SPHP 219 class:SPHP 219 class:

Any slides with asterisks are NOT on the exam

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

Assisted Living Assisted Living FacilitiesFacilities

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

Home HealthHome Health

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?