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The Yale Swallow Protocol is an evidence-based protocol that is the only screening instrument that both identifies aspiration risk and, when passed, is able to recommend specific oral diets without the need for further instrumental dysphagia testing. Based upon research by Drs. Steven B. Leder and Debra M. Suiter, an easily administered, reliable and validated swallow screening protocol was developed and can be used by speech-language pathologists, nurses, otolaryngologists, oncologists, neurologists, intensivists and physicians assistants. In addition, the protocol can be used in a variety of environments, including acute care, rehabilitation and nursing homes. The Yale Swallow Protocol meets all of the criteria necessary for a successful screening test, including being simple to administer, cross-disciplinary, cost effective, acceptable to patients and able to identify the target attribute by giving a positive finding when aspiration risk is present and a negative finding when aspiration risk is absent. Additionally, early and accurate identification of aspiration risk can significantly reduce health-care costs associated with recognized prandial aspiration.
This text is a reliable, validated, anatomically defined, and image-based tool to determine residue location and severity when performing fiberoptic endoscopic evaluation of swallowing (FEES). Based upon research by Drs. Leder and Neubauer, an easily interpreted, readily learned, and hierarchically organized pharyngeal residue severity rating scale was developed for speech-language pathologists, otolaryngologists, and other health care professionals who perform and interpret FEES. The Yale Pharyngeal Residue Severity Rating Scale works equally well for any swallow of interest, whether it is the first, subsequent clearing, or last swallow. The endoscopist simply has to match their chosen swallow with its scale mate. The Yale Pharyngeal Residue Severity Rating Scale can be used for both clinical advantages and research opportunities. Clinically, clinicians can now accurately classify vallecula and pyriform sinus residue severity as none, trace, mild, moderate, or severe for diagnostic purposes, determination of functional therapeutic change, and precise dissemination of shared information. Research uses include tracking outcomes for clinical trials, investigating various swallowing interventions, demonstrating efficacy of specific interventions to reduce pharyngeal residue, determining morbidity and mortality associated with pharyngeal residue in different patient populations, and improving the training and accuracy of FEES interpretation by students and clinicians. The Yale Pharyngeal Residue Severity Rating Scale is an important addition to the deglutologist’s tool box.
Intro -- Foreword -- Acknowledgements -- Contents -- Part I: Nutritional Care in Geriatrics -- 1: Overview of Nutrition Care in Geriatrics and Orthogeriatrics -- 1.1 Defining Malnutrition -- 1.2 Nutrition Care in Older Adults: A Complex and Necessary Challenge -- 1.3 Malnutrition: A Truly Wicked Problem -- 1.4 Building the Rationale for Integrated Nutrition Care -- 1.5 Managing the Wicked Nutrition Problems with a SIMPLE Approach (or Other Tailored Models) -- 1.5.1 Keep It SIMPLE When Appropriate -- 1.5.2 A SIMPLE Case Example -- 1.5.2.1 S-Screen for Malnutrition -- 1.5.2.2 I-Interdisciplinary Assessment -- 1.5.2.3 M-Make the Diagnosis (es) -- 1.5.2.4 P-Plan with the Older Adult -- 1.5.2.5 L-Implement Interventions -- 1.5.2.6 E-Evaluate Ongoing Care Requirements -- 1.6 Bringing It All Together: Integrated Nutrition Care Across the Four Pillars of (Ortho) Geriatric Care -- 1.7 Summary: Finishing Off with a List of New Questions -- References -- Recommended Reading -- 2: Nutritional Requirements in Geriatrics -- 2.1 Nutritional Recommendations for Older Adults, Geriatric and Orthogeriatric Patients -- 2.2 Nutritional Recommendations for Older Adults -- 2.2.1 Energy Requirement and Recommended Intake -- 2.2.2 Protein Requirement and Recommended Intake -- 2.2.3 Micronutrients and Dietary Fibers -- 2.3 Nutritional Risk Factors in Older Adults -- 2.4 Estimating Intake in Older Adults -- 2.5 Nutritional Status of Older Adults, Geriatric and Orthogeriatric Patients -- 2.6 Summary -- References -- Recommended Reading -- 3: Nutritional Assessment, Diagnosis, and Treatment in Geriatrics -- 3.1 The Nutrition Care Process -- 3.2 Nutritional Screening/Risk Detection -- 3.3 Nutritional Assessment and Diagnosis -- 3.3.1 Nutrition Impact Symptoms -- 3.3.2 Nutritional Diagnosis -- 3.3.3 Etiologic Criteria.
This book is a clinical manual that covers the whole spectrum of swallowing and its disorders. It starts with physiology of swallowing, pathophysiology of disordered deglutition, diagnostic methods (clinical and instrumental) and ends with an in-depth’s and up-to-date presentation of current treatment options. The clinically most relevant topics of dysphagia management on the stroke unit and the intensive care unit are dealt with in separate chapters. Also the closely intertwined issue of nutritional management is specifically addressed. Most importantly, the book covers all obligatory topics of the Flexible Endoscopic Evaluation of Swallowing (FEES)-curriculum, an educational initiative that started in Germany in 2014 and is currently being extended to other European and non-European countries. The book is richly illustrated and an online video section provides a number of typical patient cases. FEES is probably the most commonly chosen method for the objective assessment of swallowing and its disorders. It is used in stroke units, intensive care facilities, geriatric wards but also in rehabilitation clinics and within dedicated outpatient services. This book on neurogenic dysphagia therefore addresses a wide range of different medical disciplines, such as neurologists, geriatricians, intensive care physicians, rehabilitation physicians, gastroenterologists, otolaryngologists, phoniatrists and also speech-language pathologists.
