Podcast – Language And Communication In The Dementias – Sydney

Voice Over:

Welcome to the Dementia Researcher podcast, brought to you by dementiaresearcher.nihr.ac.uk, a network for early career researchers.

Adam Smith:

Hello, my name’s Adam Smith. I work for University College London at the NIHR, and today I’m delighted to be hosting this podcast recording for the NIHR Dementia Researcher website. This week, we’re recording on location from the sunny climate of the University of Sydney. Susan Wakil, is it Wakil? Am I saying it wrong?

Luisa Krein:

Wakil.

Adam Smith:

School of nursing and midwifery. It’s 30 degree heat while the UK is covered in snow. It’s awful isn’t it? It’s really terrible. I’m delighted to be joined today by Luisa Krein, Krein?

Luisa Krein:

Krein, yeah.

Adam Smith:

Got that right.

Luisa Krein:

Nice. I’m impressed.

Adam Smith:

Anybody whose listened to my podcast before knows I’m bad with surnames. From here at the University of Sydney. Also, Cathy Taylor-Reuben.

Cathleen Taylor:

Yep.

Adam Smith:

Got that right.

Cathleen Taylor:

Mm-hmm (affirmative).

Adam Smith:

From McGuire?

Cathleen Taylor:

Macquarie.

Adam Smith:

Macquarie University.

Luisa Krein:

You almost made it through.

Adam Smith:

Maybe it would be good to start all over again and I’ll ask pronunciations first. Cathy Taylor-Reuben from Macquarie University. I gather, you’re also jobbing clinician as well. Where do you do your day job, is it your day job? Where do you do your work?

Luisa Krein:

Yeah, I do two days a week work at Easons Speech Pathology, which is a private practice, working with adults in the community.

Adam Smith:

How about you Cathy, are you the same?

Cathleen Taylor:

No, I work in the public sector. I work in a public hospital here in Sydney, War Memorial Hospital, which is part of United Care in New South Wales, south-eastern local health district.

Adam Smith:

You’re working for the dark side?

Luisa Krein:

Pretty much, private practice. No, but very needed.

Adam Smith:

And you’re the equivalent…

Cathleen Taylor:

I’m working for the good guys.

Adam Smith:

… one of the rebellion…

Luisa Krein:

I’m Darth Vader.

Adam Smith:

You’re a Jedi knight. Makes sense actually. Today we’re…

Luisa Krein:

What are you saying?

Adam Smith:

Today we’re going to be talking about language and communication in the dementia’s. This is the first of a two-part global special. In part two, we’re going to be joined by another panel from University College London, who work in a same field I believe. It’s also a topic that we’ve discussed a little bit before. One that has proven to be one of our top listened to podcasts so no pressure you two. By way of introduction and I stole this from Louise’s briefing, communication impairment will affect people with dementia, some course of the disease. Such an impairment can have a devastating effect on the person with dementia themselves, but also on those who care for them.

Adam Smith:

For the people with primary progressive aphasia, gradual and insidious deterioration of the ability to communicate profoundly affects their lives and that of their partners. That’s primarily the topic we’re going to talk about today. Okay, I’m not going to ramble on any more than I already have. Let’s start with some proper introductions. Let’s get the experts talking about this. Luisa, could you start with telling us a little about yourself?

Luisa Krein:

Yeah, sure. You’ll hear in my accent I’m actually originally from Germany. I grew up in Cologne, but I studied my bachelor’s and master’s degree in speech pathology in Munich. As part of my master’s degree, I came over to the University of Sydney and had the pleasure to work together with Cathy Taylor and Dr. Karen Croot, who are my role models in the area of PPA. Yeah, and helped them out with a research project, and have been working with Cathy ever since collaborating on different projects since 2013.

Adam Smith:

Fantastic. And Cathy?

