The Speech-Language Pathologist’s Role at End of Life: A
Clinician Primer (Recorded Webinar)
Presented by Annette Askren
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Speech-language pathologists (SLPs) are now integral members of multidisciplinary end-of-life care teams. Medical SLPs serve as expert consultants to promote quality of life in adults with communication and swallowing difficulties during this stage. This webinar will review the evidence base that describes the SLP’s role in the assessment and management of oropharyngeal swallowing, communication, and cognitive difficulties experienced by the adult at end of life. A complex case study will illustrate the application of this knowledge.
Learning Objectives
- Distinguish the role of the speech-language pathologist (SLP) in the care of adults at end of life
- Attribute changes in hunger/thirst/oral comfort to physiologic changes that are believed to occur when death is imminent
- Analyze unique considerations for the assessment of oropharyngeal dysphagia, communication, and cognition at end of life
- Determine intervention approaches to swallowing and communication that promote quality of life
- Apply the evidence base to a complex example case study
Meet your instructor
Annette Askren
Dr. Annette “Nicole” Askren graduated with her master’s degree from San Diego State University in 2013 and her Doctor of Clinical Science degree from the University of Pittsburgh in 2018. Her clinical experience spans four VA healthcare systems across the country in a variety of settings, including acute inpatient, inpatient…
Chapters & learning objectives
1. The Role of the SLP at End of Life
Perspectives of practicing SLPs on end-of-life care will be explored, and the term “end of life” will be better defined. Support from the evidence base for SLP involvement in end-of-life care will be shared. Support from Medicare will be discussed briefly.
2. Evaluation and Management of Oropharyngeal Dysphagia at End of Life
An understanding of the physiology of the adult facing imminent death, as it applies to hunger, will be reviewed. Unique considerations for assessment will be presented, such as contraindications for instrumental exams. Unique circumstances observed within end-of-life care will be reviewed, including voluntary stopping eating and drinking (VSED). Patients’ goals of care, right to refuse, and dignity of risk will be reviewed. Interventions that support quality of life will be reviewed.
3. Evaluation and Management of Cognition and Communication at End of Life
Intervention approaches supporting communication participation will be reviewed. Cognitive interventions that vary based on stage of end of life will be discussed.
4. Application of the Evidence Base to a Complex Case Study
A case of a male adult with ALS experiencing changes to communication, swallowing, and eventually cognition (as an artifact of medications) will illustrate the application of the knowledge presented in this webinar.
5. Question and Answer Session
In this chapter, we'll analyze and answer the questions asked during the webinar.