04/12/2019. Learning Objectives. An Approach to End of Life Conversations in Dementia Care for Speech-Language Pathologists
|
|
- Cassandra Blankenship
- 5 years ago
- Views:
Transcription
1 1 An Approach to End of Life Conversations in Dementia Care for Speech-Language Emily Hornback, MS, CCC-SLP, BCS-S Communication Sciences & Disorders Learning Objectives 1. Increase knowledge of cognitive staging of dementia and correlation to dysphagia. 2. Identify behavioral indicators that may predict cognitive dysphagia and/or nutritional concerns. 3. Present a framework in order to increase knowledge and patient expectations without prior experience. Communication Sciences & Disorders
2 2 Dementia Acquired brain disease characterized by a progressive decline in cognitive domains including: Attention Linguistic expression and comprehension Executive functioning skills Learning and memory Visuospatial Skills Memory Communication Sciences & Disorders US: 5.7 million Worldwide: 50 million 2030: 82 million 2050: 152 million Prevalence Alzheimer s accounts for 60-80% of cases 1 in 10 Americans 65 + has AD 1 in 3 elderly people will die from Alzheimer s disease or another form of dementia Communication Sciences & Disorders What does it look like to die from dementia? Communication Sciences & Disorders
3 3 Assessment Framework 1. Clinical Evaluation of Swallow Instrumental Assessment, if indicated 2. Cognitive Staging 3. Education and Counseling Communication Sciences & Disorders 1. Clinical Evaluation of Swallow 1. Oral Care Oral Health Assessment Tool (OHAT) 2. Oral Mech Exam 3. PO trials 4. Behavioral Feeding Assessment Communication Sciences & Disorders Clinical Evaluation of Swallow Dementia Behavioral/Feeding Assessment Tools Dementia Mealtime Assessment Tool (DMAT) Edinburg Feeding Evaluation in Dementia Questionnaire (EdFED-Q) Communication Sciences & Disorders
4 4 Communication Sciences & Disorders Communication Sciences & Disorders Communication Sciences & Disorders
5 5 2. Cognitive Staging Global Deterioration Scale (GDS) Functional Assessment Staging Tool (FAST) Brief Cognitive Rating Scale (BCRS) Allen Cognitive Levels (ACL) Communication Sciences & Disorders Communication Sciences & Disorders Communication Sciences & Disorders
6 6 Reisberg, B. Functional Assessment Staging (FAST). Psychopharmacology Bulletin, 1988; 24: Communication Sciences & Disorders 3. Counseling and Education Current functioning and future expectations Involvement of interdisciplinary team members Communication Sciences & Disorders
7 7 S: Setting P: Perception I: Invitation K: Knowledge E: Empathy S: Strategy SPIKES Protocol Communication Sciences & Disorders Education Anticipation Preparation Communication Sciences & Disorders Goals of Treatment Mitigate risk of decline Medical Nutritional Quality of life Increase independence Communication Sciences & Disorders
8 8 Predictors of Pneumonia in Nursing Homes Dependent for feeding Mechanically altered diet Weight loss Tube fed Suction use Dysphagia Poor Pulmonary Clearance (bedfast, dependence in bed, dependence in locomotion, COPD, CHF, & CVA) 8. Depressed Immune System (Weight Loss, UTIs, and age) Communication Sciences & Disorders Indirect Interventions Modification: Environmental Auditory Tactile (include senses) Visual Diet Communication Sciences & Disorders Direct Interventions Spaced Retrieval Training Adaptive Equipment Training in hand-over-hand assistance Communication Sciences & Disorders
9 9 (Chung, 2018) Communication Sciences & Disorders GDS: 7 Cognitive-based dysphagia Dependence for oral care Dependence for feeding Oral apraxia Oral acceptance deficits Impaired attention for chewing/swallowing Confused feeding pattern attempts Unable to sustain nutrition and hydration needs by mouth Communication Sciences & Disorders When Anticipation Becomes Reality weight loss severe dysphagia dehydration wounds aspiration pneumonia Communication Sciences & Disorders
10 10 Next Steps Discussion with interdisciplinary team members. Family meeting for education and discussion regarding goals of care. Comfort Care and/or Hospice Services Alternative Method of Nutrition Communication Sciences & Disorders Case Study: Betty Betty is a 92 year old female admitted to short term rehab after being hospitalized due to sepsis secondary to UTI. Prior to hospitalization, Betty was living at a standalone ALF in memory unit. Betty has dementia and is primarily nonverbal and requires total assistance with all ADLs. Betty has had a 25 lb. weight loss in the last year. Betty was admitted to short term rehab on a regular/thin diet. Communication Sciences & Disorders Case Study: Betty GDS = 6-7 Cognitive/behavioral signs: texture aversion, oral acceptance deficit Oral signs: inability to masticate or form bolus. Communication Sciences & Disorders