Cathleen Taylor:

My background is I’m a speech pathologist. I did my undergraduate degree here in Sydney. Then PPA sort of pulled me toward it. Came from my clinical work. I started seeing people with PPA. Initially I did a master’s by research, that was at Sydney University. Then…

Luisa Krein:

Then you converted to [inaudible 00:04:28].

Cathleen Taylor:

Then I sort of thought, “Now I know what I’m doing.” I didn’t know what I was doing when I was doing the master’s. I should do all this again. So I decided to do the PhD and I went across to Macquarie with Lindsey Nichols who’s a very highly esteemed aphasiologist. Yeah, that’s about it.

Adam Smith:

Do you both work together in any way at all now? Or are you just former colleagues or friends? How do you know each other?

Luisa Krein:

As part of my master’s degree, I did an internship at the University of Sydney with Karen Croot. At that time Karen Croot was collaborating with Cathy as a practicing clinician at War Memorial Hospital. I was basically the research assistant. I like what Cathy was doing because I was able to see everything that I’d learned about in theory, actually in practice. I just kept pestering Cathy and was able to do a little bit of the practical internship at War Memorial. So we don’t work together as clinicians, but more in research. We’re in a mentoring relationship now as well.

Adam Smith:

Okay. Done some collaborations?

Adam Smith:

[crosstalk 00:05:46]

Luisa Krein:

Yeah, research collaborations more than clinical.

Adam Smith:

Obviously you’ve finished your PhD.

Luisa Krein:

No, no, no.

Adam Smith:

Oh no, you’re both still…

Luisa Krein:

I’m still going.

Adam Smith:

So how far are you in Cathy?

Cathleen Taylor:

I’m a little over half way.

Adam Smith:

Hold on, so you’re doing it over five?

Cathleen Taylor:

No, no. Because this is a rare population, a rare condition, I needed to have access to people with the condition so I continued to work part-time. So the first half of my PhD I did part-time but now I’m going to finish this next bit over the next year full-time.

Adam Smith:

Okay.

Cathleen Taylor:

Yeah.

Adam Smith:

Wow, so you’ve got a pretty intensive 2019 coming up then.

Cathleen Taylor:

Yes.

Adam Smith:

How about you Luisa?

Cathleen Taylor:

Same for me. I did the whole thing full-time but I’m two thirds in so I have one year to go.

Adam Smith:

You’re doing it in reverse? Are you now going part-time having been full-time?

Cathleen Taylor:

No, no. I’ve always been full-time and I’m finishing up so then that’s my last year now.

Adam Smith:

Oh, okay. And finding time to work as well.

Cathleen Taylor:

Yeah, apparently.

Adam Smith:

We’ve got a few questions later on about how we manage to find a work-life balance. Okay, Luisa coming to you first. Could you tell us what the focus of your PhD actually is?

Cathleen Taylor:

Yeah. My focus is obviously the area of dementia and focusing on the early identification of communication difficulties in dementia. So trying to address that gap of service delivery, which people with dementia are currently experiencing, because as you said before, communication impairment will affect everyone at some stage of their disease. It’s not necessarily that only people in the later stages of the disease have communication impairment. It can actually start quite early and PPA is a special case of that. Also, people with Alzheimer dementia might have communication impairment that will affect them to a certain extent. Some people more, some people less but the problem is that often the problems not identified early enough then they don’t get the support that they need. Early intervention is probably, in a progressive disease, one of the most important things. That we start moving forward quickly and early so that in the later stages, when the people have more difficulties, they already have some kind of strategies at hand but also to stop the difficulties from moving forward or even improving what might be a problem.

Adam Smith:

I know Alzheimer and dementia affects everybody differently, at different times and different ways but is there a point where communication difficulties start to kick in? I can imagine, particularly in years gone by, people would assume, “Oh, well that’s just a normal part of the disease we have to put up with it then.” Clearly your work suggests otherwise so is there a point where that comes in?

