Podcast – Communication training for people with language led dementia (primary progressive aphasia)

Voice Over:

Welcome to the dementia researcher podcast brought to you by dementiaresearcher.nihr.ac.uk. A network for early career researchers.

Dr Lakshini Mendis:

Hello, my name is Lakshini Mendis and welcome to our podcast recording for the NIHR dementia researcher website. This week, I’m joined by a fantastic panel of speech and language therapists who are in the studio with us to discuss their research around communication training for people with language led dementia or primary progressive aphasia.

Dr Lakshini Mendis:

Now, you may already be aware that speech and language therapists provide treatment, support and care for people who have difficulties with communication or with eating, drinking, and swallowing. However, if like me until very recently, you had no idea of the range of therapeutic intervention, speech and language therapists can offer to people living with dementia at all stages of the disease process, then you’re definitely listening to the right podcast.

Dr Lakshini Mendis:

This week I’m joined by Rosemary Townsend.

Rosemary Townsend:

Hi.

Dr Lakshini Mendis:

A specialist speech and language therapist and chief executive of Dyscover aphasia support charity in Leatherhead, Surrey, who voluntarily went on a three day silent retreat. Not an easy task for a speech therapist, I’m sure.

Dr Lakshini Mendis:

Next, we have Oliver Sawyer.

Olly Sawyer:

Hello.

Dr Lakshini Mendis:

A student speech and language therapist at the University College, London. Olly enjoys making sourdough in his spare time and spending time at the lido in the sun. And last but definitely not least, we have a regular contributor and blogger for the dementia researcher website, Anna Volkmer.

Anna Volkmer:

Hi there.

Dr Lakshini Mendis:

Anna is a NIHR doctoral research fellow and speech and language therapist also at University College, London. She’s going to be a natural at this because she did some voiceover work when she was five. So welcome, all.

Anna Volkmer:

Thank you.

Dr Lakshini Mendis:

As I mentioned earlier, our panellists have a research interest in language led dementia or primary progressive aphasia, but before we get stuck into the research, maybe we can get to know our panellists a little bit better.

Dr Lakshini Mendis:

So you already know some fun facts about them, but could each of you share a little bit more about yourself and why you chose to work in dementia?

Anna Volkmer:

Of course, and so my name is Anna Volkmer. I’m a speech and language therapist by background and I became particularly interested in working with dementia when I was working clinically because I found that many other speech therapists and many other health professionals didn’t know about the range of interventions we could offer and I felt quite passionately that this was a group that we could really support and work with to live independently for longer by working on their communication.

Anna Volkmer:

That’s also what motivated me to apply for some research funding with the National Institute for Health Research. So I am currently funded by a doctoral research fellowship and I’m running the project called “Better Conversations with Primary Progressive Aphasia” or BCPPA, for short. A nice acronym.

Dr Lakshini Mendis:

Rolls off the tongue.

Anna Volkmer:

Yes indeed. Which is how I then, I guess, drew Rosemary into working, convinced her, twisted her arm into helping me on that route, and also Olly, who is one of our students is working with us on the project too.

Dr Lakshini Mendis:

Perfect. So Rosemary, if we’re go to you then. Well, Anna said she had to twist your arm, but I am sure this is something that you were, were you already working on? Had an interest in?

Rosemary Townsend:

Yeah. I’m a clinician and have been for many years, actually. I’ve been a clinician for about 30 years, which makes me sound very, very elderly, but actually I think I just got going with my career very early, that’s my excuse anyway, but I’ve had a long term interest in aphasia and it was that mutual interest that really brought Anna and myself together.

Rosemary Townsend:

In the charity, Dyscover, that I work for, we’re specializing in group support for people with chronic aphasia and although we support people with aphasia caused by stroke, in the last five or six years I’ve developed an interest in this dementia related aphasia and through that, I’ve come to know Anna and be involved in her steering group for her PhD, which has been great.

Anna Volkmer:

I think I worked out the other day that Rosemary and I have been interacting with each other at meetings and conferences on the phone for about six years, I think it might be?

Rosemary Townsend:

Probably.

Anna Volkmer:

Five or six years at least, yeah.

Dr Lakshini Mendis:

Strong collaboration there then. And Olly, how did you get started in this area and involved with the project?