11 11 Case Study: Johnny Johnny was admitted to short term rehabilitation after being hospitalized for a right hip fracture. Johnny underwent a total hip replacement. Johnny had a history of Alzheimer s disease to which wife reported that he required assistance with bathing, walking, and was incontinent of bowel and bladder. Johnny was previously able to feed himself. Johnny usually ate softer foods at home like mashed potatoes and ground meats with gravy. Johnny was not oriented to time and did not recognize grandchildren. Communication Sciences & Disorders Case Study: Johnny Prior GDS = 6 Upon evaluation, Johnny is nonverbal and unable to self-feed. Johnny is positioned in a Broda chair for support. Oral dysphagia signs: prolonged mastication and inability to form cohesive bolus. Cognitive dysphagia signs: oral acceptance deficit, poor attention for swallowing and chewing, prolonged meal time. Communication Sciences & Disorders Case Study: Johnny Education and counseling Therapeutic interventions put into place including diet modification and education and training of staff and family. 2 weeks later patient became dehydrated and experienced increased difficulty swallowing. Increased clinical signs of pharyngeal dysphagia including coughing and choking with meals and severe apraxia of swallow. No improvements in cognition Interdisciplinary team alerted by SLP to define goals of care. Communication Sciences & Disorders
12 12 References Alzheimer s Association. (2018) Alzheimer's disease facts and figures. Retrieved from Alzheimer s Disease International. (2015). World Alzheimer Report 2015: The global impact of dementia. London, United Kingdom: Alzheimer s Disease International. Amella, E. J. (2002). Resistance at mealtimes for persons with dementia. Journal of Nutrition, Health & Aging, 6(2), Retrieved from dementia Baile, W. F., Buckman, R., Lenzi, R., Glober, G., Beale, E. A., & Kudelka, A. P. (2000). SPIKES a six-step protocol for delivering bad news: application to the patient with cancer. The Oncologist, 5(4), Retrieved from Bayles, K., McCullough, K., & Tomoeda, C. (2020). Cognitive-communication disorders of MCI and dementia: Definition, assessment, and clinical management 3rd edition. San Diego, CA: Plural Publishing, Inc. Communication Sciences & Disorders References Camp, C., Antenucci, V., Bush, J., Slominski, T. (2012). Using spaced retrieval training to effectively treat dysphagia in clients with dementia. Perspectives on Swallowing and Swallowing Disorders, 21(3), Retrieved from Chang, C., & Roberts, B. (2008). Feeding difficulty in older adults with dementia. Journal of Clinical Nursing, 17, Retrieved from Chung, C. (2018). What to expect in late stage dementia. Very Well Health. Digital print. Retrieved from Langmore, S.E., Terpenning, M. S., Schork, A., Chen, Y., Murray, J. T., Lopatin, D., & Loesche, W. J. (1998). Predictors of aspiration pneumonia: How important is dysphagia? Dysphagia, 13(2), Langmore, S.E., Sharupski, K.A., Park, P.S., & Fries B.E. (2002). Predictors of aspiration pneumonia in nursing home residents. Dysphagia, 17(4), Retrieved from Communication Sciences & Disorders References Lopez, R. P., Amella, E. J., Strumpf, N. E., Teno, J. M., & Mitchell, S. L. (2010). The influence of nursing home culture on the use of feeding tubes. Archives of Internal Medicine, 170, Martin, L. (2019). Dementia mealtime assessment tool (DMAT). Retrieved from Reisberg, B. Functional assessment staging (FAST) (1988). Psychopharmacology Bulletin, 24, Reisberg, B., Ferris, S.H., de Leon, M.J., and Crook, T. (1982). The global deterioration scale for assessment of primary degenerative dementia. American Journal of Psychiatry, 139, Stockdell, R., Amella, E. (2008). The Edinburg feeding evaluation in dementia scale: Determining how much help people need at mealtime. American Journal of Nursing,108(8), Retrieved from mentiascale pdf Communication Sciences & Disorders
13 13 References Tristani, M. (2016). Swallowing, cognition, dignity: A clinical pathway for dysphagia management in persons with dementia. ASHA Dysphagia in Older Adults Live Conference. Online. Voyzey G. A. (2010). Feeding and swallowing strategies for individuals with dementia. Perspectives on Gerontology, 15(2), Watson, R., Macdonald, J., & Mccready, T. (2001). The Edinburgh Feeding Evaluation in Dementia Scale #2 (EdGES #2): Inter- and intra-rater reliability. Clinical Effectiveness in Nursing, 5(4), World Health Organization. (2017). Dementia: Fact sheet. Retrieved from Communication Sciences & Disorders
The Chinese University of Hong Kong The Nethersole School of Nursing. CADENZA Training Programme
The Chinese University of Hong Kong The Nethersole School of Nursing CTP 004 Evidence-based Practice for Dementia Care Web-based Course Module II for Professional Social and Health Care Workers. 1 Chapter
More informationRestorative Rehabilitation Dining Programs
Restorative Rehabilitation Dining Programs SUCCESSFUL DEVELOPMENT & IMPLEMENTATION LAURA ROBERTS, MS, CCC-SLP; BRS-S Course Objectives! Summarize goals of a typical rehab dining program.! Identify indicators
More informationEnd of Life Care in Dementia. Dr Rosie Lockwood Consultant Geriatrician Sheffield Teaching Hospitals
End of Life Care in Dementia Dr Rosie Lockwood Consultant Geriatrician Sheffield Teaching Hospitals Rosie.Lockwood@sth.nhs.uk Agenda Some facts and figures What are the challenges? What is good care? How
More informationDYSPHAGIA SCREENING and CLINICAL SWALLOW EVALUATIONS. Debra M. Suiter, Ph.D., CCC-SLP, BRS-S VA Medical Center-Memphis
DYSPHAGIA SCREENING and CLINICAL SWALLOW EVALUATIONS Debra M. Suiter, Ph.D., CCC-SLP, BRS-S VA Medical Center-Memphis Suiter, ASHA, 2012 Diagnostic Tests vs. Screening Diagnostic tests are used when a
More informationScreening and Clinical Assessment for Dysphagia: How to Decide.