Cathleen Taylor:

I’m not too sure. I don’t know if there’s any research on that, to be honest. I think that there are certain characteristic patterns of how communication impairment affects the different types of dementia. For Alzheimer dementia, the most common symptom would be word finding difficulties in the earliest stages. I think there is some research also suggesting that writing abilities or the coherence in speaking is affected early. Then we have our PPA expert here, where language is the most dominant symptom of language impairments in the early stages.

Luisa Krein:

Yeah, in the primary progressive aphasia’s it’s the predominant symptom for a considerable amount of time at the beginning of the disease and into the mid-course is loss of language or loss of speech. Gradually deteriorating language and speech without the same degree of impairment to other cognitive skills.

Cathleen Taylor:

So everything is working yet it’s just a…

Luisa Krein:

Well, relatively well preserved are the cognitive skills for a number of years for these people and their suffering from this frustration of their language, their ability to express themselves and maintain relationship through conversations and communication. That’s what is causing them the most significant difficulty in their everyday life.

Adam Smith:

So, when we talk about this, we’re not just talking about talking, we’re talking about all forms of communication in that way. We’re talking about expression and writing and things like that as well.

Luisa Krein:

That’s what entails language of communication. It’s not only talking, like you said, or speaking, it’s also reading, writing, understanding language is a big one and…

Adam Smith:

Yeah, of course. I’ve got a lot of these questions written down and I’ve got a funny feeling that we’ve asked them without me having to ask the question. So are there any other common symptoms other than the ones we’ve…

Luisa Krein:

What we’re finding is the most common symptom…

Cathleen Taylor:

Although, probably the most noticeable…

Cathleen Taylor:

[crosstalk 00:11:31]

Luisa Krein:

But also understanding language, I think people underestimate often that we speak in incredibly complex sentences when we talk. We talk while we think and while we think we interrupt sentences and we start new and that’s really confusing. For people with dementia, research shows that if you form simpler sentences their understanding of what you say can be so much more enhanced and facilitated.

Adam Smith:

Okay, so let me get this question out then because I think you’re answering it already. My next question was, what does speech pathologists do to address communication impairment.

Cathleen Taylor:

Well, I suppose it’s important to say that speech pathologists approach intervention in a person-centred way. Speech pathologists have a diverse range of therapeutic methodology’s and will design a specific program for each individual dependent upon their strengths and their weaknesses. A good thorough assessment, a good collaboration with the person with the language led dementia and their caregiver leads to the development of a program that hopefully enhances their retained abilities, their strengths, and looks at compensatory strategies for their weaknesses. This group of people are very diverse, the symptom complexes are very different. It’s not a homogeneous group where everyone is exactly the same so it really takes a speech pathologist skills to work out what’s the best intervention program for each individual.

Adam Smith:

Is that the focus of your research? What is your research question Luisa? I assume that there are things you can do then?

Luisa Krein:

Yeah, absolutely. Some examples of what that might look like, what Cathy was talking about is what [inaudible 00:13:39] is doing is being on the podcast several times. Communication partner training for example, that would be actually educating and training the caregiver or more, the family member or friend, to enhance and maximize communication with little strategies like simplify what you say or collaboratively talking, things like that.

Cathleen Taylor:

We do have some, what we call, impairment focused mediation, sort of, therapy tasks. They need to be personally relevant but together again, collaborating with the person and their carer. Working out specific words that are no longer available readily for them in their conversations. An example might be, you might like to go down to the coffee shop every morning and order a soy latte and a friend, well if those nouns are not available for you anymore that whole beautiful situation becomes really difficult for you. You can actively re-learn those specific nouns and then help the person develop scrips to help them practice using them in the real life situations and that helps them be able to still participate in a social activity they love. That’s an example of how we can do impairment based interventions. For some people it’s more the motor component of their speech might be impaired and so they might benefit from alternative communication aids. So, low-tech or high-tech. It might be as simple as a pad and a paper or it might be a voiced text-to-talk app.

