Speech Therapy - HumanGood



|Speech Therapy H5MAPR0256 | |

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|Purpose |The purpose of this procedure is to identify, assess and treat speech and language problems including swallowing |

| |disorders. |

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|Preparation |Review the resident’s care plan to assess for any special needs of the resident. |

| |Assemble the equipment and supplies as needed. |

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|General Guidelines |Speech therapists treat stroke survivors and other brain injury survivors who experience impaired ability to |

| |swallow or have difficulty expressing thought or understanding language. These residents may experience: |

| |Aphasia–Expressive aphasia is a problem with what to say. Receptive aphasia is a problem with understanding what |

| |has been said. |

| |Anomia–a word finding problem. |

| |Dysarthria–muscles of the lips, tongue and other body parts used for speech are weaker than normal. |

| |Dysphagia–difficulty in chewing or swallowing. |

| |Apraxia–a disorder of the nervous system that affects the ability to sequence and say sounds, syllables and words.|

| |The speech therapist works with other rehabilitation and medical professionals and families to provide a |

| |comprehensive evaluation and treatment plan for residents with any of the problems in speech listed in paragraph |

| |one (1) above. |

| |Communicating with the elderly will sometimes require extra time and patience due to physical, psychological and |

| |social changes of normal aging. |

| |Speech Language Assessment |

| |The speech therapist completes an assessment of the following speech and language skills: |

| |Fluency, vocal quality and loudness, and the pronunciation and clarity of speech. |

| |Strength and coordination of the speech muscles. |

| |Understanding and use of vocabulary (semantics) and understanding and use of grammar (syntax). |

| |Understanding and answering both yes/no and Who, What, When, Where, How questions (e.g., What do you do with a |

| |hammer?). |

| |Understanding extended speech. The resident listens to a short story or factual passage and answers fact-based |

| |(the answers are in the passage) and inferential (the resident must arrive at a conclusion based on information |

| |gathered from the reading) questions about the material. |

| |Ability to follow directions that increase in both length and complexity. |

| |Ability to tell an extended story (language sample), both verbal and written form. |

| |Ability to describe the “plot” in an action picture. |

| |Coherence of narrative. |

| |Ability to recall words he/she needs to express ideas. |

| |Expression of thoughts (complete sentences, telegraphic sentences or phrases, or single words). |

| |Clarity of speech (slurred speech/difficult to understand or intelligible). |

| |Social communication skills (pragmatic language). |

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|General Guidelines (continued) |continues on next page |

| |Ability to interpret or explain jokes, sarcastic comments, absurdities in stories or pictures (e.g., What is |

| |strange about a person using an umbrella on a sunny day?). |

| |Proficiency with initiating conversation and conversational topics, taking turns during a discussion, and |

| |expressing thoughts clearly using a variety of words and grammatical constructions. |

| |Ability to clarify communication when his/her conversational partner does not understand. |

| |Ability to read and write letters, words, phrases, sentences and paragraphs. The speech therapist may look at the |

| |quality of the language expression, accuracy of spelling, and letter formation and spacing of words and letters on|

| |the page (to identify or rule out possible movement and/or visual-perceptual difficulties). |

| |Ability to swallow. |

| |Ability to use an alternative communication aid (as needed). |

| |Speech Therapy Treatment |

| |The speech therapist works on drills and exercises to improve specific language skills affected by damage to the |

| |brain (e.g., the resident may practice naming objects, following directions, answering questions about stories, |

| |etc.). These exercises vary depending on the resident’s needs. |

| |The speech therapist teaches the resident ways to make use of stronger language skills to compensate for weaker |

| |language skills. (e.g., Some residents may find it easier to express their ideas through gestures and writing than|

| |with speaking. The speech therapist may teach this resident to use both writing and gestures to help remember |

| |words for conversation.) |

| |The speech therapist uses a communication board to help the resident who cannot speak to express his/her ideas. |

| |If there is weakness of speech muscles, the speech therapist teaches exercises to strengthen these muscles. |

| |Before you begin your conversation, reduce background noises that may be distracting (turn off the television or |

| |radio, close the door, etc.). |

| |Begin conversation with casual topics (e.g., weather). |

| |Continue conversation with familiar subjects such as family members. |

| |Be consistent with the topic of conversation. Avoid quick shifts from topic to topic. |

| |Keep your sentences and questions short. |

| |Allow extra time for responding. Don’t rush the resident. |

| |Be an active listener. |

| |After your visit, tell others who visit (family members, physicians, nurses, aides, etc.) what you’ve learned to |

| |improve communication with the resident. |

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|Documentation |The following information should be recorded in the resident’s medical record: |

| |The date and time the speech therapy was provided. |

| |The name and title of the individual(s) who provided the speech therapy. |

| |All assessment data obtained during the speech therapy. |

| |If the resident refused the therapy, the reason(s) why and the intervention taken. |

| |The signature and title of the person recording the data. |

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|Reporting |Notify the supervisor if the resident refuses the speech therapy. |

| |Report other information in accordance with facility policy and professional standards of practice. |

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|References |

|MDS (CAAs) |Section O |

|Survey Tag Numbers |F406 |

|Related Documents | |

|Risk of Exposure |Blood–Body Fluids–Infectious Diseases–Air Contaminants–Hazardous Chemicals |

|Procedure |Date:________________ By:__________________ |

|Revised |Date:________________ By:__________________ |

| |Date:________________ By:__________________ |

| |Date:________________ By:__________________ |

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