Screening and Clinical Assessment for Dysphagia: How to Decide. How to Decide. ASHA Convention 2014 James L. Coyle, Ph.D., CCC-SLP, BCS-S Associate Professor, Communication Science & Disorders, University
More informationThe Clinical Swallow Evaluation: What it can and cannot tell us. Introduction
The Clinical Swallow Evaluation: What it can and cannot tell us Debra M. Suiter, Ph.D., CCC-SLP, BCS-S Director, Voice & Swallow Clinic Associate Professor, Division of Communication Sciences & Disorders
More information10/26/2017. Diagnostic Tests vs. Screening. Dysphagia Screening: What it is and what it is not
Dysphagia Screening: What it is and what it is not Debra M. Suiter, Ph.D., CCC-SLP, BCS-S Director University of Kentucky Voice & Swallow Clinic Lexington, Kentucky ASHA's Preferred Practice Pattern on
More informationCareFirst Hospice. Health care for the end of life. CareFirst
Hospice Health care for the end of life 1 What is Hospice? Hospice is a philosophy- When a person in end stages of an illness can no longer receive, or wants to receive, life sustaining treatment, he or
More informationChapter 2: Alzheimer s Disease and Other Dementias
By Eun-Shim Nahm, PhD, RN Assistant Professor University of Maryland School of Nursing OUTLINE What is Alzheimer s disease? Causes of Alzheimer s disease? Cognitive Changes Behavioral, Psychiatric issues
More informationEnter Stage Right: A Script For Dementia Intervention
Enter Stage Right: A Script For Dementia Intervention Jocelyn Alexander, MA CCC-SLP Michele Kramer, MA CCC-SLP Therapy Partners ASHA CONVENTION 2010 Philadelphia, PA Objectives Be able to differentiate
More informationDysphagia Management in TCP. Susan Smith and Vanessa Barkla Speech Pathologists, Ballarat Health Services May 2012
Dysphagia Management in TCP Susan Smith and Vanessa Barkla Speech Pathologists, Ballarat Health Services May 2012 The role of the Speech Pathologist To assess swallowing status To provide management and
More informationDysphagia (swallowing problems)
Dysphagia (swallowing problems) Speech and Language Therapy Department Patient Information Leaflet Introduction This leaflet is for people who have dysphagia. It gives information on what this condition
More informationFact Sheet. VitalStim Therapy
VitalStim Therapy Fact Sheet Dysphagia, or difficulty with swallowing, is a sorely neglected medical disorder that impacts as many as 15 million Americans, with approximately one million people annually
More informationSession #: R10 CASE STUDIES IN DYSPHAGIA DIAGNOSIS, TREATMENT AND REDUCTION OF REHOSPITALIZATIONS
Session #: R10 CASE STUDIES IN DYSPHAGIA DIAGNOSIS, TREATMENT AND REDUCTION OF REHOSPITALIZATIONS PRESENTERS Dr. ERIC BLICKER, CCC-SLP.D., BCS-S COMMUNITY CARE PARTNERS, INC. EMAIL: CEUCUSTOMERCARE@GMAIL.COM
More informationQuick Death, Slow Death, Hopefully No Death
Quick Death, Slow Death, Hopefully No Death Collaborative presentation on learning from choking and nutrition incidents in RWT. Introduction of IDDSI for food and fluids Why there is an NPSA Alert Safe
More informationChapter 19. Nutrition and Fluids. All items and derived items 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
Chapter 19 Nutrition and Fluids Nutrition Nutrition--processes involved in the ingestion, digestion, absorption & use of foods & fluids by the body. The person s diet affects physical & mental wellbeing
More informationDysphagia and Swallowing. Jan Adams, DNP, MPA, RN and Karen Kern
Dysphagia and Swallowing Jan Adams, DNP, MPA, RN and Karen Kern Scope of the Problem and Incidence 15 million people in the US have some form of Dysphagia. Every year, 1 million people are diagnosed with
More informationDysphagia Identification and Management
Dysphagia Identification and Management Presented By Speech-Language Pathologist Developmental Disabilities Administration DC Department on Disability Services Training Objectives After this training session
More informationNew Evidence-Based Support of a 3 Ounce Water Swallow Challenge Protocol
New Evidence-Based Support of a 3 Ounce Water Swallow Challenge Protocol Steven B. Leder, Ph.D. Yale University School of Medicine New Haven, Connecticut Debra M. Suiter, Ph.D. VA Medical Center-Memphis
More informationPalliative Care Swallowing Management HEATHER STORIE M.S.,CCC-SLP, BCS-S SPEECH LANGUAGE PATHOLOGY, BOARD CERTIFIED SWALLOWING SPECIALIST
