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Counseling in the Post-Acute setting

Counseling in the Post-Acute setting. Aaron Reese, EdD, CCC-SLP November 15, 2012. SPHP 219 class:. Any slides with asterisks are NOT on the exam . Working with Adults**. Geriatrics vs Pediatrics? Does the setting in which adults are being treated make a difference?. Post-Acute Settings.

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Counseling in the Post-Acute setting

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  1. Counseling in thePost-Acute setting Aaron Reese, EdD, CCC-SLP November 15, 2012

  2. SPHP 219 class: Any slides with asterisks are NOT on the exam 

  3. Working with Adults** Geriatrics vs Pediatrics? Does the setting in which adults are being treated make a difference?

  4. Post-Acute Settings Long Term Acute Care (LTAC) Skilled Nursing Facility (SNF) Assisted Living Facilities Home Health

  5. LTAC • 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

  6. Assisted Living Facilities

  7. Assisted Living Facilities

  8. Assisted Living Facilities 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.

  9. Home Health

  10. Home Health

  11. Home 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.

  12. Skilled Nursing Facility Nursing Home Split between long-term care (e.g., dementia units) and short-term rehabilitation. Medicare and MediCAL funded.* Rehab Driven…$$$

  13. SNFs • 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 (?)

  14. Factors 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

  15. Factors Working Against SLPs and 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.

  16. What Not to Say** Dysphagia, Phonology, Morphology… Mortuary Diarrhea Jaws of Life Bring it down a notch

  17. How would you explain this to a family or 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?

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