored further in the book Speech-Language Pathology and Palliative Care (2025) edited by L.Chahda, B. Mathisen and L. Carey, which brings together international perspectives on how communication and swallowing support can enhance comfort, dignity, and person-centred care during this stage of life.