Palliative Care Swallowing Management HEATHER STORIE M.S.,CCC-SLP, BCS-S SPEECH LANGUAGE PATHOLOGY, BOARD CERTIFIED SWALLOWING SPECIALIST Objectives Gain a general understanding of normal swallowing Gain
More informationFree Water Protocols and Its Implementation in Health Care Facilities
Free Water Protocols and Its Implementation in Health Care Facilities Sarah Petullo, MA, CCC-SLP Speech Language Pathologist Instructor/Clinical Supervisor ID-HCC Conference Des Moines, Iowa March 27,
More informationCourse Handouts & Disclosure
ALS: DISEASE TRAJECTORY AND HOSPICE ELIGIBILITY Terri L. Maxwell PhD, APRN VP, Strategic Initiatives Weatherbee Resources Inc Hospice Education Network Inc Course Handouts & Disclosure To download presentation
More informationNeuroPI Case Study: Palliative Care Counseling and Advance Care Planning
Case: An 86 year-old man presents to your office after recently being diagnosed as having mild dementia due to Alzheimer s disease, accompanied by his son who now runs the family business. At baseline
More informationDocumentation ASSOCIATION OF NUTRITION AND FOOD PROFESSIONALS. Amber Gordon RD LD Consultant Dietitian, Carolina Nutrition Consultants
Documentation ASSOCIATION OF NUTRITION AND FOOD PROFESSIONALS Amber Gordon RD LD Consultant Dietitian, Carolina Nutrition Consultants Objective Review nutrition documentation with focus on individualization
More informationDementia Wellness Program
Dementia Wellness Program Stacy McLaughlin, M.A. CCC-SLP Laura Lagala, M.A. CCC-SLP Kessler Institute for Rehabilitation West Orange, New Jersey Chester, New Jersey Disclosure Statement We have no relevant
More informationUnderstanding late stage dementia Understanding dementia
Understanding late stage dementia About this factsheet This factsheet is for relatives of people diagnosed with dementia. It provides information about what to expect as dementia progresses to late stage.
More information5 Things I Want You to Know About Dysphagia. Prof Maggie-Lee Huckabee The University of Canterbury Rose Centre for Stroke Recovery and Research
5 Things I Want You to Know About Dysphagia Prof Maggie-Lee Huckabee The University of Canterbury Rose Centre for Stroke Recovery and Research 5 things 1) Why we can t diagnose dysphagia at bedside. 2)
More informationEvaluating Functional Status in Hospitalized Geriatric Patients. UCLA-Santa Monica Geriatric Medicine Didactic Lecture Series
Evaluating Functional Status in Hospitalized Geriatric Patients UCLA-Santa Monica Geriatric Medicine Didactic Lecture Series Case 88 y.o. woman was admitted for a fall onto her hip. She is having trouble
More informationObjectives 2/11/2016 HOSPICE 101
HOSPICE 101 Overview Hospice History and Statistics What is Hospice? Who qualifies for services? Levels of Service The Admission Process Why Not to Wait Objectives Understand how to determine hospice eligibility
More informationThis is a provisional PDF comprising this cover note and the manuscript as it was upon acceptance for publication.
This is a provisional PDF comprising this cover note and the manuscript as it was upon acceptance for publication. A typeset PDF article will be published soon. Revisiting the Use of Percutaneous Endoscopic
More informationCOLLABORATION WITH OT IN TREATMENT OF DYSPHAGIA IN SEVERE DEMENTIA
COLLABORATION WITH OT IN TREATMENT OF DYSPHAGIA IN SEVERE DEMENTIA Bob LeJeune; M.A., CCC SLP Progressive Step Rehab Sharon Kurfuerst; Ed.D.; OTR/L Christiana Health Services Dementia Defined The American
More informationRole of Dining Services and Dietary Needs of the Resident, 2014
Role of Dining Services and Dietary Needs of the Resident, 2014 It is the dining services role to provide quality meals and service to all residents that is as home-like as possible. This will be done
More informationHealthy Body, Healthy Mind
Volume 3 Spring 2016 The Firelands S.P.O.T. Inside this issue: 2 Speech Therapy Corner REPORT 3 Physical Therapy Corner Your quarterly guide to new information, insights, and events from Speech, Physical,
More informationSection K Swallowing/ Nutritional Status
Instructor Guide Section K Swallowing/ Nutritional Status Objectives State the intent of Section K Swallowing and Nutritional Status. Describe how to conduct an assessment of a resident s nutritional status.