Adam Smith:

That was going to be my question. Has technology kicked in because…

Cathleen Taylor:

Technology, yeah.

Adam Smith:

… technology’s coming in across the board now…

Cathleen Taylor:

Yeah, yeah.

Luisa Krein:

Super exciting.

Cathleen Taylor:

… in wearable technologies and particularly in other areas like we’ve seen used…

Luisa Krein:

Telehealth as well.

Cathleen Taylor:

… so heavily in motor neuron disease and things like that.

Luisa Krein:

Yeah, so providing therapy via Skype or video conferencing or using picture based communication has been proven extremely…

Adam Smith:

Pictures, yeah. I’ve seen that. A lot of conferences where they are bringing in…

Luisa Krein:

That’s great. I didn’t answer your question before.

Adam Smith:

I was going to say, what is your research question?

Adam Smith:

Have you decided on it?

Luisa Krein:

I guess my point was that there is lots that can be done that’s not on the forefront of people’s minds. When we think of dementia we often think of the cognitive aspect, language is part of cognition, but I guess more of the memory aspect of it. Language, as a cognitive ability, is also impaired and I’m not saying the rest of the cognitive abilities are not important but because we express who we are, that’s almost the essence of being human, we need to put a focus on that as well. The problem is, like I said before, that people with dementia who have communication difficulties often don’t get the support that might help them or that they need so I’m working on a tool, on a simple questionnaire, that can easily identify people who have the need for communication support. So, is there communication impairment present and also, what level of support might they need. The whole thing obviously sound so nice and I was supper happy when I was…

Adam Smith:

No, that stuff is really interesting because you’ve got various aspects there, don’t you? You’ve got the quantitative part to that, by proving that there is a need for this by looking at the statistics around use and support. Of course all this works on the premise that there are the clinic services and the money and the support there to actually deliver this but again you can use your research to make an argument for investment in those ways.

Luisa Krein:

Absolutely, we gather more evidence to support the use of behavioural interventions then we can apply for funding of more service to deliver it.

Adam Smith:

Yeah, when it’s proven that it’s needed. That’s fascinating, thanks Luisa.

Luisa Krein:

No worries.

Adam Smith:

Cathy, can I come to you and ask, because your research is a little… well, I’m not going to say more specialised because that sounds like it’s… better in some way.

Adam Smith:

[crosstalk 00:18:08]

Adam Smith:

It is quite specialised, looking at a specific, very particular aspect of this challenge so can you tell us about your research?

Cathleen Taylor:

Yeah, so my research focuses on primary progressive aphasia and you’ve explained what that is. These behavioural interventions can enhance people’s wellbeing and ability to communicate and so my research looks at which ones are effective and what makes them effective and which ones are more suitable for which people.

Adam Smith:

All right so there are multiple tools you can play.

Cathleen Taylor:

Multiple tools.

Adam Smith:

Are these things that are already in use in clinic practice or are these new things that you are developing or are you pulling from various places.

Cathleen Taylor:

That’s a good question. Some interventions have been taken from the practice that we use in stroke aphasia. We need to be able to establish whether they are effective for people with progressive language led dementia’s. That’s one aspect. Some need to be modified and tweaked and have additional strategies to help for instance with things like generalisation. So when I gave the example of learning the words, we know that people with language lead dementia’s can learn words, individual words, but we’re having great difficulty proving that people can use those words in everyday, real life, situations and that’s the goal of treatment. One of the studies in my research looks at additional therapeutic techniques that can be added to that learning to help achieve the generalisation of the positive gain into everyday life.

Adam Smith:

Do you get thorough finding? Obviously in research, you set your research question and you go about proving whether that works or doesn’t work. Of course, that’s not particularly helpful in real life clinical practice when you’re trying to use these tools. Do you have the opportunity to tweak and refine your tool along the way or do you separate out the period of developing this tool, this intervention, that we’re going to apply and you realise during that time you’re going to have some things that work and some things that don’t work. Then when you finally arrive at a tool that you think works is when you kick in with the measured approach.

