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Focus on Geriatric and Adult Services

Answering Questions About My Career As an SLP

Published August 11, 2011 9:08 AM by Jennifer Kay-Williams

I love questions about my career as a speech-language pathologist. I've been passionate about it from the beginning, and I enjoy telling others about this rewarding career, especially those thinking of a career as an SLP.

I began my career working in the public schools, and those years working with children, teachers, parents and fellow SLPs were quite rewarding, as well as demanding, frustrating, inspiring, creative, and busy. Encouraging comments were the norm.

There were always some not-so-welcome comments ("Educators have it so easy" or "Wow, I wish I could play games with kids all day and get paid"), but mostly, the reactions were supportive.

After about five years with the schools, I decided to give adult therapy a try. I wanted to work with adults in treatment before I had worked in pediatrics too long to make the transition. I sent out feelers, talked to recruiters, and was offered a position in geriatrics at a skilled nursing facility (SNF). The questions and comments changed immediately.

Question: "What's a skilled nursing facility?"

Me: "It's a nursing home."

Question: "Oh, isn't that really depressing?"

Me: "No. Actually, it's very rewarding. I help a lot of people."

Question: "Really? My friend's cousin's brother-in-law's mother was in a nursing home. I heard it was horrible. Aren't they all there because they are going to die?"

People tend to think of working with children, or young adults, as rewarding and positive and good for everyone. But they often see working with older adults and senior citizens as hopeless and depressing, and quite often, as a waste of time.

Each of my patients has had a story to share, a unique life history and perspective. Like kids, many have a great sense of humor and joy; others may be more difficult to get to know. Some are friendly and outgoing; others are shy, or unable to communicate well. They are intelligent, witty, passionate and, surprisingly to some, full of life and vitality. In short, they are just like the rest of us, only older.

To me, our elders deserve just as much care and support as our children. They have more years behind them than ahead of them - that's true. But they have insight into parts of history we only get to experience through them.

Our children are always worth our time because we, as SLPs, are helping them to reach their potential, to experience full and productive lives, and to communicate with those they love. Our seniors are always worth our time because we, as SLPs, are helping them to share their diverse experiences, and to teach others to appreciate how important communication is throughout our lives. No matter if you are 9 or 99, there is someone out there who wants to hear you say, "Thanks", "Good morning" or "I love you."

Check back in one week to read my next post, "Five Great Ways to Work with Geriatric Patients"!


I am considering moving from pediatric work to a skilled nursing facility.  However, like others who posted here, I have a limited experience with adults.  I also have very little interest in swallowing but would enjoy adult speech and language.  I have always had the impression that SNF include mostly swallowing cases. Is that true? My other question is, how much do I have to know when I go into a SNF position? Is there any help or on the job training for aspects of the job I wont be familiar with?

emily October 30, 2014 11:04 AM

Any advice for someone who has worked with pediatrics (private practice) who is interested in making the switch to adults/geriatrics? I am interested in gaining experience in an adult setting but feel as though I do not have enough experience or knowledge to even qualify and/or talk my way through an interview!

Elizabeth Delaney April 2, 2014 8:38 AM

Thank you for writing this! I've been looking all over the web for any blogs that even mention adults! Our pediatric SLP colleagues tend to have the most blogs!

I completed my CFY year in a SNF and really enjoyed it, challenges and all. When a school opportunity became available (a rarity in my area) I jumped on it without asking the right questions (huge caseload and workload!) and now I am feeling like I cannot complete the year there! I'm constantly bringing work home and stressing over RR and IEP dates as well as just getting the paperwork copied and filed in the right places at the end of the day. When I entered this field, I thought that peds therapy was for me, but I have so enjoyed working with the adult and geriatric population that I am excited to go back! I cherish my PRN days at my former SNF. I will soon be starting in home health, which is exciting and scary all the same!

It's great that we do have so many options to work in, but each one differs significantly.

Heather SLP, School - SLP December 30, 2013 9:25 AM

What are the top 10 resources you would suggest for a Speech Therapist who is just starting to grow a SNF Speech Therapy Dept? The facility is willing to purchase some things and I want to make wise choices!

Sally, Speech Therapy - Speech Therapist, SNF March 19, 2013 2:42 AM

I too get the questions, and after starting in public school, going to private school, then trying early intervention before I decided to try working with adults.

When I chose adults I went to a population I thought I knew pretty well,  adults with Mental Retardation. I stayed with them for 8 years, and saw young adults through people on their deathbeds. When I decided to change I had dysphagia, dementia and all types of communication under my belt.