More informationA Palliative Approach in Caring for the Person and Family Living with Dementia Hospice and Palliative Nurses Association (HPNA) Online Education
A Palliative Approach in Caring for the Person and Family Living with Dementia Anne Carr, GNP BC Anne Mahler, GCNS BC, ACHPN Created May 2017 Disclosures Anne Carr and Anne Mahler have no real or perceived
More informationWithholding & Withdrawing Life Sustaining Treatment: A Lifespan Approach
Withholding & Withdrawing Life Sustaining Treatment: A Lifespan Approach Kenneth Brummel-Smith, M.D. Charlotte Edwards Maguire Professor, Department of Geriatrics FSU College of Medicine Basic Concepts
More informationTable of Contents: Amyotrophic Lateral Sclerosis (ALS)
Guidelines for Hospice Admission Amyotrophic Lateral Sclerosis (ALS) Cancer Cerebral Vascular Accident / Stroke or Coma Dementia / Alzheimer s Failure to Thrive Adults Heart Disease / CHF HIV Disease Huntington
More informationCourse Handouts & Post Test
STROKE/COMA: DISEASE TRAJECTORY AND HOSPICE ELIGIBILITY Terri L. Maxwell PhD, APRN VP, Strategic Initiatives Weatherbee Resources Hospice Education Network Course Handouts & Post Test To download presentation
More informationTRAJECTORY OF ILLNESS IN END OF LIFE CARE
TRAJECTORY OF ILLNESS IN END OF LIFE CARE By Dr Helen Fryer OBJECTIVES To be aware of the three commonest trajectories of decline in the UK To understand the challenges faced in delivering effective Palliative
More informationALF Boss's ALF Cheat Sheet For ADRC's Phone Interview For Long Term Care
DIRECTONS: Answer the following questions to help prepare for the ADRC phone interview. The more details you can provide regarding the resident's care and health needs the better. Resident Name: 01. How
More informationThe COLLaboration on AGEing (COLLAGE)
The COLLaboration on AGEing (COLLAGE) Professor D. William Molloy University College Cork, Ireland. The Lessons from Europe Seminar 23-09-15 Overview Exemplars within COLLAGE: 1. What is COLLAGE? 2. The
More informationDementia. Memory Evaluation Center Neurology
Dementia Memory Evaluation Center Neurology Topics Overview of dementia Stages Medications Advanced planning What is Dementia? Dementia = significant global decline in cognitive function not due to medicine
More informationSCALES SCALES SCALES. Performance Scales WHAT SHOULD THE RAINBOW FISH DO WITH ALL OF THESE SCALES?? KPS FAST ECOG PPS NYHA MRI ALSFRS
SCALES SCALES SCALES WHAT SHOULD THE RAINBOW FISH DO WITH ALL OF THESE SCALES?? Karen L. Cross, MD, FAAHPM Performance Scales KPS FAST ECOG PPS NYHA MRI ALSFRS PPS = 30, 40, or 50 ECOG = 2, 3, or 4 NYHA
More informationEnd of Life with Dementia Sue Quist RN, CHPN
End of Life with Dementia Sue Quist RN, CHPN Objectives: Describe the Medicare hospice benefit and services. Discuss the Medicare admission criteria for hospice patients with dementia due to Alzheimer
More informationHospice Eligibility August 2018
Hospice Eligibility August 2018 Objectives Identify who can make a hospice referral Review hospice eligibility and disease-specific prognostic indicators Review Open Access philosophy Who Can Make A Referral
More informationFall Risk Assessment and Prevention in the Post-Acute Setting A Road Map
Fall Risk Assessment and Prevention in the Post-Acute Setting A Road Map Cora M. Butler, JD, RN, CHC HealthCore Value Advisors, Inc. Juli A. James, RN Primaris Holdings, Inc. Objectives Explore the burden
More informationCLINICAL MAPPING TOOL. Therapy Clinical Care Pathway
CLINICAL MAPPING TOOL Therapy Clinical Care Pathway 2 Table of Contents Clinical Mapping Tool Procedure Safe Transition Planning Tool 4 5 Benchmarking 8 Clinical Outcome Tracking Form 9 Pathways to Success
More informationNutricia. Nutrition and Dysphagia
Nutricia Nutrition and Dysphagia 1 Introduction What is Dysphagia? The inability to swallow normally or freely. Disorder in the swallowing process that does not allow safe passing of food from the mouth
More informationEffects of Oral Health Screening on Aspiration Pneumonia Risk for Adults with Dementia in Residential Aged Care
Wicking Dementia Research and Education Centre Effects of Oral Health Screening on Aspiration Pneumonia Risk for Adults with Dementia in Residential Aged Care L. Goldberg, J. Westbury, S. Langmore, L.
More informationWhat is Occupational Therapy? Introduction to Occupational Therapy. World Federation of Occupational Therapists 2012
World Federation of Occupational Therapists 2012 Introduction to Occupational Therapy Suki HUI Occupational Therapist I Statement on Occupational Therapy Occupational therapy is a client-centred health
More informationEnd of Life Care in Dementia. Sue Atkins Dignity in Care/Dementia/Learning Disabilities Clinical Nurse Specialist
End of Life Care in Dementia Sue Atkins Dignity in Care/Dementia/Learning Disabilities Clinical Nurse Specialist Objectives Understanding the decline in people with dementia To recognise when patients
More informationAssessing the Eating Needs of Personal Care Services (PCS) Beneficiaries Effective 12/1/2016
Assessing the Eating Needs of Personal Care Services (PCS) Beneficiaries Effective 12/1/2016 The Freedom to Succeed November 22,2016 Content Introduction Signs and Symptoms Caring for Individuals with
More informationReview of dysphagia in poststroke
Review of dysphagia in poststroke patients Danielle Thompson, Speech and Language Therapist Northwick Park Hospital With acknowledgement to Mary McFarlane, Principal Speech and Language Therapist, Acute
More informationThree triggers that suggest that patients could benefit from a hospice palliative care approach
Why is it important to identify people nearing the end of life? About 1% of the population dies each year. Although some deaths are unexpected, many more in fact can be predicted. This is inherently difficult,
More informationDysphagia after Stroke. Wendy Busby Stroke Service Dunedin Hospital
Dysphagia after Stroke Wendy Busby Stroke Service Dunedin Hospital Incidence IN NEW ZEALAND 9,5000 new stroke per year Rate is decreasing More people surviving Major cause of disability in adults Prevalence
More informationSafe swallowing strategies
Learning Guide Safe swallowing strategies 27468 Apply safe swallowing strategies in a health or wellbeing setting Level 3 5 credits Name: Workplace: Issue 2.0 Copyright 2017 Careerforce All rights reserved.