Cathleen Taylor:

Yeah, I think that would be the way to go. I think it’s different… I’m developing a tool from scratch basically and until this tool can be used I probably need to do a post-hoc. It won’t even be in the state of being used after this PhD unfortunately. It will be a draft, a pilot version but then you need to test it, see if it’s usable, if people actually take it up.

Adam Smith:

You’ve got a quite qualitative approach to this. We’ve got all the quantitative bit before about looking at the challenges and whether this is useful and…

Cathleen Taylor:

Well because they come up as you do your research. Obviously I’ve had conversation with speech pathologists in the field to speak about… Because I really want to do something practical, something that I can give to the community after I was finished. That was my great vision when I started the PhD 10 years ago.

Adam Smith:

In my own work I love their being a direct line of sight between what we’re doing and people really benefiting at the end. This idea that we researchers research for research’ sake with a question that pops up and gets published in some obscure journal. All respect to people who work in that way but…

Cathleen Taylor:

Absolutely, I agree. You don’t want it to be collecting dust somewhere…

Adam Smith:

… it doesn’t excite me. No! You want something that’s actually going to be out there in use. That’s your aim.

Cathleen Taylor:

Yeah, and I’ll continue to work on that aim but there’s also time restraints. I think I spent about half a year finding my topic and when I had it I was like, “Yes! This is great, this is it.” Then you run into all these difficulties like, I’ve come up with a great set of items and you have this tool that is in good shape and then you ask yourself, how do I scale these items? How do I make sure that people, in the end, are going to answer all these questions? But how do I make sure that they get divided into the right category? How am I going to assign points to each item? Does the item have the same value, each item of the tool. Do I give it one point or a three points? How, in the end, will I decide who is in what category?

Cathleen Taylor:

So I have a huge appreciation now for good tools as well, for good instruments that can measure because it’s actually really difficult. It’s not just coming up with questions but it’s a really thorough process that takes a long time if you want to have a good research tool.

Adam Smith:

And having a tool is no good if nobody knows how to actually use it.

Cathleen Taylor:

Yeah, that’s right.

Adam Smith:

So you’ve got to produce the kind of instructions to go alongside that and the training and the support. I guess, if you get that all out of the way then when you do come around to spread and adoption and promotion of this it should be applicable. Is that the same in your work Cathy?

Cathleen Taylor:

Mm-hmm (affirmative), absolutely. I came to research from a different angle than Luisa in that the questions arose in my clinic work and so I went into the PhD having a really good idea of what I was interested in finding out about. Again, the same as you’ve just mentioned, both of you, the idea is that it will translate into clinical practice. Some years ago a colleague and I, Rachel [inaudible 00:24:32], did a survey of a speech pathologist attitudes and knowledge of PPA and service provision, in PPA, in New South Wales. [inaudible 00:24:44] repeat replicated that and expanded upon it in the U.K. and we both found that speech pathologist felt very lacking in resources and lacking in clinical pathways to manage this case load. I’m hoping that my research will answer some of those questions and provide some of that guidance of how we should manage this population with an evidence base.

Adam Smith:

Have you both had something that just didn’t work? The interesting this is, because you both come from the background before and you’re working practice, what it seems is that everything you try you just know will work. I don’t know if that’s really true. Have you developed something and people didn’t get it or it wasn’t working in the population that you’ve tried?

Luisa Krein:

I think for me it’s more the methodology. I think I overestimated what I could achieve in three years. So tools, you want them to be psychosomatically valid, reliable and valid for use. I’ve come as far as proving that the content of the tool, content validity is good, is valid and I’ve tried to develop the items of the tool with people with dementia and their carers and experts around the world through a Delphi survey. I was hoping that I would get much further with a pilot tool that is much more usable than it is right now.

