A Day in the Life of a Speech-Language Pathologist

It can be difficult to fully describe the role of a Speech-language Pathologist, as the rehabilitative work they do throughout their days is extremely varied and complex. In order to give our readers a more accurate idea of what an SLP does, we asked one to tell us a little more about her patient work here at an Ernest Health Hospital, as well as walk us through her activities throughout the day.

EH: Can you share with us what a typical day looks like for you?

SLP: I get to work around 7 or 7:30 a.m. to help patients with using their safe swallow strategies during breakfast.

We have a short staff meeting at 8:00 to quickly discuss appointments, discharge plans, medical complications, etc. I treat patients from 8:30 to 12. I personally have more energy in the morning, so I try to see my patients then and save documentation for the afternoon

I document daily/weekly progress notes during lunch and begin therapy again at 1:00. I have 2-3 sessions in the afternoon, and then I need to write daily/weekly notes. Part of my role in the afternoon is to look at the patients we will have in the evening and which therapists will be coming in for the evening shift and get the patients signed out to a therapist accordingly.

Some of the things that I have to think about as I’m evaluating patients is: Are the patients sticking to their diet? Are they ready for advancement? How are they handling the diet?

EH: What does the majority of your work involve at Ernest Health, and how would you describe the majority of the patients you work with?

SLP: I provide individual sessions and group therapy sessions two days a week. The majority of my patients have cognitive impairments that limit their ability to make safe decisions.

Stroke and head injury are the majority of the causes.

EH: What treatments/therapies do you use to work with your patients at Ernest Health?

SLP: For dysphagia (swallowing issues): I use myofascial release therapy and e-stim (electrical stimulation) modalities.

Myofascial release therapy is a treatment for patients with dysphagia that aims to loosen up muscles in the cervical area to allow for more contraction in swallowing.

E-stim modalities are used for neuromuscular re-education, which is a technique used to help the patient contract the muscles used in swallowing to teach the patient what it should feel like. E-stim machines can be used for a variety of purposes, though, and all depends on the settings (pain management, muscle contractions, etc.).

One of our SLP’s main focuses is keeping the patient safe by educating them and family members on things like locking the wheelchair and using the call light for help. In addition to these practices, she also does her best to find fun and fresh ways to help retrain patients to their former levels of functionality. Using music therapy and technology like iPad games, for instance, allows the patient to learn in a way that feels less like work and more like recreation.

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Her empathy for the patients, dedication, and caring personality are shining examples of the qualities that Ernest Health values in its team members.

EH: Why did you choose Speech-Language Pathology as a career?

SLP: I chose to be an SLP because I wanted a career that would make a positive impact on someone’s life.

My first semester in undergrad, I, by chance, saw a class schedule with a class about Communication Disorders.  I decided to take it and knew from the beginning this was what I wanted to do with my life.

EH: What hobbies or interests do you have?

SLP: I teach fitness classes before and/or after work. My alarm usually goes off at 4:30 so I can fit in my hobbies. My husband and I enjoy traveling, skiing, and fly fishing together.

Speech-Language Pathology’s Role in Stroke Recovery

Stroke recovery is a complex process that varies from one patient to the next. Because of this, speech-language pathologists play an important role in a stroke patient’s rehabilitation. Last week, we discussed how a speech-language pathologist could help a stroke survivor regain their ability to read. However, with one fourth of stroke patients suffering from language impairments, an SLP usually plays a sizable role in most stroke patient’s recovery. Here are a few of the responsibilities you can expect them to take part in during the recovery process.

They make a plan.

Because every stroke is different, and every patient is different, it is only natural that every recovery plan is different as well. Speech-language pathologists work with their inter-professional team but also work with a patient’s case history and their family to come up with a plan that will work for every individual patient. Creating a successful rehabilitation plan requires an SLP to know the patient medically and personally. A speech-language pathologist’s close involvement throughout the treatment allows them to alter the rehabilitation plan if necessary.

They help patients relearn how to communicate.

Depending on which area of the brain is affected by the stroke, patients may either have difficulty communicating their thoughts through words or writing, or have difficulty understanding spoken or written language. Either way, an SLP’s education equips them with the ability to help both of these conditions. They use different techniques and exercises to help patients circumvent their disabilities such as making symbol cue cards or simply repeating phrases with their patient. All of this is done with the end goal of helping the patient relearn their communication skills or learn new methods of communicating. 

They help patients with self-awareness.