Olly Sawyer:

I am a student speech and language therapist, as we said before, here at UCL. I have had not quite as much research experience as these two wonderful panellists, but I have a background in working with patients with neurological conditions and spent quite a bit of time working with patients with progressive conditions, which sparked an interest in what the role of speech and language therapy is, working with people with dementia, for example.

Olly Sawyer:

As part of our MSC in speech and language therapy at UCL, we are to complete a research project and Anna’s luckily came up for our year. So myself and three other students on the speech therapy training program are working with Anna and the BCPPA team.

Dr Lakshini Mendis:

Perfect.

Olly Sawyer:

Yeah. It’s exciting.

Dr Lakshini Mendis:

And do you think you’ll continue with research, then?

Olly Sawyer:

I’d like to think so. I’d like to dip my toe clinically, a bit of research, and see where things go.

Anna Volkmer:

Clinical academic.

Olly Sawyer:

Yeah, exactly.

Dr Lakshini Mendis:

Great, awesome. So maybe we can get stuck into a little bit more about your research now because that sounds really interesting, but before we start, maybe Rosemary, can you start us off by explaining what primary progressive aphasia is for our listeners who might be unfamiliar with this neurological condition?

Rosemary Townsend:

Yeah, certainly. It’s unfortunate, I think, that speech language therapy is full of terms which need a lot of explanation. It’s a real shame, but not many people even know what aphasia is, so let’s take one bit at a time. Aphasia is an acquired language problem. The problem that’s caused by damage to the language processing parts of the brain, and it can result in difficulties with understanding language, which includes reading, understanding what you read, understanding what you hear and encoding what you want to say. So you’ll have an idea in your head, but you can’t put it into words and sentences necessarily.

Rosemary Townsend:

And aphasia is probably most commonly caused by stroke, but we’re here to talk about a progressive type of aphasia, which is a form of dementia, frontal temporal lobe dementia. So in this condition, the parts of the brain which are involved in processing language are effected by abnormal proteins being deposited in that area and so the result is a progressive language loss over time.

Rosemary Townsend:

And the reason it’s called primary progressive aphasia is that the language is leading the dementia. People often think of dementia as being memory problems and there are obviously types of dementia which fit into that kind of pattern but this is a language led dementia.

Dr Lakshini Mendis:

Right. It’s really interesting to hear about it as well, like you said. Is it a rare condition or how-

Rosemary Townsend:

Yes, it is a rare condition. It’s one of the rare dementias and there are sub categories of PPA. It’s a condition which there’s been a great deal of research into in recent years, and therefore there’s much more understanding of the different types of variant that can exist, and that really helps us as clinicians and as researchers because it helps us to specify what we can do to help people with the condition.

Anna Volkmer:

And interestingly, I would add that actually those variants that Rosemary was just explaining about are often quite hard to differentially diagnose. So often a speech and language therapist might be involved with supporting the differential diagnosis between those different types as they present with differing language profiles, if you will, across those three variants.

Dr Lakshini Mendis:

Great, and so obviously speech and language therapists then, they play a role in diagnosing the disease, but how do you work with people living with PPA then? Maybe Olly, I know you’re just getting started with this but…

Olly Sawyer:

It’s really interesting and as we touched on just then people with PPA do present with a history of slowly worsening communication over time. It is a progressive condition. So that means that people with PPA may struggle with their family life, with their social relationships, with work. So speech and language therapists play quite a… or have a broad role across the disease process from the very start to throughout the condition.

Rosemary Townsend:

As I said, it can be quite broad. You can work on lots of different things such as more traditional impairment type approaches that can look at word re learning and whereas you can also look at things which are more functional, like day to day tasks such as having a conversation or ordering a coffee when you go out to a cafe with your friends and family. So it can really touch on so many different areas.

Dr Lakshini Mendis:

Quite a diverse role.

Olly Sawyer:

Definitely, yeah.

Dr Lakshini Mendis:

Well, I think that leads nicely into your research then, as well, because you’re looking at one specific intervention if I’m right. So maybe we can start off with really honing in on what the primary question of the research that you’re doing with this project is.

Anna Volkmer:

Yeah.

Dr Lakshini Mendis:

And Anna, maybe you can start us off because you’re kind of key in talking about this project.

Anna Volkmer:

Absolutely. So communication training is an intervention that Olly mentioned just now. It’s a commonly used therapeutic intervention by speech and language therapist across different caseload. So we use this approach working with people with stroke related aphasia quite commonly and actually, it’s one of the most commonly used approaches used by speech and language therapists working with language led dementia or PPA.

