Saturday, January 24, 2015

closing the sale

  "OK - you see that we have to keep many things in mind, during each day spent as a speech-language pathologist. We are expected to produce revenue, so that every success we see with the patient's function should accumulate alongside the successes with business volumes. That business perspective we can't ever lose, but neither can the business side be the predominant reason we do this work. We are here to help people; it's the reason many of us agreed to carry hefty student loans to begin our careers. So - if you need some guiding principles that help you meet the twin objectives, fiscal and clinical, here are some suggestions: -"

"The people we serve deserve quality healthcare".

"To get the best outcome for people with whom we work, the relationship you forge with them must be primary".

"Making progress towards the desired outcomes requires excellent time management”

 “Establish a context for the activities you bring to each session: WHAT I WANT TO DO TODAY IS…”

 “You are required to negotiate with the resident on the plan along the way”

“Complete necessary documentation of the plan's progression in a timely manner”

“Do not forget to train the patient, family and all who will be involved in assuring the plan's successful completion."

“Are you aware of the rules and regulations set by payer sources that influence how you do your job? Get a working knowledge of them”.

“Acronyms, jargon and shorthand, oh my! Learn the language of the persons with whom you are communicating, and speak or write in the language of your audience”.

“If you serve a person, by breaking down a single act they do not perform well into its components – then train the person to perform those components very well, without training the person to incorporate the components back into daily life – how has your work benefited the person?”.

“When you give someone a direction on performing an act – why not show them how YOU would do it? Provide a model.”

Persons who have difficulty initiating an action you want to see: Cue them first by saying “I want you to __________________”, instead of saying “Would you _______?”.

“Let’s address each of these principles for meeting both the fiscal and the clinical objectives”.

Saturday, January 3, 2015

It's Too Dry, So - Make It Wet!!

Blogger's note: in the recent post "It's Too Dry", I had indicated a following post would supply some solutions to the dilemna - often seen in a clinical situation - of a person served who does not consume some foods due to their being dry or without flavor.To recap - why does this matter?

* Good nutrition and hydration is critical to recovering and maintaining wellness;
* Persons served may have problems with eating/drinking, therefore impairing wellness;
* Persons not eating a healthy diet may face serious compromises to their general health;
* Persons with impaired eating/drinking may have salivary production diminished;
* Impaired salivary production limits persons' thoroughly eating dry, coarse foods on a "general diet";
* Persons served may not drink enough, to aid in swallowing dry foods chewed;
* Persons served may be fed by institutional kitchens that limit moisture to limit fat/calories;
* Your intervention with the persons served may include reclaiming moisture for food;
* Reclaimed moisture for food will help improve food viscosity, and an easier swallow;

OK, let's figure out how to do this now. Increasing moisture in food may be a matter of increasing salivary flow. The person may also benefit from coaching to use a favorite beverage frequently. Still another approach would require amending flavors in the food this person receives, while remaining as true as possible to the dietary "restrictions" imposed by either conscience or doctor's orders.

Improved salivary flow? What about: regular and thorough oral care (brushing, rinsing, flossing)? What about stimulating saliva flow between meals, with water breaks and with flavors (eg fruit, mint) in candy or gum? How about flavor amendments (herbs, non-sodium spices) for our food?

A beverage at mealtimes, used not to fill up the stomach with frequent gulps but to form and wash out oral food material, will allow the person with practice to consume more of a dry solid diet. Alternating sips of a beverage with bites of food, is a natural strategy that helps function in all the valves of the swallowing system under our direct control.

Flavor amendments can be internal (again, through herbs, spices or other secrets) or external. Betsy Towner in the AARP Bulletin, created a comprehensive list of "Flavors to Shake the Salt Habit" for the holiday season. 1 Avoiding sodium is still a core aim of medically-modified diets, and this list assists in adding flavors internally. By contrast, adding externally a sodium-free or low-sodium flavoring, sauce or condiment to a dish will help accentuate the flavors, and stimulate more chewing/salivating/easy swallowing.

I would love to hear feedback from readers, on any similar enhancements to food that has helped persons challenged by eating/drinking. Please post comments!

1 Towner, Betsy, "Flavors to Shake the Salt Habit", AARP Bulletin, 12/1/2010. Online version  http://www.aarp.org/food/diet-nutrition/info-12-2010/healthy_herbs_and_spices.html accessed 1/3/15.