Adam Smith:

I think if anybody who has listened to our previous podcasts will know that that is such a common theme throughout this. You start off thinking, hey, I’m full-time. I can do this, and then a year in you’re thinking, oh my goodness I’ve not made a half as much of progress.

Luisa Krein:

Yeah.

Adam Smith:

It’s not just necessarily a problem with the student understanding the amount of work. There are systematic delays along the way. Getting ethics can take quite a long time. Finding the subjects, the people to participate in your research, can take a long time. Particularly, this is a nice segue into my next question, if you’re working and trying to earn a living in your chosen profession as researchers, students and jobbing clinicians how do you manage your time to do all those things? Do you sleep? Do you actually have a social life?

Cathleen Taylor:

Yeah. Oh yeah!

Adam Smith:

Go on Cathy.

Cathleen Taylor:

Oh yeah.

Luisa Krein:

I think in Australia you’re very precious about your work life.

Adam Smith:

It’s like doing [inaudible 00:27:41] on holiday, right? Because it’s sunny all the time.

Luisa Krein:

That’s right. You go to the beach, you take your laptop. You know, make sure you don’t get sand on it.

Cathleen Taylor:

There’s some big practical problems like you have two emails, two sets of administrative systems that you’re working in, two sets of colleagues.

Luisa Krein:

And you have to wear a uniform.

Cathleen Taylor:

No, not in Australia. Not where I work. There are really great synergy’s because the clinical work and the PhD work is the same topic, the same group. I’m always thinking about PPA and behavioural interventions in PPA and what works and what doesn’t work, one informs the other. There’s challenges but there’s great advantages too.

Luisa Krein:

Yeah, that’s probably the ideal for someone like Cathy, to work clinically in the exact field that you’re researching. For me, I work in the private practice so it’s a very diverse case load. One of my largest case load at the moment is people with intellectual disability. So it’s not so related, you do get the occasional person with dementia but this area is actually under serviced. Even if we do get people with dementia it’s often that we look more at swallowing difficulties not at communication difficulties.

Adam Smith:

Wow, that’s [inaudible 00:29:11] we should do another one on that because that has come up quite a few times before as well. I suppose dealing with anybody with communication difficulties suffers from have to deal with the frustration that that brings. And dealing with agitation is obviously a big topic in dementia as we reduce use on anti-psychotic medications that we’ve been trying over the last few years. You can still use the strategies that you employ working with people.

Cathleen Taylor:

Yeah, that’s right. For sure. That’s why Luisa’s work is going to add a lot because often if strategies can be put in place early a lot of that frustration and agitation can be minimised or avoided for a long time if partners learn how better to communicate with their person with dementia. Challenging behaviours sometimes don’t develop to the same extent or in the same way. It’s almost like a preventative strategy to come in early with an intervention. It would be really good.

Adam Smith:

I think it’s different for you as well, isn’t it, because I guess the work you’re doing to also living and keeping the wolf from the door is generally, in the field of research, you’re not having to take work outside of your area. I’m guessing, as we’ve just said, remaining in practice actually helps even if it does mean your study might take a bit longer. Are your supervisors sympathetic to this? In fact Cathy, one assumes you have a supervisor, you’re an expert in your area, you’ve been doing this a long time. Is your supervisor less experienced than you?

Cathleen Taylor:

Oh no! No, not at all. I have a great…

Luisa Krein:

Be careful what you say.

Cathleen Taylor:

I have fabulous supervision from Professor Lyndsey Nickles and my co-supervisor is Doctor Karen Cruz.

Adam Smith:

Oh, okay.

Cathleen Taylor:

They’re both eminent experts in aphasia and primary progressive aphasia. They absolutely have been supportive of me being part-time up until now because of that idea of trying to recruit people, access to the population has been the main issue.

Adam Smith:

I suppose it’s interesting going about finding a supervisor when you are so experienced. Then you’re looking to the people who are very eminent in their profession, it can be a bit different.

Cathleen Taylor:

Yeah.

