Speech-language pathologists who serve elders in a variety of long-term care settings have a variety of professional skills and responsibilities. Fundamental to quality service is knowledge of aging and communication changes and disorders associated with this process, institutional alternatives, and the changing nature of today's elders in long-term care. Excellence in service also involves meeting third party payers' requirements, teamwork, and advocacy. In addition, professionalism is demonstrated through maintaining privacy, ethical practice, staff and family in-service and counseling, and self-care. Innovative programming also involves developing new outcome measures and environmental engineering that enhances the communication skills and opportunities of elders in long-term care settings.As a result of this activity, the participant will: (1) describe the changing nature of long-term care settings and residents, (2) understand the broad and complex professional skills that contribute to excellence in practice in this setting.