“Is NPO the Only Option?" An Innovative Research-Based Framework for Oral Intake Recommendations in the Seriously Ill (FR412)

Abstract

•Describe the four main domains by which swallowing therapy can benefit a patient or family, whose goals of care are comfort, based on framework of the World Health Organization’s components of palliative care.•List three benefits of providing nuanced swallowing recommendations for patients with advanced diseases and those receiving palliative care through the management of communication and swallowing difficulties (dysphagia).•Discuss a framework and multiple strategies to enhance the timely collaboration between instrumental/procedural swallow evaluations and palliative care consultation across the continuum of care, including the palliative care unit (PCU), hospital, home, and nursing home and hospice care. Speech and language Pathologists (SLPs) can improve the quality of life of people receiving palliative and/or Hospice care through the management of communication and swallowing difficulties (dysphagia). Swallowing difficulties may result in discomfort for patients and concern from caregivers; however, their role in this domain is evolving and little is understood about the current professional practice in this field. While palliative care (PC) aims to affirm life and minimize the complications of life limiting disease, speech-language pathologists (SLPs) typically work with people with progressive and life limiting disease as rehabilitation experts but often work independent of specialist palliative care teams and Hospice providers. Rehabilitation may seem incongruent with palliation; however, SLPs have a vital role in the empowerment of patients with communication difficulties and symptom reduction through specialist dysphagia management and communication therapy. Patient care provided by the speech-language pathologist can align with the framework of the World Health Organization’s components of palliative care and can be delineated into four main domains of expertise. PC multidisciplinary teams do not typically integrate SLP and may be a lack of understanding between professionals regarding the SLP role. The presentation will explore the evolving interface of SLPs and palliative care. We will highlight current practices and contrast it with innovative methods of approaching patient care based on our ongoing research that will be presented. The panel will include discussion by an SLP, PC and Hospice Providers, Geriatrician and nurse practitioners providing care in the Palliative care Units (PCU, Hospitals, nursing home and home based PC and Hospice). The session will further explore the development of the speech-language pathologist as a participating member of the PC and hospice interdisciplinary team, across the continuum of care and how that would support the overall goal of providing quality care for patients and families served by hospice.