Although speech and language are in the title, speech-language pathologists help with much more than that. SLPs also help stroke patients regain their self-awareness. This can mean anything from helping a patient learn that they don’t swallow all of their food during meals, to learning how to comb their hair. A speech-language pathologist may set up different daily challenges such as basic cleaning, to personal grooming to help a patient recover their self-awareness. These skills will help a stroke survivor’s day to day life become less frustrating as their recovery goes on. 

The extensive duties of a speech-language pathologist in stroke recovery differ with each patient, but for every patient they make an incredible difference. We are committed to bringing the best care to our patients, and because of that, we appreciate the speech-language pathologist on staff!

 

Stroke Survivors and Reading

When one experiences a stroke, many parts of the body are often affected, requiring physical therapy and exercise in order to reach a previous level of mobility. What this also means is that, in order to recover the energy used in various therapies, patients must spend a lot of time resting. In these periods, boredom and depression can settle in, making pleasurable distractions, like reading a book or magazine, a welcome escape.

Unfortunately, a frustrating discovery that many stroke patients experience is that reading (something they were likely proficient at before) has suddenly become a struggle. Words either seem to disappear or escape their grasp, and sentences are overwhelming.

Alexia- what it is:

Reading difficulties after a stroke are often referred to as “alexia” or “acquired dyslexia.” When the left side of the brain experiences damage or trauma, it is common for language abilities to suffer due to the fact that most language functions occur in the left hemisphere.

Reading impairments, along with the damage to language function, are also commonly caused by visual disruptions. Symptoms such as double vision or blind spots in words and sentences make even silent reading a struggle, and the act of communicating it verbally can seem almost impossible.

How a stroke affects reading:

Because Alexia occurs after a patient has fully developed their reading abilities, there are usually remnants of language skills still functioning. For example, many stroke survivors find it easier to read silently to themselves than to read aloud. Word retrieval is an incredibly common difficulty among stroke survivors, so coupling the act of visually comprehending with audibly reading can cause stress and confusion.

Depending on the extent and location of the damage, however, even silent reading can become severely impaired. Words that aren’t easily sounded out based on their letters, or those that are abstract in nature, commonly create frustration for stroke survivors.

How to work around reading impairments:

Couple listening with reading. One way to enjoy a favorite form of entertainment and work toward the correction of reading impairments is to pair media with printed words. By watching a TV show or movie with the captions turned on, a patient can experience the words through sight and sound simultaneously. Similarly, reading a physical book while listening to that same book on tape will provide an opportunity to match the look of words to their sounds and pronunciations.

Remove the written part of a task:

Another way to work around alexia is to simply remove the written part of a task to gain more independence. A task like visiting the grocery store in order to stock the pantry can become very overwhelming for someone who is having trouble reading. Rather than writing out a shopping list, many stroke survivors have found that creating a list using product logos and pictures allows them the independence to accomplish this previously simple task.

Talk to a Speech Language Pathologist. An SLP is trained to, among many other things, diagnose cognitive problems caused by strokes. By getting a formal diagnosis, an SLP will then be able to work with a patient and his or her needs, so that they may come up with a personalized treatment plan.

The SLP will use exercises, such as sounding out and naming letters, to help a stroke survivor work through their reading impairment and make progress toward reaching their previous level of ability.

Circulation & Diabetes

The possible outcomes of poor circulation in diabetics can be quite scary, but the reality (as it is in most diabetic complications) is that the more dramatic results can often be staved off by positive lifestyle choices.

Exercise

The act of exercising your body is beneficial in countless ways, including increased blood flow through the dilation of the blood vessels. When you exercise, vessels open up to allow more blood to feed the muscles with much-needed oxygen. For someone suffering from poor circulation, this provides a much-needed boost of blood to parts of the body that may have been desperately needing it.

While there are certain full-body exercises that are especially good for circulation, such as Yoga and swimming, even a short-but-brisk walk will provide the extremities with more blood.

Exercising on a regular basis will allow your body to replenish limbs with blood frequently, and help prevent complications like sores and ulcers that are difficult to heal.

When dealing with poor circulation, it is incredibly important to speak with your physician about your exercise options. He or she might have exercise plans that are specific to your circulatory needs that will better aid you in your recovery.

Diet

Along with exercise, consuming foods that help control your blood sugar (especially those that inherently improve blood flow themselves) can keep the symptoms of poor circulation at bay. High-saturated fat, high cholesterol, and high-sugar foods all have the tendencies to clog arteries, and adding the blood vessel-damaging power of high glucose to the mix creates the perfect environment for poor circulation.

