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Prevention Profile: A Prevention Approach to Dysphagia Rehabilitation

From the  ASHA Leader
by Fred Schmidt

For Sherry Curtiss, a North Carolina speech-language pathologist, education is the foundation for dysphagia rehabilitation. She found an effective way to put this into practice through prevention activities during May Is Better Hearing and Speech Month (BHSM).

"Since I began my work, I've felt that if people knew what a hearing and speech specialist did, they'd appreciate the role of patient care and rehabilitation," said Curtiss, who is on the staff of Guardian Care in Rocky Mount. "But what we do is harder to understand and is certainly less known than what a doctor or a physical therapist does. We all have the same goal and that is return the patient--as much as possible--to good health and function."

In preparation for BHSM, Curtiss paid personal visits to local businesses and community groups to educate them about the importance of prevention and intervention for communication, cognition, hearing, and swallowing disabilities. She also distributed brochures describing the mission of speech-language pathologists (SLPs).

"I was surprised at how few people really understood what our mission is," Curtiss said. "One man I talked with wasn't familiar with SLPs even though his father had a stroke. That really surprised me. It also points to the need for some kind of program for SLPs to let others know what we do and how we can help them."

Health care colleagues also need to understand the contributions made by speech and language professionals to patient rehabilitation, Curtiss says. She believes that any effort to educate health care workersÑfrom doctors to aidesÑ improves the recovery process. Family support for treatment also is crucial.

"Everyone understands other rehabilitation activities, like exercise, changing dressings, and giving out medications. But unless you tell them, staff members may not know how important swallowing exercises are to patient outcomes," noted Curtiss. "This is especially true for the weekend staff. They often feel isolated from the rest of the facility's employees. But when I've taken the time to explain my part in patient rehabilitation, they make an effort to help any way they can."

As part of her prevention activities for BHSM, Curtiss encouraged members of the facility's staff to collaborate to help patients and their families. She organized teams and an awards ceremony to recognize those who were active in prevention activities. Prizes donated by local merchants were distributed to people selected by their team members and to the staff member who displayed the greatest understanding of swallowing difficulties.

I wanted to design something that would capture everyone's attention and make them see each other in a new light. It helped because everyone could interact in a different framework than that of just 'patient and staff,'" said Curtiss.

"I know what my patients get from SLPs," she said. "If you've had a stroke and can't swallow, helping dysphagia treatment is just as critical as any other procedure. It's a matter of life and death. We must make people understand, not only for our patients but also for our profession.

"In a nursing home, reimbursement plans and company requirements are always going to change. But the fundamental principles of what an SLP does should not and cannot change," Curtiss said.

"Over time, the goal is to maximize the quality of care and the quality of life for patients. Clinicians play a key role--as part of an interdisciplinary team approach."

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