Anna Volkmer:

However, it’s an area where there is very, very little research, so evidence. So there’s very little research evidence of the effectiveness of this yet clinically we feel, I guess from our knowledge based practice, that this is an effective intervention for people with PPA. So my research project, I’ve developed and refined a communication training program that had been originally designed for people with stroke related aphasia called “Better Conversations with Aphasia” and I’ve refined it with input from people with PPA and their families and input from speech and language therapists.

Anna Volkmer:

And we’ve looked at the current research literature that there is around interventions for people with PPA and a UK wide survey from speech therapist, and we’ve gathered all that information together to refine the program, and we’re now actually piloting it across seven NHS trusts to see essentially whether it’s feasible to deliver this type of intervention.

Anna Volkmer:

So we’ve developed this program as a free online resource for speech therapists to download and then use in training the people with PPN, their partners, and we’ve developed four therapy sessions, and what we want to know is whether it is feasible to deliver it across four therapy sessions. Is it acceptable for families and people with PPA? Is it something that they feel is useful and develops their understanding and their communication? And then, of course as a pilot study, we’re also looking at the most sensitive and useful primary outcome measure, we want to monitor recruitment and retention with the idea of actually running a full trial to examine its effectiveness in the future.

Dr Lakshini Mendis:

Perfect. I’m not that familiar with any of the work that you do as a speech and language therapist, so could you just define quickly what communication training is?

Anna Volkmer:

That’s a very good question. So essentially, in the communication training program we’ve developed, we support people to identify what the barriers and facilitators are in their conversations. So what are things that make conversation go well? For example, that could be the partner giving the person with PPA a bit more time to generate some words and what are the things that are perhaps barriers.

Anna Volkmer:

So sometimes barriers can be, especially in the partner… One of the most common barriers that a partner can use is something that we call a test question where they ask them a question that is essentially a test where both people know the answer and that’s often a question that changes the balance or the power in a conversation. It’s typically the kind of question that you would use in a teacher student relationship or a doctor patient relationship, not in a partnership relationship.

Anna Volkmer:

So often we will look at the balance of that conversation. We’ll look at how topics are chosen, whether they’re finished. We’ll look at whether turn-taking is happening or interruptions are happening. We look at things like errors and conversation breakdown, how that’s repaired and identify which are part of their routine conversational style and which ones we can work with, set strategies with and actually practice the facilitators more.

Anna Volkmer:

The idea is that if you do more of the things that facilitate and keep a conversation going, the easier it is to have a balanced conversation. So we actually practice those with them in the intervention as well.

Dr Lakshini Mendis:

Great. No, that sounds really great. And so why do you think communication training is particularly helpful for people living with primary progressive aphasia? I know you’re trialling this at the moment, but do you have any thoughts around it? So maybe we can go to any of our panellists.

Anna Volkmer:

Go on Olly. What have I taught you?

Olly Sawyer:

So I’ve been part of the BCPPA project properly, maybe for a couple of months now, so it’s very early on. So I might have to share this question with Anna. Anna, do you want to leave?

Anna Volkmer:

I can if you’d like. And so essentially I think that when I’ve been working with people with primary progressive aphasia or PPA clinically, they will often find it very frustrating to work on impairment based tasks and that’s where the majority of the research literature is in this area.

Anna Volkmer:

So a task such as practicing word lists every day, like a drill, can be very, very difficult because you have to do them every single day and yet you’re not necessarily going to improve that. You may only maintain those words and as soon as you stop practicing them, that will deteriorate. And actually it doesn’t necessarily have an impact on functional. I mean, Olly was alluding or describing the kind of functional conversations you might have with your partner in a coffee shop, doesn’t focus on real life conversations. So often patients and people with PPA come to us asking for help with actual conversations.

Anna Volkmer:

The other thing is that partners want to know what they should be doing and I think one of the great things about communication training approaches is that they demonstrate that communication happens in the space between two people. It’s not the person with PPA’s responsibility to participate in that conversation and keep it going. It’s actually something that both people in that conversation have to participate in.

Dr Lakshini Mendis:

So then, as part of the training, you’re working with carers, families, partners, to assess what sort of delivering that training then for the people living with PPA, is that correct?