The last two and a half years I have been a traveling SLP going to SNFs mostly in rural areas of Tennessee. who can not find anyone on a full time basis and will contract me for 13 weeks at a time. The question now has become, Why do you Tavel? Don't you miss your family? How does your husband like you traveling?

Well, I enjoy it because being from a strict southern home, I went from from my Mother to my husband with my only independence being my college years in West Tennessee. Yes, I miss my family very much, However  pictures, emails,  facebook , and cell phones make things a little easier.  My husband is left with a dog and a cat to take care of, and when he traveled I was left with 3 kids and a dog. Who had it easier?

I am by nature a quiet, shy person and 13 weeks means I really have to step out there and get to know my patients, their families, and the staff with whom I work. So I am very passionate about my work, and want to do what is right for my patients.

My 1 question still unanswered is are other traveling SLPs in SNFs out there who would like to network for some support and just plain sharing things we each learn at each new job we do? Maybe there is some way my email can be given to those travelers?  

Judy, SLP, Nashville, TN.

Judy Freeman, , SLP SNF December 18, 2011 7:02 PM
Wartburg TN


I also worked in schools for 5 years before making the switch to SNF. I often get comments how it must be depressing to work in "a nursing home." Although it presents its own set of challenges, I have found it to be extremely rewarding and nice change from the chaos of the school setting. I will continue to follow your blog for resources.

Jamie, SLP December 11, 2011 6:06 PM

Jennifer, thanks so much for your ideas.  I'm currently in a SNF and I'm not super happy.  My passion is dysphagia, but I get a LOT of cognitive/linguistic pts. (obviously-being in a SNF).  My hardest thing is making therapy FUNCTIONAL.  We don't have an ADL suite or kitchen or anything like that at my facility, so I feel somewhat limited in what I can do therapeutically that will carry over to a home environment for safety awareness/problem solving etc.  I don't love a lot of worksheets because I don't see how they correspond to the pt. in real life.  I don't mean to sound negative, but I'd love any help you could provide as I'd love to have a new passion for my facility.  Thanks so much!!

Lauran, SNF - SLP September 12, 2011 9:19 PM
Charlotte NC

Thanks, Jennifer.  I have never really specialized between adults or peds...they have all been in my caseload for the past 35 years but I have worked more with peds --infants thru school aged.  Now, however, I am about to work in skilled nursing b/c I was so inspired when subbing for a colleague going on maternity leave at a facility that included inpt, outpt and home health care!  I had forgotten how much fun and rewarding it was to work with adults who appreciate the tx and actually say, "Thank You", most of the time.  I also get to see my skills vary from one age group to another.  I do like the idea of some current references.  I have purchased some current books about Alzheimer's and bought The Source for Executive Function that seems to have great information about memory issues.  Any other current ideas would be most welcome.  I will be going to SoCal to work this winter.  Susan B. Nachimson, SLP

Susan B. Nachimson, private practice - SLP August 27, 2011 10:43 AM
Garberville CA

@ Mandy- I suggest taking some CEU courses to brush up on dysphagia and cognitive-linguistic based tx in adults. I found that many of the language and speech tx ideas I used with peds I could adapt to geriatrics. Also, try to find a colleague in your area who can mentor you. I think I will will devote a blog post to tx books and materials that helped my transition!

Jennifer Kay-Williams August 24, 2011 10:48 PM

I enjoyed reading your blog, Jennifer, and I can identify well with everything you said. I have worked many years in schools and then I switched for a few years to working in SNF's. Although I am working in schools again, I still see a couple of home health adult patients each week. It is a shame that we as therapists have to defend our choice in the population we work with. I have experienced much joy in working with both children and adults and I deeply appreciate all of the seniors I have met who have shared their history with me. Look forward to more info!

Kim Salinas, , SLP School/Home Health August 22, 2011 8:42 AM
Mansfield OH

Love this Jennifer! So glad to finally read about geriatrics! It is VERY rewarding! I wouldn't have it any other way! I know I have helped someone each and every day and lots of time....made their day!

Ashley, Speech Pathology - Speech-Language Pathologist, Skilled Nursing Facility August 18, 2011 10:36 PM
Alamo TN

Good for you!  I've considered making the switch from peds to adults, but after 10 years of only peds experience, I'm a little intimidated.  Were there any resources you found especially helpful in "brushing up" your skills?  It really seems like eons ago that I took grad classes in dysphagia and neurogenics, etc.

Mandy, SLP August 18, 2011 10:24 PM

Love your perspective, Jennifer.    Looking forward to reading about your experiences in this rewarding setting.

Nance, SLP August 11, 2011 3:30 PM
Chicago IL

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