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The Diet Waiver Alternative: How to Advocate for Patients’ Rights

presented by Jeanette E. Benigas, PhD, SLP and Pamela A. Smith, PhD, CCC-SLP, ASHA Fellow

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Disclosure Statement:

Financial: Jeanette E. Benigas receives compensation from MedBridge for this course. She also receives royalty payments from Health Professions Press for the publication of the book Spaced Retrieval Step by Step: An Evidence-Based Memory Intervention.
Financial: Pamela A. Smith receives compensation from MedBridge for this course. She also receives stipends from Relias and the University of St. Augustine for Health Sciences, Moravian University, and Ohio University. She has no other relevant financial relationships.

Nonfinancial: Jeanette E. Benigas is a founding member of the Fix SLP platform and the SLP Data Initiative. She is the cohost of the Fix SLP and Other SLPs’ Pockets podcasts. She has no competing nonfinancial interests or relationships with regard to the content presented in this course.
Nonfinancial: Pamela A. Smith has no competing nonfinancial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

MedBridge is committed to accessibility for all of our subscribers. If you are in need of a disability-related accommodation, please contact [email protected]. We will process requests for reasonable accommodation and will provide reasonable accommodations where appropriate, in a prompt and efficient manner.

Accreditation Check:
Video Runtime: 182 Minutes; Learning Assessment Time: 70 Minutes

This course provides the legal background surrounding patients' and residents' rights in directing their own care specifically related to dysphagia and diet consistency recommendations. It includes interviews with individuals who have served as expert witnesses as well as an attorney who specializes in this area of elder care. We discuss the reasons for this problem, how to approach the conversations, examples of positive and negative conversations, documentation suggestions, and the problems associated with waivers. We provide a template for use in planning team meetings where these topics can be discussed with families. The course is intended for any professionals involved in eating and swallowing management or oversight.

Meet Your Instructors

Jeanette E. Benigas, PhD, SLP

Jeanette E. Benigas is the owner of Safe Swallowing Diagnostics, a mobile FEES company serving eastern Ohio and western Pennsylvania. Her extensive clinical experience has included work with adults in acute care, inpatient rehabilitation, post-acute rehabilitation, long-term care, home health, and outpatient settings. Benigas's research interests include improving the quality of life for persons with…

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Pamela A. Smith, PhD, CCC-SLP, ASHA Fellow

Pamela A. Smith has been a speech-language pathologist for 35 years with experience in acute care, acute rehab, skilled nursing, and outpatient settings. Dr. Smith completed her undergraduate education at Kutztown University (Pennsylvania) with a degree in special education - speech/language pathology, her master's degree at Ohio University (hearing and speech sciences), and her doctoral…

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Chapters & Learning Objectives

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1. The Right to Decide

We discuss the Patient Self-Determination Act, what it means for patients and residents as they direct their own care, and the requirements of care providers. Discussion includes the possible penalties if we do not follow the law.

2. Safe Swallowing and Pneumonia

We describe the science behind the development of pneumonia. This provides the clinician with necessary knowledge to participate in discussions with the medical team about the reality of the relationship between aspiration and potential for negative consequences.

3. Linking Legal and Clinical, Part 1

Individuals who have served as expert witnesses describe their experiences. We learn about cases that have come to litigation, the task of being an expert witness, and observations these individuals made about case management and documentation.

4. Linking Legal and Clinical, Part 2

We interview Michael Hill, an elder attorney, who shares his observations and insights on cases that come to litigation. He describes the importance of following the process of informed consent to demonstrate that patients/residents have been able to participate in their own care. We also discuss the problems with waivers and the necessity of documentation of conversations.

5. From Information to Conversation

Learn how to have nonbiased conversations in team meetings so that patients/residents and their families can receive the information they need to make informed decisions. We provide simulations of both biased and nonbiased conversations.

6. Administrative Challenges

It can be difficult for a clinician to navigate change in the facility if administrative staff are reluctant or fearful. We discuss the importance of having open conversations, addressing the priorities of the specific listener, recognizing the source of their reluctance, and ensuring that the clinician approaches the conversation with full preparation of theory and patient-specific information.

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