Adam Smith:

What about you Louisa?

Luisa Krein:

I guess I feel, at the moment, this is the pinnacle of what I wanted to do. Being able to practice in the field but also have that academic or research opportunity. I think we talk a lot about evidence based practice and unless you know both sides of the coin? Of the picture…

Adam Smith:

Yeah, coin. Coin works.

Luisa Krein:

Thanks! How is someone who works in clinic, and has never read an article or learned to understand how research methodology works, how are they going to work evidence based? Or how is a researcher who doesn’t know what the restrictions of practice are, the challenges that clinicians have, how are they going to actually know the intervention that they are planning are applicable and can be translated…

Cathleen Taylor:

Translated, yeah.

Luisa Krein:

… into practice. I think it’s beautiful to have that opportunity to be the link between both worlds and I think that’s really what I wanted to strive for just with a little bit more experience though that’s going to come.

Adam Smith:

So would you encourage others? I mean, obviously, I’m hoping this podcast is listened to because there’s a real push at the moment, particularly in the U.K., I don’t know if it’s the same here in Australia, to encourage the non-medical professionals. People working in allied health professions like physiotherapists, speech and language therapists and nurses and others to come out from the water and do more work in academia. Would you recommend that to other people or is it just the kind of people you are? I’m a big fan because I think they’re the people who really know what’s needed…

Luisa Krein:

Yes!

Adam Smith:

… particularly in that kind of area.

Luisa Krein:

Absolutely. Look, I would. As you said, I’ve been in this job for a long time and I’ve found engaging in the PhD has made it all much more stimulating and exciting. I have learned new skills that then translate back to the work force that I share with my colleagues back at the hospital. I’m constantly excited about what I’m going to do next. I think because I have a background of having worked for a long time in stressful hospital environments that I cope with the stress of doing a PhD much better than if I had approached it younger. I think there’s lots of benefits. I would encourage people.

Adam Smith:

You don’t just magically one day fill in a form and say, “I’m a researcher now.” Do you get the opportunities to go and learn different research methods? Do your Universities provide those courses?

Luisa Krein:

I don’t know about Macquarie, I’m assuming it would be similar or the same, but the University of Sydney is incredible in supporting their researchers. I can visit any seminar that I want to visit. There’s all that technical support.

Adam Smith:

Things like using statistics or?

Luisa Krein:

Yeah, or like online survey tools with things like that there’s ample support. We’ve got our room even, you can borrow a laptop for a time. I just feel extremely supported. There isn’t a reason why you wouldn’t be able to finish your PhD from the start with that type of experience.

Cathleen Taylor:

Yeah, that was my same experience at Macquarie.

Luisa Krein:

Yeah.

Cathleen Taylor:

Yeah.

Luisa Krein:

Having said that, I know that from Germany, where I did my master’s degree, they expect much more autonomy. You do have a similar support but you have to go look for it. I feel like here it’s served to you on a silver platter.

Adam Smith:

You are just very supported.

Luisa Krein:

Yes.

Adam Smith:

It’ll be interesting, I’ll have to ask that question to colleagues back in the U.K. to see if they feel it’s the same there. I know I’ve got a colleague at the minute, [inaudible 00:36:05], who has been looking at what support universities offer you in terms of that training and support. I think that particularly if you’re coming out of clinical practice you need that. It’s not like you’ve followed this academic career straight from doing a master’s into a PhD and that comes with it. You need those skills. Also, should mention this, if you’re coming to academia later in life when this hasn’t been something that’s been there during your earlier career.

Luisa Krein:

Yeah. Can I just add too, your question before as to whether you’d recommend doing a PhD while working or even coming from a [inaudible 00:36:48] into a PhD. My first reaction was, “Yes, yes! Do it.” But then, research isn’t for everyone. If you’re not passionate about your topic, if you don’t like lots of reading and writing and taking the next step as it comes I don’t think I would recommend it because then it will just be a big pain.

