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The Role of Speech Pathologists in Regards to Determining Feeding Tube Placement melissa n., SLP As a Speech Pathologist working in thelong term care setting, dysphagia and the effects that it has on a patient and his or her overall health status are a daily battle. In 1999, 46.9% of Speech-Language Pathologists reported that they regularly serve individuals with dysphagia on their caseload. The percentage exceeded 91% for professionals working in hospitals and residential health care settings (ASHA, 2000). The recommendation for “NPO with alternate means of nutrition” is not one that is easily determined, and the decision making that follows for the patient and his or her family is difficult, to say the least. It is essential that Speech Pathologists are well-versed on the advantages and disadvantages related to the placement of feeding tubes and the effects that non-oral nutrition may have on the patient and his or her family psychosocially. The risk of aspiration with oral intake, the quantity of oralfalse

Melissa N., SLP Collecting an oral history is an individualized, fun, functional method to begin therapy with an adult in any setting. Using a set of “interview” questions, a Speech Pathologist is able to modify the task to fit each patient’s goals. An oral interview addresses functional receptive and expressive language, long term memory, thought organization, and problem solving skills. The patient can be asked to compare/contrast life now to life at a certain age (problem solving), give instructions on how to cook or bake their favorite dish (sequencing), or recall daily events as a young parent (memory). Completing an oral history with a patient and writing responses on paper is an easy, insightful way to establish rapport, facilitate language, and stimulate memory skills. Once completed, the written responses can be given to the patient to be handed on to family members or friends for genealogical purposes. The format that I use is as follows, however, an SLP may add, modify, or reduce the interview asfalse

By J. Lorin G., OTR/ L Congestive Heart Failure (CHF) is one of those diagnoses that I have frequently encountered in many environments as an occupational therapist, adult day health care, outpatient hand therapy, and now working at a SNF. What is CHF and what can we do about it in occupational therapy or other healthcare fields? Phyllis Ehrlich, OTR/L states that CHF is a “physiologic state in which the heart is unable to pump enough blood to meet the metabolic demands of the body at rest or during exercise” (1). It’s a complicated condition, called by different names, congestive heart failure (CHF), chronic heart failure (CHF) and heart failure (HF). CHF can be caused by many different factors including hypertension, ischemic heart disease, or cardiomyopathy (2). Obesity and aging are both big contributions to CHF, because of the difficulty of the heart muscle getting blood to all of the body’s tissues,

Lorin G. (OT) Working in a SNF, I recently encountered a man who had just hada Coronary-Artery Bypass Graft (CABG), Chronic Obstructive Pulmonary Disorder (COPD), and one or two other co-morbidities. I was told I really needed to watch sternal precautions for this patient, but what could I do with him to help him with ADLs, basic light easy therapeutic exercises and functional transfers and mobility? I remembered very little from school about sternal precautions. I remembered something about avoiding bending, lifting and twisting (avoid those BLTs). What could I do for getting this gentleman out of bed, getting him moving and making sure he didn’t push himself too much?

A Little Conversation Walks a Long Way: Ryan G., PT I often find conversation to be one of my greatest, most