Rosemary Townsend:

Yeah, I mean in my clinical experience I’d say that it’s one of the most effective ways you can help someone with PPA because this is a progressive condition. Their language ability is going to be declining over time and one thing you can do that really makes a difference is to equip the partner with an understanding of communication strategies, and I always say, a good partner gets you a long way. It’s a bit like Strictly, when you have a rubbish dancer, and then the pro comes along and all of a sudden they’re dancing.

Rosemary Townsend:

Conversations a bit like that and you can really enjoy the moment if you know you’ve got somebody leading you. Conversation is, again, it’s like the glue of relationships. It’s what holds you together. Even if there’s not many words, you can still have conversation.

Anna Volkmer:

I was just going to give an example of somebody I worked with where the person with PPA, he was trying to say he had a type of PPA that meant it was very difficult to find words. And his partner said that she felt he’d stopped listening to her and he said that he didn’t realize that she felt like that because he was spending so much time trying to find the words that they realized they’d stopped having a relationship.

Anna Volkmer:

And he said to her, “Why don’t you help me find the words?” And she said, “Well I didn’t know you even wanted me to help.” And they’d not actually had that conversation about what strategies they wanted one another to use and their opinions about one another and their relationship had suffered as a consequence. And so that really feeds into that lovely metaphor of using Strictly. I do think conversation is like a dance or a tennis game. The more skilled the opponent, actually the better you are as well in that interaction.

Rosemary Townsend:

And the more confident you can be. I think confidence plays a massive part in conversation when you have aphasia. If you feel you can, and you’ve got a partner who’s accepting and supportive, then you know you can go a long way.

Dr Lakshini Mendis:

Definitely. So as part of your project then, I guess because it’s a pilot as well, and you mentioned that you’re getting your feedback from other speech and language therapists, but also people living with PPA who were part of your pilots then and obviously then partners, family members, carers and that kind of thing as well. Is there any way in particular that you’re involving them or is it just a conversation after, I guess, delivering the training itself or at which stage when you’re designing the project, would you start approaching these people?

Rosemary Townsend:

Well, I can speak from being on Anna’s steering group as a speech and language therapist and in fact, we’ve just come from a meeting today which has included couples who are living with PPA, a psychologist as well, and that’s been, I think what appealed to me about Anna’s research is, it was really practical and really inclusive and I’m sure many people doing research don’t consult with people in the way she is.

Rosemary Townsend:

She’s really taking time to ask people to help structure the program that she’s actually designing and I think that’s really going to pay dividends when it comes to being used by therapists. And prior to this stage of the project, Anna did a lot of research across the country to find out what speech and language therapists were doing, and there’s a great need for this kind of… just a program that people can access and feel confident in using because it’s a rare condition. Therapists don’t come across it often. They need this kind of support to help them get underway.

Dr Lakshini Mendis:

Yeah, sounds like it’s a great resource in the making. How long has the pilot been running for?

Anna Volkmer:

So the pilot itself opened in November, late November last year and we’ve actually had two sets of students helping us on that project. So the other avenue we’re using is I’m involving students, speech and language therapists, as Olly mentioned. He and three other students, so four of them from the current cohort, four from the previous cohort, are helping in collecting the outcome measures after the participants have done the intervention with the local speech therapists in the NHS trusts.

Anna Volkmer:

So we’re trying to involve speech and language therapists who are both students who are clinically practicing. We’re trying to co-develop resources with people with PPA and their families, and we’re also… I have been able to consult with organizations such as the rare dementia support group, the PPA support group which is hosted here at UCH and at the welcome trust as well by people like Chris Hardy, he’s another dementia researcher.

Anna Volkmer:

And they’ve been able to contribute right from the get go. When I was writing the grant to apply to the NHR for funding, they contributed to the development of the idea, the methodology and then right through to now. We’ve had people contributing and co-developing actually, some of our consent forms and some of the handouts we use in the intervention. Things like choosing the right images, which Olly knows from working clinically, images are quite subjective and what we think as clinicians is a great image.

Olly Sawyer:

Absolutely. It’s very challenging.

Rosemary Townsend:

It’s really difficult to choose that kind of material. So it’s been really useful having that interaction.

Dr Lakshini Mendis:

Great. And how long are you running the pilot for? So you said you’d started last November, when are you hoping to get the first, I guess, all of the results in by, and start [crosstalk 00:23:52].

Anna Volkmer:

You’re hoping to [crosstalk 00:23:54] of what we’re seeing.

Dr Lakshini Mendis:

Well.