Adam Smith:

Yeah.

Luisa Krein:

If you have an interest in research, if you’re interested in becoming that link between practice or even just becoming a lecturer. We need researchers in the field of speech pathology allied health. Particularly I think in speech pathology because we need the evidence base to say we got the practical knowledge, we think that a lot of things work but nowadays we’re so focused on numbers and tangible evidence that just saying, “oh yeah, it works in practice.”, doesn’t help anymore. If you’re helping the profession, you’re helping the people that you’re working with by becoming a researcher and adding to that evidence. So generally, yes, but don’t just go for the sake of it. Don’t just do it for getting a title.

Adam Smith:

You have to be driven and passionate about it because the dropout rate among PhD’s are huge aren’t they? I have so many questions I’d like to ask you but I realize that we’ve talked so much that we’re almost out of time. Just before I go into the final bit here, we did touch on this before, of course we’re here in Sydney, which is a fantastic place. We have listeners to our podcast from across the world. The majority are the U.K. but then I think the U.S. and Australia and India and over 47 different countries. People from across the world listen to our podcast. So, this is probably more particular to you Luisa, you came from Cologne to Sydney. Was that a good decision, would you recommend others…

Luisa Krein:

Yeah! If you like summer, come visit.

Cathleen Taylor:

She’s convincing.

Adam Smith:

If you like sunshine and daylight and the beach.

Luisa Krein:

Yeah, pretty much. Sydney is a great city to live in. The quality of life standard is extremely high. I must say I love my hometown and I do miss it a lot.

Adam Smith:

Your Mom’s listening to this now.

Luisa Krein:

Probably all my friends.

Adam Smith:

Watch, I’m going to look at the statistics. Thankfully, we had somebody else do this who did the AIC last year and suddenly we had this little spike in New Zealand because all his fans, they listened. We’re going to watch for that in Cologne.

Luisa Krein:

No, but Sydney, if you love the beach, like I said, and summer and the sunshine, it’s an amazing city to be living in.

Adam Smith:

So you both recommend your Universities as fantastic places to study…

Cathleen Taylor:

Absolutely!

Luisa Krein:

Yes.

Adam Smith:

… in Sydney. Everybody should consider apply…

Luisa Krein:

Yeah, come over! And let us know if you do.

Adam Smith:

I could support that. Okay, it’s time to end this podcast recording. I’d like to thank our panellists Luisa and Cathy. You know what? I’ve got this question in here. Luisa, you and I are recording another podcast later on so I’m going to reserve that question. Cathy are you on social media? Are you a tweeter?

Cathleen Taylor:

I am, yes!

Adam Smith:

What’s yours?

Cathleen Taylor:

I’m a very sparse tweeter but I do have a Twitter account. CathleenReuben1.

Adam Smith:

CathleenReuben1. We’ll put that in the feed for this as well so if anybody would like to touch base with Cathy after hearing the podcast today and to talk more about your work. As well, we publish biographies on all of our panellists on the website as well. If you got to Being A Dementia Researcher on the website you’ll find profiles on all our contributors. If anybody has got anything to add on this topic, please do put your comments on the forum or on our website or drop us a line on Twitter using #ECRDementia.

Adam Smith:

If you enjoyed this episode please remember you can tune into part two, which is also available in the feed, to hear how researchers at University College London are also looking at the same topic. If you’d like to come into the studio to talk about your own work please drop us a line. So finally, remember to subscribe, like and share and review our podcast. Please do tell your friends and colleagues.

Adam Smith:

Thank you very much! Thank you Luisa, thank you Cathy. Hope you enjoyed this, I certainly did. It was fascinating. Thank you.

Cathleen Taylor:

Thank you.

Luisa Krein:

Thank you.

Voice Over:

This was a podcast brought to you by Dementia Researcher. Everything you need in one place. Register today at dementiaresearcher.nihr.ac.uk.

END