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see also: Main Story | To Determine Care Level | References
Mr. J.W., 82, was referred to speech services by the Visiting Nurse Service of New York due to decreased speech intelligibility related to Parkinson's disease.
During the evaluation in the patient's home, the speech-language pathologist also completed a speech telepractice screening protocol. She determined that the home environment, client/caregiver capabilities, and recommended treatment interventions could be delivered appropriately with a combination of home and telepractice visits. The patient and family consented to the delivery of service using both methods.
The field SLP established a plan of care with the patient and obtained orders from the physician for one home visit per week and three telepractice sessions per week for speech/voice treatments.
During the course of treatment, the field SLP obtained objective SPL levels for loudness on a weekly basis while in the home and established the home exercise program. The program consisted of LSVT® (Lee Silverman Voice Treatment) daily exercises and other transfer activities for carryover of improved speech and voice production in functional activities. The patient participated in interactive speech telepractice sessions conducted by the speech clinical specialist, which followed the identical plan of care as established by the field SLP.
The patient made excellent progress, achieving >95% intelligibility at discharge. Over a five-week period he received five in-home patient treatments with 12 speech telepractice treatments. The patient's satisfaction was 4.8 on a Likert scale of 1-5, with 5 indicative of a highly satisfied rating.
The patient and his wife reported that speech telepractice services positively affected his clinical outcome and plan of care.
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