sphp 219 class:sphp 219 class: any slides with asterisks are not on the exam
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Working with Adults**Working with Adults**
Geriatrics vs Pediatrics?
Does the setting in which adults are being treated make a difference?
Post-Acute SettingsPost-Acute Settings
Long Term Acute Care (LTAC)
Skilled Nursing Facility (SNF)
Assisted Living Facilities
Home Health
LTACLTAC
Post-Acute, but patient required intensive medical care
Tracheostomy & Ventilator Needs Severe CVAs with global effects Rehab (PT, OT, SLP) often a main focus Select Specialty Hospitals NPO, PEG Tubes, AAC, very limited language
Assisted Living Assisted Living FacilitiesFacilities
For “residents” who maintain some level of safety at an independent level
Non-acute “residents” who need little nursing or rehab care
Typically one-bedroom apartments with private bathrooms and kitchenette
Nursing staff available on-call, or ONE nurse overnight on staff.
Home HealthHome Health
Provides in-home healthcare services typically after an acute-care stay
Nursing, Social Work, Physical Therapy, Occupational Therapy
And…Speech “Therapists.”
Give up on Speech Pathologist…lol.
Skilled Nursing FacilitySkilled Nursing Facility
Nursing Home
Split between long-term care (e.g., dementia units) and short-term rehabilitation.
Medicare and MediCAL funded.*
Rehab Driven…$$$
SNFsSNFs
Patients who need 24-hour care, but no longer need acute care.
Specific Rehabilitation needs CVA’s, post-orthotic surgery, Parkinson’s
Patient’s admitted on short-term basis typically leave facility after completion of therapy.
Combination of hospital and home (?)
Factors Working Against SLPsFactors Working Against SLPs
Multiple health problems
Depression due to illness and current placement
Surrounding can be difficult to deal with.
Hopelessness, what’s going to happen next?
Dreaded word: NURSING HOME
Factors Working Against SLPs Factors Working Against SLPs and Service Deliveryand Service Delivery
Children VS Adult’s
Similar family dynamics
Making a case for SLP services…people like to eat and talk…
SLP required to screen EVERY patient
Engage the patient, find about them and incorporate that into therapy.
What Not to Say**What Not to Say**
Dysphagia, Phonology, Morphology…
Mortuary
Diarrhea
Jaws of Life
Bring it down a notch
How would you explain How would you explain this to a family or this to a family or
patient?**patient?** Your father has severe pharyngeal dysphagia and
may need a j-tube or g-tube.
What if he doesn’t get better?
What if you get a patient whose “looked of strokes online” and knows everything about strokes now?
How do you explain to a family that you just evaluated their 98 old mother and you are recommending NPO?