Working with communication and swallowing problems
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Working with Communication and Swallowing Problems. Sarah Maslin Sarah Holdsworth Speech and Language Therapists Therapy assistant Conference November/December 2013. Aims and Objectives. To outline the role of the Speech and Language Therapist (SLT) in a range of settings

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Working with Communication and Swallowing Problems

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Working with communication and swallowing problems

Working with Communication and Swallowing Problems

Sarah Maslin

Sarah Holdsworth

Speech and Language Therapists

Therapy assistant Conference November/December 2013


Aims and objectives

Aims and Objectives

  • To outline the role of the Speech and Language Therapist (SLT) in a range of settings

  • To discuss communication and swallowing problems

  • To think about how you as Therapy Assistants can help when working with these patients


Myths and truths true or false

Myths and TruthsTrue or False?

  • Everyone with a swallowing problem should have thickener in their drinks

  • Only Doctors/nurses can refer to SLT

  • If someone can’t speak they won’t understand what I am saying

  • SLT can advise around communication support strategies (visual charts, gesture)for patients

  • Patients having difficulty with medication, The SLT needs to assess their swallowing.


What do we do

What do we do?

Communication

Swallowing


What can cause some of these problems

What can cause some of these problems?

  • CVA

  • Parkinson’s Disease

  • Motor Neurone Disease

  • Multiple Sclerosis

  • Huntingdon’s Chorea

  • Myasthenia Gravis

  • Head Injury

  • Brain Tumour

  • Dementia

  • Head and neck cancer

  • Tracheostomy/intubation

  • Developmental / congenital conditions


Communication

Communication


Types of communication problems

Types of Communication Problems

  • Dysphasia (or aphasia): difficulty understanding or producing language (words, sentences, conversation), which may include reading and writing

  • Dysarthria difficulty producing clear speech, “slurred” speech, due to muscle weakness

  • Dyspraxia difficulty planning how to pronounce words (can also affect planning other types of movements)

  • Dysfluency stammering / stuttering Types of Communication Problems

  • Dysphonia difficulty producing adequate voice, from hoarse voice to total loss of voice


What do slts do with communication impairments

What do SLTs do with communication impairments?

  • Assess and diagnose communication impairments

  • Direct work with clients

  • Work with communication partners

  • Compensatory strategies

  • Support or confidence building in specific situations

  • Communication support for specific discussions or decision making


Communication tips

Communication Tips

  • Glasses and hearing aids

  • Give your full attention

  • Sit or stand at the same level as the person

  • Give eye contact

  • Speak slowly and use simple language

  • Ask yes/ no questions

  • Give additional time for communication

  • Reduce distractions and background noise as possible

  • Make use of gestures, facial expression, writing and pictures to support your communication

  • Understand the specific difficulty – speak to the SLT


Swallowing

Swallowing

Problems with swallowing known as“dysphagia”


Definitions

Definitions

What do you understand by the term?

  • Aspiration

  • Aspiration pneumonia

  • Feeding at Risk


Signs and symptoms of a swallowing problem

Signs and symptoms of a swallowing problem

  • Coughing whilst eating and drinking

  • A ‘wet’ or gurgly voice after swallowing

  • Shortness of breath after eating and drinking

  • Choking, red face and watering eyes

  • Food or drink coming down the nose

  • Pain or discomfort on swallowing

  • Difficulties chewing

  • Excessive drooling

  • Difficulties clearing the mouth of all food after a meal


How do we manage swallowing problems

How do we manage swallowing problems

  • Bedside assessment

  • Therapy

  • Diet or fluid texture modification

  • Specific postures/ manoeuvres

  • Training

  • Objective assessment

  • Non-oral nutrition/ hydration


Case study 1

Case study 1

  • John, aged 70, in hospital following CVA

  • Expressive and receptive dysphasia

  • John can produce single words if given time to respond and he often makes mistakes e.g. says “bath” when means “bed”

  • SLT have provided a communication chart – John can correctly point to pictures of what he wants / needs

  • Can understand simple phrases but not long complex sentences

  • Think about how you would facilitate this patients communication in one of your sessions?


Case study 2

Case study 2

  • Claire, 40 Attending MDH for OT and Physio,

  • Recently discharged from hospital following CVA

  • Patient complaining of poor saliva management and you notice when drinking in sessions patient clearing her throat.

  • Patient feels generally well in herself

  • How would you manage this?


Questions

Questions


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