'Tis Challenging Speech

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www.IShouldSendThemACard.com

Ph#: 815-541-1857

OFFICES:

1706 Superior Ave,  Savanna, IL 61074

1356 NW Boca Raton Blvd, Boca Raton, FL 33432

EMAIL:

talkndr@yahoo.com

Juice Plus URL:

www.GladITakeJuicePlus.com   



I am so happy to announce that I have put together a seminar on feeding strategies for nurses and nurse's aides to receive CEUs (continuing education units)!

The seminar focuses on: reasons for aspiration or silent aspiration

             *   hands on mixing of thickened liquids

             *   using body positions and adaptive equipment; feeding tube options;

             *  understanding various dysphagia situations and stages of swallowing; utilizing a treatment

                      plan designed by a speech pathologist; distinguish between altered diet consistencies

             * communication strategies to use while feeding another person

The seminar is offered to take place at your facility OR at a conference center.

 Please email me with "RN CNA Seminars" in the subject line (talkndr@yahoo.com) or phone me (815-541-1857) for the state and month you are interested in attending a seminar and if we can't get one in your facility, I'll let you know of one that is nearby.

I like to keep the class size to 10-30 people and will do various times of the day to assure that all shifts at the facility have the ability to attend.

OUTLINE FOR SEMINAR

Stages, Symptoms & Reasons for Dysphagia: muscular, neuroanatomical, cognitive, structural, medication induced, relationship to the stages of the swallow, silent aspsiration vs aspiration pneumonia

Evaluation of Swallowing Ability & Design of the Plant of Treatment: How can you be involved? How to communicate the plan of treatment with staff, Utilizing the Speech Pathologist, Bedside & Videofluoroscopy swallow evaluations, Communication's role during the meal, Thermal stimulation, surface EMG biofeedback, & other treatments

Examples of Altered Diet Consistencies: Liquid consistencies & presenting liquids, Solid consistencies & feeding guidelines, Keeping the diet palatable while using the thickeners, Addressing inadequate nutrition, Increasing patient compliance of the diet, Feeding Tube Considerations: options regarding a feeding tube, pleasure eating status & liquid intake while NPO, interventions to use during non-oral feedings

Compensatory Strategies for Each Stage of Swallowing: Body positioning, Adaptive equipment, Diet consistency, Reasons for chin tuck, effortful swallow, supraglottic swallow

Hands-on Mixing with Thickeners for Various Liquid Consistencies: Honey, nectar, pudding consistencies of liquids, What liquids are already these consistencies?

Responsibilities to Assure a Successful Eating Event: Guidelines to share with staff or family that are feeding people, Importance of oral hygiene, Considerations when designing a feeding program, Strategies for impulsive/rapid intake eater, cheek pocketing, straw sucking safety, Involving the person in feeding versus total dependent feeding

Oral Motor Exercises: Specific exercises for various types of dysphagia, Masako maneuver, Shaker exercises & others, Incorporating oral motor exercises with general patient contact

Patient's Rights in Oral & Non-Oral Feedings: Documenting the decision of AMA (against medical advice)

From my seminars, participants have requested the following:

Dvsphagia Recommendations / Orders

‘Tis Challenging Speech, Jeanne Byers Spraetz, MA CCC SLP

815-541-1857
Name:

Acct. #:

MR#:

Physician:

Jeanne

Diet

Charting / Monitoring

 

NPO/Nonoral nutritional support

 

Listen for vocal quality throughout meal

 

Remove water from bedside

 

Watch for swallow with every bite

 

Saline nasal spray                               

 

 

 

Lemon water

 

Estimated Nutritional Needs per R.D.

 

No liquid restrictions

 

Calorie count per Dietary

 

Thin liquids                                       

Other:

 

Thick liquids:      nectar    honey    pudding

 

 

 

 

 

 

Pureed solids

 

 

Mechanical soft solids

 

 

    Ground                Fork mashed vegetables / fruits

Aspiration Precautions

 

    Bite-size

 

Supraglottic (safe) swallow

 

Soft solids

 

Super-supraglottic swallow

 

Regular solids

 

Compensations for pocketing

 

Only foods that form cohesive bolus / moistened

 

      Sweep mouth with tongue

 

Avoid sticky foods

 

     Sweep mouth with finger

 

Temperature of food

 

      External pressure to cheek

Food Presentation

 

No liquid wash between bites

 

Cup type

 

Multiple swallows (patient does / does not need cues)

 

Straw

 

Mendelsohn Maneuver

 

Adaptive equipment specify:

 

Hold breath, then swallow

 

Alternate liquid swallows every    _____    bites

 

Encourage / stimulate lip closure

 

Spoon only

 

Empty mouth before next bite

 

Turn plate occasionally

 

Eat slowly

 

Put liquids within reach

 

Swallow hard

Positioning

 

Alternate liquid, solid, cough during meal

 

Sitting up at 90°

 

Sour bolus at the start of the meal / during meal

 

Reclined to

 

Cold bolus at the start of the meal / during meal

 

Head turned to

 

Rinse mouth after meal

 

Chin tuck

 

Complete oral care after meals

 

Head tilt to

 

Small sips only

 

Stay seated upright            minutes after meals

 

Cough after each sip

Status

 

 

Independent /feeds self

 

Re-evaluation:

 

Verbal cues / standby assistance

 

 

 

Minimal physical assistance

 

 

 

Moderate physical assistance

 

Other:

 

Maximal physical assistance

 

 

 

Dependent in feeding

 

 

 

Aide to give choice of food; name food/ drink/ as given

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date:                                            Speech-Language Pathologist:

Date:                                  Physician agrees et orders above recommendations: