The ASHA Leader - February 2015 - 53
Rosemary is nonambulatory, alert and
conversational at times. She has the classic
problems with oral-stage dysphagia, including
prolonged chewing and pocketing and refusal of
food. I determined that Rosemary, as well as her
caregivers, would be good short-term candidates
for "rehab light." I counseled her husband and
daughters on meal timing, size and textures that
would best motivate Rosemary to take food by
mouth. I partnered with them as they slowly
understood how to balance tube and mouth feeds
for optimal nutritional support. On my fourth and
final visit, I scheduled a three-month re-evaluation
to determine if there was any change of status that
would warrant moving her into "rehabilitation in
reverse."
You might wonder: Why not just let the nurse or
dietician handle all the instruction and teaching?
Because we are the medical professionals who
are the most knowledgeable and skilled to
provide this training and instruction. Delivering
holistic treatment is part of our responsibility on
interdisciplinary, palliative care teams.
This brings me to what I call the "soft side"
of caring for those with advanced illness. At
the Level 1 trauma center where I worked for
20 years, it was typical for chaplains or social
workers to address emotional or spiritual
issues, giving me the impression that these
aspects weren't my responsibility. Yet the Joint
Commission, in a 2003 article (bit.ly/emotionalneeds), maintains that "nurses, physicians,
clinicians and other caregivers play equally
important roles" when it comes to such matters.
And so it is that I've come to appreciate that
addressing the psychological, social and spiritual
needs of our patients and their caregivers is the
responsibility of every single one of us.
Maggie Vescovich, MS, CCC-SLP, is a speech-language
pathologist at holy redeemer home Care and hospice
in philadelphia and section leader of the allied Therapy
section for the National hospice and palliative Care
organization. she is an affiliate of asha special Interest
group 15, gerontology.
mvescovich@holyredeemer.com
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The ASHA Leader - February 2015
Table of Contents for the Digital Edition of The ASHA Leader - February 2015
Contents
The ASHA Leader - February 2015 - Intro
The ASHA Leader - February 2015 - Cover1
The ASHA Leader - February 2015 - Cover2
The ASHA Leader - February 2015 - Contents
The ASHA Leader - February 2015 - 2
The ASHA Leader - February 2015 - 3
The ASHA Leader - February 2015 - 4
The ASHA Leader - February 2015 - 5
The ASHA Leader - February 2015 - 6
The ASHA Leader - February 2015 - 7
The ASHA Leader - February 2015 - 8
The ASHA Leader - February 2015 - 9
The ASHA Leader - February 2015 - 10
The ASHA Leader - February 2015 - 11
The ASHA Leader - February 2015 - 12
The ASHA Leader - February 2015 - 13
The ASHA Leader - February 2015 - 14
The ASHA Leader - February 2015 - 15
The ASHA Leader - February 2015 - 16
The ASHA Leader - February 2015 - 17
The ASHA Leader - February 2015 - 18
The ASHA Leader - February 2015 - 19
The ASHA Leader - February 2015 - 20
The ASHA Leader - February 2015 - 21
The ASHA Leader - February 2015 - 22
The ASHA Leader - February 2015 - 23
The ASHA Leader - February 2015 - 24
The ASHA Leader - February 2015 - 25
The ASHA Leader - February 2015 - 26
The ASHA Leader - February 2015 - 27
The ASHA Leader - February 2015 - 28
The ASHA Leader - February 2015 - 29
The ASHA Leader - February 2015 - 30
The ASHA Leader - February 2015 - 31
The ASHA Leader - February 2015 - 32
The ASHA Leader - February 2015 - 33
The ASHA Leader - February 2015 - 34
The ASHA Leader - February 2015 - 35
The ASHA Leader - February 2015 - 36
The ASHA Leader - February 2015 - 37
The ASHA Leader - February 2015 - 38
The ASHA Leader - February 2015 - 39
The ASHA Leader - February 2015 - 40
The ASHA Leader - February 2015 - 41
The ASHA Leader - February 2015 - 42
The ASHA Leader - February 2015 - 43
The ASHA Leader - February 2015 - 44
The ASHA Leader - February 2015 - 45
The ASHA Leader - February 2015 - 46
The ASHA Leader - February 2015 - 47
The ASHA Leader - February 2015 - 48
The ASHA Leader - February 2015 - 49
The ASHA Leader - February 2015 - 50
The ASHA Leader - February 2015 - 51
The ASHA Leader - February 2015 - 52
The ASHA Leader - February 2015 - 53
The ASHA Leader - February 2015 - 54
The ASHA Leader - February 2015 - 55
The ASHA Leader - February 2015 - 56
The ASHA Leader - February 2015 - 57
The ASHA Leader - February 2015 - 58
The ASHA Leader - February 2015 - 59
The ASHA Leader - February 2015 - 60
The ASHA Leader - February 2015 - 61
The ASHA Leader - February 2015 - 62
The ASHA Leader - February 2015 - 63
The ASHA Leader - February 2015 - 64
The ASHA Leader - February 2015 - 65
The ASHA Leader - February 2015 - 66
The ASHA Leader - February 2015 - 67
The ASHA Leader - February 2015 - 68
The ASHA Leader - February 2015 - 69
The ASHA Leader - February 2015 - 70
The ASHA Leader - February 2015 - 71
The ASHA Leader - February 2015 - 72
The ASHA Leader - February 2015 - Cover3
The ASHA Leader - February 2015 - Cover4
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