1.
An analysis of an empirical research study that
is 10 years or less in age and that provides support for either the
compensatory approach or the rehabilitative approach (given) that you select. This
section should be 3-4 pages in length.
Short-Term Goals
Compensatory
Approach (1 week):
§
Within one week, Ana
will utilize compensatory swallow strategies and maintain a chin-tuck posture
during oral intake to consume IDDSI level 4 (pureed) safely and adequately and
IDDSI level 3 (moderately liquids) with maximum assistance, thereby reducing
the risk of aspiration.
Rehabilitative
Approach (2 weeks):
Ana will
initiate oral motor exercises targeting lingual strengthening and
coordination within two weeks with maximum assistance.
Brief
Description of Treatment Approaches:
Compensatory
Approach: Focuses on adapting the environment or behavior to improve
safety and function without directly changing the underlying impairment.
For example, using a specific posture to reduce aspiration risk.
Rehabilitative
Approach: Aims to improve or restore function by directly addressing the
underlying impairment through exercises or therapies. For example,
targeting specific muscle groups for strengthening and coordination to
improve swallowing function.
Case Study information: 1. The IMPRESSIONS from the MBS report are
as follows:
a.
Severe dysphagia characterized by piecemeal oral
transfer of pudding consistency, delayed pharyngeal swallow response, impaired
laryngeal closure, and impaired pharyngeal motility
b.
Laryngeal penetration down to the level of the
folds secondary to impaired laryngeal closure and also due to impaired
pharyngeal motility. Over the course of several swallows, including dry
swallows, the penetrated material accumulated to the point of causing
aspiration up to the 5% level.
c.
No cough in response to laryngeal penetration
and aspiration.
Case study: Date of birth June 6, 1946 Location of study St. Matthew’s Regional Medical Center Patient’s current hospital status Inpatient in acute rehabilitation unit of St. Matthew’s Regional Medical Center Date of admission to hospital March 23, 2024 Date of study March 25, 2024 Referring physician Mark Kawasaki, M.D. (Physiatrist) Date of onset: March 20, 2024 Location of acute hospitalization Broward County Medical Center Discharge diagnosis from Broward County Right thrombotic CVA Prior medical diagnoses Hypertension treated with Zestril 20 mg 1x/day; hyperlipidemia treated with Lipitor 20 mg 1x/day Major signs and symptoms of primary illness Left hemiparesis, mild cognitive-linguistic impairment, moderate dysphagia Previous swallowing evaluation Clinical swallowing evaluation on March 21 characterized by wet upper airway sounds following the first dose of nectar-thick liquid and for each small dose of other consistencies. Evaluation stopped after four small doses. Re-assessed on March 22 with similar results. Current route for nutrition and hydration NPO since admission to Broward County Medical Center. NG feedings as a rate of 80cc/hour started on the morning of discharge from Broward County Medical Center. Prior Level of Function Independent for all activities at the community level