More informationCASE STUDY RESIDENT WITH SENILE DEMENTIA
CASE STUDY RESIDENT WITH SENILE DEMENTIA INFORMATION COLLECTION Mr. Frank Miller, 72 years old Occupation: Has recently worked for the building authority Social situation: widowed, recently he lived with
More informationTo Tube or Not To Tube Carole R. Roth, Ph.D., CCC, BC-NCD Head, Division of Speech Pathology Naval Medical Center San Diego
To Tube or Not To Tube Carole R. Roth, Ph.D., CCC, BC-NCD Head, Division of Speech Pathology Naval Medical Center San Diego Outline Dysphagia: : Etiologies and Diagnosis Dysphagia and Its Consequences
More informationThe Role of the Speech Language Pathologist & Spinal Cord Injury
The Role of the Speech Language Pathologist & Spinal Cord Injury Facts According to the National Spinal Cord Injury Statistical Center (NSCISC) there are approxiamtely 12,000 new spinal cord injuries (SCI)
More informationESPEN Congress Geneva 2014 NURSING SESSION! NUTRITION IN PALLIATIVE CARE. Nutrition in stroke patients and chronic surgical diseases K.
ESPEN Congress Geneva 2014 NURSING SESSION! NUTRITION IN PALLIATIVE CARE Nutrition in stroke patients and chronic surgical diseases K. Boeykens (BE) Nutrition in Stroke Patients and Chronic Neurological
More informationWorkbook. Apply safe swallowing strategies as a health assistant in an aged care, health or disability context. US Level 4 Credits 4. Name...
Workbook Apply safe swallowing strategies as a health assistant in an aged care, health or disability context US 27468 Level 4 Credits 4 Name... US 27468 Level 4 Credits 4 All rights reserved. Careerforce
More informationEating/Drinking Nutrition/Hydration in Late and End Stage Dementia. Difficult choices Difficult Process
Eating/Drinking Nutrition/Hydration in Late and End Stage Dementia Difficult choices Difficult Process diannadrascic@gmail.com Interactive workshop Literature, research, data do not equal people 3 points
More informationPROJECTION: Worlds dementia population is expected to triple by 2050
DEMENTIA C L I S K C O N S U LTA N T P H Y S I C I A N I N A C U T E M E D I C I N E A N D G E R I AT R I C M E D I C I N E, B A R N E T H O S P I TA L, R O YA L F R E E N H S F O U N D AT I O N T R U
More informationDelirium. Delirium is characterized by an acute onset (hours or days) and fluctuating course of deterioration in mental functioning.
Delirium Delirium is characterized by an acute onset (hours or days) and fluctuating course of deterioration in mental functioning. DELIRIUM IS A MEDICAL EMERGENCY! Delirium: Hallmark Features Inattention-
More informationDetermining Eligibility for Hospice Care
Determining Eligibility for Hospice Care Main Number: 203 739-8300 Toll Free Number: 888 357-3334 www.regionalhospicect.org Many people may not understand all that Regional Hospice can offer or they are
More informationAdvance Care Planning: What s the Physician s Role? Dr. Tim Jessick Palliative Medicine Aurora West Allis Medical Center October, 2015
Advance Care Planning: What s the Physician s Role? Dr. Tim Jessick Palliative Medicine Aurora West Allis Medical Center October, 2015 Objectives Define usual medical care vs palliative care vs hospice
More informationFor all the places our children have meal times.
