# Third-party disability: An analysis of speech-language therapists’ experiences in adult dysphagia management in South Africa

## TL;DR

This study explores how speech-language therapists in South Africa manage the challenges faced by caregivers of adults with swallowing difficulties, known as third-party disability.

## Contribution

The study contributes new insights into the role of speech-language therapists in managing third-party disability in adult dysphagia care in South Africa.

## Key findings

- Caregivers receive inconsistent counseling due to the absence of a standardized protocol.
- Environmental and contextual factors influence third-party disability according to the ICF framework.
- Not all ICF components were applicable, and some relevant factors were missed.

## Abstract

Dysphagia, a swallowing impairment, has left people in need of assistance and care. Therefore, the lives of caregivers to those individuals with dysphagia change drastically. There is scarce research about the difficulties experienced by caregivers in caring for their loved ones with dysphagia, a phenomenon known as third-party disability (TPD).

This study explored Speech Language Therapists’ (SLTs’) experiences with caregivers when managing adult patients living with dysphagia in South Africa.

This study made use of a qualitative approach through an online survey with an optional follow-up interview using an adapted framework of the International Classification of Functioning, Disability and Health (ICF) model. Thirteen participants took part in the survey and two completed the follow-up online interview. Data were analysed using a top-down thematic analysis approach.

Third-party caregivers receive counselling at various times with different content because of the lack of a standardised counselling protocol. Furthermore, using the ICF framework, the article identified that environmental, and contextual factors contribute to TPD. However, not all ICF components were applicable, and additional relevant factors were not captured.

Understanding SLTs’ experiences in managing TPD in the adult dysphagia population was achieved.

The study contributes to literature regarding TPD of adult patients living with dysphagia and has captured the role of the SLT in managing TPD in diverse settings across South Africa.