Anna Volkmer:

And so the idea is that the study is open essentially till June 2019 and-

Dr Lakshini Mendis:

Have you taken a peak already? Do you have some interim results?

Anna Volkmer:

No, of course not. We haven’t. We are ethical researchers. What I can say is that I guess we’ve had positive reactions from both speech and language therapists and from the people with PPA and their families. People have generally been very interested in participating in research that is focused on an intervention, that is focused on speech and language therapy for people with PPA. There are very, very few intervention studies or research that’s done by speech and language therapists that is, I guess, focused on interventions and people are really interested in participating in that as well. So it’s generally been very positive, I think.

Dr Lakshini Mendis:

Yeah, it’s good to hear that the feedback has been positive generally.

Rosemary Townsend:

I think that the key thing is to get it out there that speech and language therapy is valuable in primary progressive aphasia. I think too many people tend to discount it and think, well communication’s deteriorating, why bother? But in fact PPA is quite a slowly progressive condition often and if you think of the number of conversations you have day to day, isn’t it worth doing something? I mean, the way I’ve worked slightly differently at Dyscover, we work with a similar conversation therapy model to Anna but in groups. So we’re introducing people, relatives and people with the diagnosis to one another, which is incredibly helpful because people feel much less alone.

Anna Volkmer:

Hmm. Indeed, and although it’s a slowly progressing condition, I think, I’ve had comments from other health professionals, I won’t name the disciplines, who’ve stated things such as, well, what’s the point? Especially when people are in the more moderate to severe stages, surely you can’t do anything, so why bother? And actually I think it’s really, really worthwhile because as we’ve highlighted here today, it’s not just about supporting the person with PPA themselves, it’s supporting their communication partners, developing their environment.

Anna Volkmer:

And actually even in the most profound stages of dementia, not even just language led dementias, there are strategies and potential interactions that can be enhanced by speech and language therapy professionals. And there are communication aids, both high and low tech, that are developing and this is an always developing area, and I think that there are always some ideas and options that we may be able to explore in those settings.

Olly Sawyer:

Absolutely.

Dr Lakshini Mendis:

And what would you say to other people out there who are living with PPA, looking for some kind of help? Obviously one of the first points of call would be their local speech and language therapist, but are there any other resources they can access more information? And I guess, if you are part of a family with someone living with PPA as well as we’ve discussed, it’s so important to be aware of what’s happening. So maybe you can highlight some resources for us that people can go and check out?

Anna Volkmer:

I guess the first thing to say is that generally medical professionals, in general, medical professionals are the gatekeepers to our service. There is some geographical variation, so in some areas in the UK, you can self-refer to speech and language therapy but otherwise, I would say go and see your GP, your neurologist, your psychiatrist, your gerontologist, and ask them to refer you to speech and language therapy.

Anna Volkmer:

That said, not all speech and language therapy services have the provisions to deliver lots of support in the community, so it may be that people need to choose to look for other avenues to get seeking support, and there are many avenues that come to my mind that are perhaps outside of the classic NHS structure, such as the organization that Rosemary works for, Dyscover.

Rosemary Townsend:

Although we are local to the South East, I have to say.

Dr Lakshini Mendis:

And do you have any sort of sister organizations or similar organizations regionally?

Rosemary Townsend:

We don’t. We’re a small charity but we have quite big ambitions and we’ve recently done a piece of outreach taking our PPA course into Hampshire, which was very helpful. And my wish is that more speech and language therapists adopt this approach. It’s not rocket science, and I think Anna’s research and designing this intervention, hopefully we’ll achieve that because people will be able to pick it up and feel confident using it.

Dr Lakshini Mendis:

Perfect. And so just to finish off, we’ve touched a little bit on this with your advice as well to other speech and language therapists, but what would each of you say to other speech and language therapists, I guess, coming into more a research aspect of things? So crossing over into research and crossing that divide that you sometimes see. Olly, maybe you are perfectly placed [crosstalk 00:29:51] .

Olly Sawyer:

I think it’s a really exciting time to be a speech and language therapist and a trainee speech and language therapist. I think there’s so many doors that are opening for people who maybe want to know more or want to investigate more. Wanting to pursue research that actually is achievable and you can do it and you can approach people to discuss your ideas.

Olly Sawyer:

I think a key takeaway so far to our training is that clinical work is what we’re trying to do, but we’re also trying to look at the research and to say look, you can go into do things like what Anna’s doing, going into a PhD route, do research at Master’s level, and it’s really exciting to think that it’s… Clinical work, it isn’t the only thing that you will ever do as a speech and language therapist, at any point you can come into research and explore your interests.