Eating foods that are high in antioxidants, vitamins, and whole sources of fiber have been known to increase blood flow, as well as help in waste removal from the blood. Raw seeds, oats, citrus fruits, and leafy greens are fantastic foods to add to your weekly menu, bringing anti-inflammatory properties and much-needed minerals to the plate.

As with exercise, speaking to your physician about diet changes (especially if a patient is diabetic) is imperative when trying to manage your circulation issues. If you’ve been honest and thorough when sharing your medical history, your doctor might be able to assign a more personalized diet to you that could provide you with a much speedier recovery than you had anticipated.

Other Treatments

If diet and exercise simply are not helping with circulatory issues, then medical or surgical intervention may be utilized. Certain diabetes, cholesterol, and blood pressure medications have been known to help with circulation, and medications that help prevent blood clots may be prescribed as well.

Surgical options are angioplasty (inflation of a small balloon inside an artery), stents, artery bypasses, and surgical plaque removal.

Simple Steps = Simple Success

Managing diabetes and diabetes-related circulation issues go hand in hand. Many of the lifestyle changes demanded by diabetes are the same as the ones that will help improve your circulation: increased exercise, healthy diet, and not smoking. Simple changes like taking the stairs instead of the elevator or a quick walk after dinner can make an immense difference in your circulation.

Sources:

http://www.diabetesselfmanagement.com/managing-diabetes/complications-prevention/diabetic-leg-pain-and-peripheral-arterial-disease/

http://www.livestrong.com/article/153025-exercises-to-increase-blood-circulation-for-diabetics/

http://www.onegreenplanet.org/natural-health/healthy-foods-that-improve-your-blood-flow/

How Diabetes Relates to Heart Disease & Stroke

Being diagnosed with diabetes usually means you have to watch your blood sugar, mainly through diet, exercise, and medication. However, diabetes can cause a variety of complications throughout the entire body—but how?

The answer is the circulatory system.

The circulatory system is responsible for the transportation of blood throughout the body, providing nutrients and oxygen to cells, as well as transporting waste and carbon dioxide away from them. When the body begins producing and retaining too much glucose (blood sugar), the substance is not isolated to one sector of the body. The circulatory system pushes and pulls the glucose throughout the entirety of the body via the blood. The excessive amounts of sugar cause damage to blood vessels and the organs that are associated with those vessels suffer the consequences.

Diabetes and Heart Disease

One of the organs that most severely feels the effects of diabetes is the heart. Simply being diagnosed with diabetes dramatically raises a patient’s chances of encountering heart disease. The chances of getting heart disease at a younger age than most, as well as the severity of the heart disease itself, are increased when diabetes enters a patient’s life.

As the vessels supplying blood to the heart become damaged, clogged, or hardened by the high presence of glucose, the heart’s ability to receive (and therefore send out) blood is negatively affected. Types of heart disease that are specific to diabetes are Coronary Heart Disease (a buildup of a substance called “plaque” in the arteries), Heart Failure (when the heart is unable to pump the necessary amount of blood), and Diabetic Cardiomyopathy (a disease that damages the actual function and structure of the heart).

Diabetes and Stroke

Another major organ that suffers damage from diabetes is the brain. The brain thrives on oxygen-rich blood in order to function, and when the blood vessels that provide the blood are affected by excessive glucose, very serious complications can occur. When a vessel responsible for providing blood to the brain closes off or bursts, that part of the brain will become oxygen-deprived, and the cells will die. This can result in speech impairments, vision problems, and mobility issues, including paralysis. Like heart disease, being diagnosed with diabetes can significantly raise your chances of stroke.

We know the struggles that patients encounter as they work to regain lost abilities, and our goal is to help those patients overcome them. We feel it is also our responsibility, however, to educate our community about the causes of these conditions, in the hopes of preventing them.

We will continue to explore the topic of diabetes and circulation in our next post, as we learn about lifestyle changes and management techniques that may help patients cope with (and even prevent) these complications.

Sources:

http://www.diabetes.co.uk/body/circulatory-system.html

http://www.diabetes.org/living-with-diabetes/complications/heart-disease/

http://diabetes.niddk.nih.gov/dm/pubs/stroke/

http://www.nhlbi.nih.gov/health/health-topics/topics/dhd