Donna Edwards, MA CCC SLP, BCS S Board Certified Specialist in Swallowing and Swallowing Disorders ASHA Fellow Dayton Children s Hospital Dayton, OH For Children! For Parents! For Professionals! For the
More informationAppendix 1. Frailty as a confounder of the effectiveness of preventive treatment. Abbreviations: t1 = time one. t2 = time 2. This model indicates the
Appendix 1. Frailty as a confounder of the effectiveness of preventive treatment. Abbreviations: t1 = time one. t2 = time 2. This model indicates the interrelatedness of comorbidity, frailty, and ADL dependency,
More informationResearch & Policy Brief
USM Muskie School of Public Service Maine DHHS Office of Elder Services Research & Policy Brief Caring for People with Alzheimer s Disease or Dementia in Maine A Matter of Public Health Alzheimer s disease
More information11/2/2011 DOWNLOAD THE HANDOUTS OBJECTIVES. Determining Terminal Status: Dementia Due to Alzheimer s Disease and Related Disorders
Determining Terminal Status: Dementia Due to Alzheimer s Disease and Related Disorders Joy Barry, RN, MEd, LNC Weatherbee Resources, Inc. Hospice Education Network, Inc. DOWNLOAD THE HANDOUTS Click on
More informationMDS 3.0. Acronyms. Terminology & Definitions 8/22/2016 CAA CAT ADL BMI BIMS PT/OT/ST QI QM MDS RAI OMRA (SOT) OBRA RUG CMS COT OMRA ARD
MDS 3.0 Acronyms MDS RAI OMRA (SOT) OBRA RUG CMS COT OMRA ARD CAA CAT ADL BMI BIMS PT/OT/ST QI QM Terminology & Definitions Active Disease Diagnosis Acute Change in Mental Status Period Reference Date
More informationSCHERVIER NURSING CARE CENTER. Wadie Utkovic, LCSW
SCHERVIER NURSING CARE CENTER Palliative Care in Long-Term Care: Good Practices and Tools for Success Wadie Utkovic, LCSW Social Work Supervisor, Schervier Nursing Care Center, Bronx, NY 1 Bon Secours
More informationSwallowing Screen Why? How? and So What? พญ.พวงแก ว ธ ต สก ลช ย ภาคว ชาเวชศาสตร ฟ นฟ คณะแพทยศาสตร ศ ร ราชพยาบาล
Swallowing Screen Why? How? and So What? พญ.พวงแก ว ธ ต สก ลช ย ภาคว ชาเวชศาสตร ฟ นฟ คณะแพทยศาสตร ศ ร ราชพยาบาล Dysphagia in Stroke The incidence of dysphagia after stroke ranging from 23-50% 1 Location
More informationV2.1 Cluster 2 Acute Care to Rehab & Complex Continuing Care (CCC) Referral
Referral Destination Referral to Rehab: (Please check one) HTSD / Regular stream LTLD/slowstream Either (Receiving facility to determine) Referral to Complex Continuing Care (CCC) (For LTLD / slowstream
More informationN.C. Nurse Aide I Curriculum MODULE T. Dementia and Alzheimer s Disease. DHSR/HCPR/CARE NAT I Curriculum - July
N.C. Nurse Aide I Curriculum MODULE T Dementia and Alzheimer s Disease DHSR/HCPR/CARE NAT I Curriculum - July 2013 1 Objectives Define the terms dementia, Alzheimer s s disease, and delirium. Describe
More informationReluctance or refusal to feed or eat. Understanding Feeding Aversion in a City Full of Foodies. Presentation Outline. Learning Objectives
Understanding Feeding Aversion in a City Full of Foodies Amy Houtrow, MD, MPH Pediatric Physical Medicine & Rehabilitation UCSF Department of Pediatrics June 2, 2007 Learning Objectives Learners will be
More informationSWALLOWING DIFFICULTIES IN HD
Nutrition, eating and swallowing needs, challenges and solutions Workshop SWALLOWING DIFFICULTIES IN HD Angela Nuzzi Speech and Language Pathologist (SLP) EHDN Language Coordinator - Italy The role of
More information4/26/2012. Laura Grooms, MD Assistant Professor Geriatric Medicine Department of Family and Geriatric Medicine University of Louisville April 20, 2012
Laura Grooms, MD Assistant Professor Geriatric Medicine Department of Family and Geriatric Medicine University of Louisville April 20, 2012 Laura Grooms, MD Assistant Professor Geriatric Medicine Department
More informationDoctor, can I have oral feeding again? please.
Doctor, can I have oral feeding again? please. Dr Kwok C.L. Princess Margaret Hospital 25 Mar 2011 History Madam Yip / 86 years old Nursing Home Resident Chair bound, ADL up to feeding indep Barely communicable
More informationTHE POTENTIAL IMPACT OF VITALSTIM THERAPY ON HEALTHCARE COSTS: A White PaperVitalStim Therapy has significant
Dysphagia THE POTENTIAL IMPACT OF VITALSTIM THERAPY ON HEALTHCARE COSTS: A White PaperVitalStim Therapy has significant Contents potential to dramatically impact the health care costs arising from oropharyngeal
More informationUnderstanding Dementia &
Understanding Dementia & Care Options for Those Suffering with the Disease Paige Landry BSN Hospice Care Consultant SouthernCare New Beacon Hospice Objectives Understand Dementia Understand Common Problems
More informationRecognizing Signs and Symptoms of Alzheimer's Disease in Earlier Stages Can Lead to Diagnosis
A joint publication of the Illinois Health Care Association and CE Solutions November 2015 Recognizing Signs and Symptoms of Alzheimer's Disease in Earlier Stages Can Lead to Diagnosis Early diagnosis
More informationResident Assessment Best Practices M E G A N M. G R A E S E R, D N P, G N P - BC P H Y S I C I A N H O U S E C A L L S, L L C
Resident Assessment Best Practices M E G A N M. G R A E S E R, D N P, G N P - BC P H Y S I C I A N H O U S E C A L L S, L L C Who are you assessing? Elders that needing to make a transition in their care
