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WRHA Long-Term Care

Speech-Language Pathology Services

WHOM do we service?

  • 38 long term care homes, approximately 5706 beds in the WRHA

WHAT services do we provide for residents, facilities and families?

  • Swallowing and communication assessment, consultation & education

WHAT does a SWALLOWING CONSULTATION include?

  • CLINICAL swallowing assessment within the resident’s LTC facility
  • INSTRUMENTAL swallowing assessment (i.e., Video fluoroscopic swallowing study – VFSS) is available with SLP recommendation and with physician diagnostic imaging requisition order
  • EDUCATION for residents/family/staff.  SLP provides counseling and education to residents, families, and team members regarding the nature and management of a resident’s swallowing disorder, associated risks, available interventions, and anticipated outcomes
  • CONVERSATIONS regarding END-OF-LIFE and QUALITY of LIFE related to the progression of swallowing difficulties and how they may impact decision making
  • MANAGEMENT of swallowing, including diet texture modifications and resident-specific safe-feeding and swallowing strategies
  • COLLABORATION with other disciplines (e.g., RD, OT, nursing, Dental, GI) as swallowing difficulties may be impacting or be impacted by other factors.

Referral Criteria: Swallowing Assessment

  • Any signs/symptoms of possible swallowing difficulty on meal observation screening (MOS) or reported by staff/family/resident
  • Choking event – urgent referral
  • Significant change in swallowing, absent swallow or query NPO status – urgent referral
  • Recurrent chest infections
  • Admitted with tube feed
  • Continuation of care from acute care for follow-up of swallowing recommendations and re-assessment for any possible changes
  • Potential for diet texture upgrades – includes residents admitted on most restrictive diet textures (e.g., pureed diet, thickened fluids)
  • Family could benefit from education related to swallowing difficulties, associated risks, available interventions, end-of life swallowing and anticipated outcomes

WHAT does a COMMUNICATION CONSULTATION include?

Direct treatment for communication impairments is not available. Our focus is on assessment of functional abilities and providing recommendations and limited training in the use of strategies to facilitate residents’ communication with staff and family.

Referral Criteria: Communication Assessment

  • Sudden change in communication (speech, language or cognitive-linguistic communication)
  • Possible benefit from augmentative-alternative communication – initial assessment may lead to further referral to Communication Devices Program
  • Possible benefit from SLP therapy – LTC SLP can provide brief assessment to determine candidacy for therapy and provide information regarding how to access public or private SLP therapy
  • Family/staff could benefit from education regarding communication strategies for individual residents

HOW TO REFER?

SPEECH-LANGUAGE PATHOLOGY REFERRAL FORM

Any member of the medical team may refer for swallowing assessments or communication assessments.

ANNUAL TRAINING

FEEDING/SWALLOWING MANAGEMENT of RESIDENTS in LONG TERM CARE

Training Resources:

  • Mealtime Assistant Training (MAT) for Volunteers & Families (video) (pdf)
  • Diet Order Training (video) (pdf)
  • Dysphagia Management Staff Training (DMST) (video) (pdf)
  • Management of Obstructed Airway Training (ask your LTC site educator for specific training)
  • Safe Feeding & Swallowing management Quiz (pdf)

Other Resources:

  • Standard feeding procedures (pdf)
  • Diet Texture Quick Reference Chart (pdf)
  • Swallowing difficulties brochure English/ French (pdf)
  • Oral medication administration guidelines for residents with dysphagia (pdf)
  • Conversations in Long-Term Care (see below):
    1. Meals in LTC home (English/ French)
    2. Difficulties with meals for people with dementia (English/ French)
    3. When a person has trouble eating and swallowing (English/ French)
    4. Nourishing the whole person (English/ French)
    5. Nutrition and swallowing at the end of life (English/ French)

Click here for a pdf of the contents of this webpage.

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