Now with videos! Dysphagia Following Stroke, Third Edition is a practical and easy-to-use resource for clinicians treating swallowing disorders in the stroke population. The authors bridge the gap between academic and clinical practice with up-to-date research and clinical case examples throughout. In addition to a thorough overview of dysphagia diagnosis and management, this text focuses heavily on evaluation and management of stroke. Key topics include neural underpinnings of normal and disordered swallowing, swallowing screening, the clinical swallowing examination including cough reflex testing, the expanding array of instrumental swallowing modalities, and the rehabilitation of swallowing including strength training, non-invasive brain stimulation, and skill training. While geared toward practicing clinicians, Dysphagia Following Stroke is also useful for students in professional training programs. New to the Third Edition: A third author, Kristin Gozdzikowska, bring a fresh perspective as a young clinician and researcher with particular expertise in high resolution manometry and various cutting-edge treatment techniquesNew larger 6" x 9" trim sizeUpdated chapters on assessment to include new and emerging instrumental technologies, including high resolution manometry, impedance, and ultrasoundUpdated chapters on management to include the newly described International Dysphagia Diet Standardization InitiativeNew and expanded framework for rehabilitation, with a shift from peripherally focused rehabilitation to neuromodulation of cortical swallowing controlNew and updated research and trends in clinical practice throughoutIncludes videos This thoroughly updated and enhanced edition of Dysphagia Following Stroke is sure to remain a valued resource for clinicians working with stroke patients in all settings. Disclaimer: Please note that ancillary content (such as documents, audio, and video, etc.) may not be included as published in the original print version of this book.
Clinical Case Studies for the Family Nurse Practitioner is a key resource for advanced practice nurses and graduate students seeking to test their skills in assessing, diagnosing, and managing cases in family and primary care. Composed of more than 70 cases ranging from common to unique, the book compiles years of experience from experts in the field. It is organized chronologically, presenting cases from neonatal to geriatric care in a standard approach built on the SOAP format. This includes differential diagnosis and a series of critical thinking questions ideal for self-assessment or classroom use.
Implement FEES successfully into your practice! In the 10 years since Dr. Langmore pioneered and described endoscopic technique for evaluating pharyngeal swallowing function, the use of FEES (flexible endoscopy) has grown exponentially. The procedure is used throughout the world, with workshops held to sold-out attendance; demand for training materials continues unabated. Now there is one book that comprehensively covers the role of endoscopy in the assessment and treatment of oropharyngeal dysphagia. Written in step-by-step detail by the creator of the technique, the book gives you all the information you need to implement FEES in your practice. It offers valuable comparisons to other imaging tools, especially fluoroscopy, showing how this portable technique is the most efficient and cost-effective for patients who cannot easily be transported to a hospital. Highlights of the book: Comprehensive review of anatomy/physiology of oral & pharyngeal musculature Provides FEES protocol sheets for complete how-to instruction Shows how to score a FEES examination & possible abnormal findings Demonstrates the use of endoscopy in a wide range of populations infants, children, and geriatric patients, and those with head and neck cancer Lays out rehabilitative & compensatory techniques for each dysphagia problem Summarizes safety data from the three largest clinical studies ever undertaken Includes dozens of "best practice" case studies
THE ADULT SPEECH THERAPY WORKBOOK is your go-to resource for handouts and worksheets. It was designed for speech therapists new to adult speech therapy and covers the most common diagnoses and disorders across all adult speech therapy settings, from hospitals, to skilled nursing facilities, to home health. This workbook is packed with over 580 pages of practical, evidenced-based treatment material.
In this intimate portrait of an extraordinary father-son relationship, Mark K. Shriver discovers the moral principles that guided his legendary father and applies them to his own life When Sargent "Sarge" Shriver—founder of the Peace Corps and architect of President Johnson's War on Poverty—died in 2011 after a valiant fight with Alzheimer's, thousands of tributes poured in from friends and strangers worldwide. These tributes, which extolled the daily kindness and humanity of "a good man," moved his son Mark far more than those who lauded Sarge for his big-stage, headline-making accomplishments. After a lifetime searching for the path to his father's success in the public arena, Mark instead turns to a search for the secret of his father's joy, his devotion to others, and his sense of purpose. Mark discovers notes and letters from Sarge; hears personal stories from friends and family that zero in on the three guiding principles of Sarge's life—faith, hope, and love—and recounts moments with Sarge that now take on new value and poignancy. In the process, Mark discovers much about himself, as a father, as a husband, and as a social justice advocate. A Good Man is an inspirational and deeply personal story about a son discovering the true meaning of his father's legacy.