More informationMaximizing Functional Outcomes for Patients With Dementia: Best Buy FACULTY
FACULTY Michelle S. Bourgeois, PhD, CCC-SLP, is an ASHA Fellow and a professor in the Department of Communication Sciences and Disorders at the University of South Florida. She has received numerous grants
More informationChapter 27 & 28. Key Terms. Digestive System. Fig. 27-1, p. 443 Also known as the Gastrointestinal System (GI system)
Chapter 27 & 28 Nutrition & Fluids Key Terms Aspiration Dehydration Edema Dysphagia Gastrostomy tube Intravenous therapy (IV) Digestive System Fig. 27-1, p. 443 Also known as the Gastrointestinal System
More informationDeath by Bedrest: The Perils of The Hospital
Death by Bedrest: The Perils of The Hospital Mindy Fain, MD Professor of Clinical Medicine Director, Arizona Reynolds Program of Applied Geriatrics Section Head, Geriatrics & Gerontology University of
More informationKaren Schoeneman Consul6ng 1
+ New Dining Standards of Practice How Do We Get There? Karen Schoeneman + How Did They Happen? 2 n CMS and Pioneer Network co-sponsored a symposium on the food and dining requirements, and culture change
More informationPediatric Modified Barium Swallow Studies. Presented by Jody Bousquet, MA, CCC- SLP Susan Shonbrun, MS, CCC- SLP November 7, 2015
Pediatric Modified Barium Swallow Studies Presented by Jody Bousquet, MA, CCC- SLP Susan Shonbrun, MS, CCC- SLP November 7, 2015 Definition * Modified Barium Swallow Study * Assesses swallow functions
More information5/3/2012 PRESENTATION GOALS RESPIRATORY THERAPISTS ROLE IN END OF LIFE CARE FOR THE PULMONARY PATIENT
RESPIRATORY THERAPISTS ROLE IN END OF LIFE CARE FOR THE PULMONARY PATIENT Presented by Carrie Black Bourassa, LRT, RRT PRESENTATION GOALS Define palliative care Define hospice care Discuss pulmonary hospice
More informationUnderstand Normal vs. Disorder. Normal Aging- Motor Function. Normal Aging- Sensory Function. Other Normal Changes in Aging 1/27/18
Understand Normal vs. Disorder Dysphagia in Patients with Dementia- Strategies for Success Amber Heape, ClinScD, CCC-SLP, CDP Presbyphagia Declines of swallow associated with normal aging (Wirth et.al,
More informationGeriatric Pain Assessment and Management. Robin Arends, DNP, CNP, FNP-BC
+ Geriatric Pain Assessment and Management Robin Arends, DNP, CNP, FNP-BC + Objectives List three reasons why elderly are less likely to report pain. List three barriers to pain management Describe two
More information2013 Charleston Swallowing Conference
Providing Quality Affordable Continuing Education and Treatment Materials for over 30 years. 2013 Charleston Swallowing Conference Session 9 Bedside Assessment: What Does It Tell You? 10:00 11:30 am Saturday,
More informationMemoryCare Professional Caregiver Dementia Education Program
Dementia: End of Life Issues Objectives MemoryCare Professional Caregiver Dementia Education Program Module VI Dementia: End of Life Issues Presenter: Margaret A. Noel, MD Learn to recognize the end stage
More informationEfficacy of breathing exercises and relaxation techniques for patients with neurological disorders
Efficacy of breathing exercises and relaxation techniques for patients with neurological disorders Delphine Herrmann Rachael Katz Svetlana Piliavsky Shelley Rice ASHA 2008-CHICAGO WHAT IS THE BENEFIT OF
More informationCritical Review: Is a chin-down posture more effective than thickened liquids in eliminating aspiration for patients with Parkinson s disease?
Critical Review: Is a chin-down posture more effective than thickened liquids in eliminating aspiration for patients with Parkinson s disease? Nadia Torrieri, M.Cl.Sc. (SLP) Candidate The Unversity of
More informationRehab to Home. Stroke Recovery EDUCATION BOOKLET FOR: Care & Safety Tips. Frequently Asked Questions. Working Toward Independence. Adaptive Equipment
Stroke Recovery Rehab to Home Care & Safety Tips Frequently Asked Questions Working Toward Independence Adaptive Equipment Summary of Progress Different Types of Therapy Personal Goals EDUCATION BOOKLET
More informationNUTRITION AT END-OF-LIFE HANDOUTS OBJECTIVES. Hospice Education Network. Nutrition at End-of-Life, by C. Andrew Martin, MS, RN, CHPN
NUTRITION AT END-OF-LIFE C. Andrew Martin, MS RN CHPN Hospice Education Network camartin@hospiceonline.com HANDOUTS Pause the presentation Click on the link for the PowerPoint handouts and any supplemental
More informationEarly Intervention the Key to Geriatric Assessment: Geriatric Assessment Outreach Teams
Early Intervention the Key to Geriatric Assessment: Geriatric Assessment Outreach Teams Regional Geriatric Program of Eastern Ontario Outpatient Clinics Geriatric Rehabilitation Unit Community Referrals
More informationDeath With Dignity-Albany. Sept 12 th, Judith Schwarz, PhD, RN Clinical Director End of Life Choices New York
Death With Dignity-Albany Sept 12 th, 2018 Judith Schwarz, PhD, RN Clinical Director End of Life Choices New York I have been the Clinical Director, EOLCNY & predecessor group for more than 15 years Not-for-profit
More informationPalliative Performance Scale (PPS)
Palliative Performance Scale (PPS) Description The Palliative Performance Scale is a reliable and valid tool used for assessing a patient s functional status. PPS was developed by Victoria Hospice Society,
More information