Rosemary Townsend:

I think you’re right, Olly. I think in years past it was an either or decision and now there’s even a Twitter hashtag isn’t there?

Anna Volkmer:

There is. It’s clinacslt, so clinical, academic SLTs, and I think actually that historically speech and language therapists have a… and I certainly would say the same, I have felt that I wasn’t academic enough to do research. I wasn’t clever enough to do research. That researchers are actually these super-duper serious people. I think I spoke about this on the last podcast I did, which was around imposter syndrome and I sometimes think that I’m a complete imposter, but most clinicians perhaps feel like this a little bit when they’re thinking about research. Actually I think speech and language therapists have many skills that make them really useful-

Dr Lakshini Mendis:

Yeah, and there’s a practical aspect that you bring to the research that you’re conducting as well.

Anna Volkmer:

Absolutely.

Dr Lakshini Mendis:

Like you said, this is sort of a tangible intervention for someone living with the condition. So I think-

Anna Volkmer:

Sorry, I totally interrupted you, but we’re really, we’re trained to be good communicators. Actually in research, one of the key skills is communication. It’s networking with people, it’s communicating with participants. It’s finding the person who can help you with your stats because actually you don’t have to be good at stats. You just have to know someone who is and know how to find someone who can help you apply the theory actually good communication, enthusiasm, endurance, I think they’re the things.

Anna Volkmer:

Being able to set goals and break goals down into smaller goals that see you through some of these mammoth… Doing a PhD seemed so mammoth when I started, but actually a clinician speech and language therapist constantly having to goal set with children or adults and we are trained to set these long-term goals, midterm goals and short term goals and make them measurable and achievable and realistic and actually that’s what you do in research.

Anna Volkmer:

So I think there’s heaps of skills we can carry over. I think more speech therapists should do research. It’s super exciting.

Dr Lakshini Mendis:

It is. Well that sounds great and our time’s just sadly drawing to a close. We’ll have to wrap up this podcast. And so just to sum up a few key points I think that we’ve learned today. Definitely learned what primary progressive aphasia is. It’s a neurological syndrome in which your language capabilities become slowly or progressively impaired and unlike other forms of aphasia which are more common that can result from a stroke or injury, PPA is caused by neurodegenerative diseases such as Alzheimer’s or frontal temporal lobe dementia.

Dr Lakshini Mendis:

We’ve heard about the role that speech and language therapists play in helping diagnose this kind of aphasia, but also the broad range of therapeutic interventions that they can offer to people living with dementia, PPA, but dementia in particular at different stages of the disease.

Dr Lakshini Mendis:

And finally, it’s great to hear that there are some tangible strategies where people can feel more confident in these conversations that they’re having and it’s great to see such enthusiastic speech and language therapists who are clearly making a difference.

Dr Lakshini Mendis:

And so, with that, I’d like to thank our panellists, Anna, Olly and Rosemary for taking time out of their busy schedules to share their research with us today. Thank you all.

Anna Volkmer:

Thank you.

Rosemary Townsend:

Thank you.

Olly Sawyer:

Thank you.

Dr Lakshini Mendis:

And listeners, don’t forget to visit our website to check out the profile of our panellists and they’re all happy to interact with you on Twitter. Maybe you can quickly share with us each of your Twitter handles.

Olly Sawyer:

Yeah, mine’s @oliversawyerslt.

Anna Volkmer:

Mine is @Volkmer, V-O-L-K-M-E-R_Anna.

Rosemary Townsend:

And mine’s @rosemarytowns15 and there’s also a Twitter account for Dyscover. Spelt D-Y-S-C-O-V-E-R.

Dr Lakshini Mendis:

Great. Definitely check out the other hashtag as well. #Clinacslt. Great, and as always, you can post any questions in our comments section or in our forum on the dementia researcher website. So that’s dementiaresearcher.nihr.ac.uk. Drop us a line on Twitter, that’s @dem_researcher, or use our hashtag ECR dementia.

Dr Lakshini Mendis:

You can also check out the blogs on our site, especially the ones Anna’s written about her work and experience as an early career researcher. Thank you for listening. Please remember to subscribe to this podcast through SoundCloud and iTunes. Tell your friends and colleagues about dementia researcher.

Voice Over:

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END