4.10 (4.10) SLP in PC

Question 1

What phase of swallowing are SLPs involved in the management of?

Answer 1

dysphagia in the oropharyngeal stage

Question 2

SLP is not always indicated in the setting of PC if a patient is not likely to have an improvement in function or QOL. List five principles for guiding the involvement of SLP in the care of a palliative patient

Answer 2

• assess only as required to provide answers to plan management
• minimum interventions for maximum gain
• maintain function where possible
• improve function if probable and realistic
• utilize compensatory strategies, diet modifications, and safe swallow strategies
• work as member of multidisciplinary team
• provide holistic individual centred care
• facilitate communication between individual and team
• provide education and information
• advise on risk benefit evaluation

Question 3

A patient is admitted to your PCU and SLP has not been involved in the care of the patient. List four signs, symptoms, or situations that would suggest an SLP referral is appropriate

Answer 3

persistent throat clearing or coughing during or after eating or drinking

symptoms such as general weakness and mental status changes

changes in medical diagnosis such as recent stroke or thyroid disease

introduction of new medications particularly if these are likely to impact on LOC or used to tx oropharyngeal symptoms (ie. oral pain meds for throat ca)

recurrent asp pna

significant weight loss of greater then 5-10% or recurrent episodes of dehydration

SOB

taking longer then usual to eat or drink

pain/discomfort with swallowing

difficulty initiating swallow

Question 4

A patient you are following on the PCU is found to have issues with asp. What are three general categories of intervention that an SLP may use

Answer 4

compensatory (ie. change in food consistency)

Rehabilitative - improve strength /speed/timeliness of swallow

Compensatory/rehabilitative - are compensatory but may lead to improved swallowing without continuing the intervention in the longer term (ie. super supraglottic swallow, increased sensory stimulation with flavours)

Question 5

You have a patient with COPD who has frequent non-infectious exacerbations of his COPD. What condition can contribute to this that an SLP can assist with? What are the benefits of SLP involvement?

Answer 5

dysphagia with silent aspiration

improvement in self-management and swallowing related QOL , physical problems of dysphagia, managing diet options and food selection

Question 6

What four communication issues are commonly addressed by SLPs?

Answer 6

dysphasia/aphasia - difficulty understand and/or using spoken or written language

dysarthria - impaired speech due to muscle weakness

dyspraxia/apraxia - difficulty forming speech sounds and words due to impaired motor programming

dysphonia - voice impairment

Question 7

What are three causes of hoarseness in COPD?

Answer 7

GERD
xerostomia
inhaled ICS

Question 8

Name 5 common disorders an SLP referral may be indicated

Answer 8

Brain cancer
Stroke
Dementia
Neurological conditions (ALS, parkinson’s)

Head and neck cancer
Lung cancer/COPD