Bedside Evaluation of the Dysphagia Patient The Dysphagia Patient by alicejenny



Bedside Evaluation
of the Dysphagia
Charleston, WV                        Charleston, WV
February 17                              February 18

Columbus, OH                           Columbus, OH
February 19                              February 20

Cincinnati, OH                         Cincinnati, OH
March 8                                      March 9

Louisville, KY                          Louisville, KY
March 10                                    March 11

Indianapolis, IN                      Indianapolis, IN
March 12                                    March 13

                    The Dysphagia
                        Modified Barium Swallow
                      and Therapeutic Intervention
                 Bedside Evaluation
                             of the
u   Identify red
    flags you will find
    during chart review
    and patient observation
    Identify disorders and  Patient
    associated dysfunctions of the
u   Discuss the oral, pharyngeal and
    esophageal stages of swallow
u   Identify medications that would adversely
    affect the swallow
u   Discuss the use of specific assessments such as the
    CODA, MASA and SAFE in the beside evaluation

Understanding the Dysphagia Patient
In order to evaluate a patient, health care professionals must be familiar with numerous
disorders which may impact swallowing. Not only is the disorder(s) important, but one
must be aware of the impact of various medications on the swallowing mechanism. This
one-day course will discuss numerous disorders that impact the oral, pharyngeal and
esophageal stages of swallowing, and medications often prescribed. The function of
the muscles and cranial nerves will be reviewed. In addition, bedside evaluation will be
outlined and various dysphagia assessments will be presented for consideration in the
evaluation process.

                                    Who Should Attend
                                    u    Speech-Language Pathologists
                                    u    Speech Therapy Assistants
                                    u    Nurses
                                    u    Restorative Nursing Staff
                                    u    Dietitians
                                    u    Dietary Managers
                                    u    Rehab Managers
                                    u    Social Workers
                                    u    Case Managers
                                    u    Nursing Assistants
                                    u    Nursing Home Administrators
                                    u    Activity Professionals
                                    u    Occupational Therapists

What You Will Learn
u   Recognize who is at risk for dysphagia        Course Content
    and why                                       DYSPHAGIA
u   Understand disorders that may impact the      u Statistics
    oral, pharyngeal and esophageal swallow       u Predictors of dysphagia
u   Identify medications that adversely affect    u Symptoms and red flags
    the swallowing mechanism                      u Mealtime behaviors
u   Discuss function of specific muscles in the   u Review of the oral stage
    oral, pharyngeal and esophageal stages of        - muscles
                                                     - cranial nerves
u   Identify assessments available for use        u Review of the pharyngeal stage
    in the bedside evaluation
                                                     - muscles

What to Bring                                        - cranial nerves
                                                  u Review of the esophageal stage
u    Stethoscope                                     - muscles
u    Flashlight                                      - cranial nerves
u    Watch with second hand/stopwatch             DISORDERS

Dates & Locations
                                                  u Disorders which may result in dysphagia
                                                  u Impact of disorder of each stage of
CHARLESTON - February 17, 2010                       swallow
Holiday Inn Charleston House
600 Kanawha Blvd. E., Charleston, WV 25301
304-344-4092                                      u Common medications prescribed
                                                  u Impact on swallowing
COLUMBUS - February 19, 2010
                                                  u Contraindications
Crowne Plaza Columbus North
6500 Doubletree Ave., Columbus, OH 43229          BEDSIDE EVALUATION
614-885-1885                                      u Assessments
CINCINNATI - March 8, 2010                           - cranial nerve examination
Embassy Suites Hotel Northeast                       - auscultation
4554 Lake Forest Dr., Cincinnati, OH 45242           - Frenchay Dysarthria exam
513-733-8900                                         - Clinical Observational Dysphagia
LOUISVILLE - March 10, 2010                       u Assessment—CODA
Holiday Inn Hurstbourne                              - Mann Assessment of Swallowing
1325 S. Hurstbourne Pkwy., Louisville, KY 40222   u Ability—MASA
                                                     - swallowing ability and function
INDIANAPOLIS - March 12, 2010                     u Evaluation—SAFE
Crowne Plaza Indianapolis Airport
2501 S. High School Rd., Indianapolis, IN 46241

                                                                Register online at
                                                    Use Express Registration Number: 125762
                                    The Dysphagia
u   Identify the
    anatomical                                  Modified Barium Swallow
    landmarks and
    terminology in the                                   and Therapeutic
    modified barium swallow
u   Discuss rationale for various food
    items in the modified barium swallow
u   Discuss how to increase calorie intake rather
    than volume of food to help patients who are at
    risk nutritionally
u   Define compensatory strategies and rationale for their use
u   Identify specific exercises to improve lip, tongue,
    velopharyngeal insufficiency and laryngeal movements

Understanding the Dysphagia Patient
Health care professionals will often recommend the modified barium swallow to assess swallow
function and determine least restrictive diet, swallowing strategies and therapeutic intervention.
This one-day workshop will discuss the rationale for a modified barium swallow, completion
of study and interpretation of the x-ray. Diets and thickened liquids will be reviewed as well as
alternative methods of nutrition, waivers and non-compliance. Therapeutic interventions will be
presented in a lab format. Participants will construct therapy materials and have hands on practice
with specific exercises to address lips, tongue, chewing, laryngeal elevation and velopharyngeal

                                 Who Should Attend
                                 u Speech-Language Pathologists         u Case Managers
                                 u Speech Therapy Assistants            u Nursing Assistants
                                 u Nurses                               u Nursing Home
                                 u Restorative Nursing Staff
                                                                        u Activity Professionals
                                 u Dietitians
                                                                        u Occupational
                                 u Dietary Managers                       Therapists
                                 u Rehab Managers
                                 u Social Workers
What You Will Learn Course Content
u Identify anatomical landmarks in the oral,
                                                    MODIFIED BARIUM SWALLOW
  pharyngeal and esophageal phase of swallow
u Discuss terminology for the report                u Rationale
u Understand tray preparation and rationale         u MBS vs. FEES vs. barium swallow
  for items                                         u SLP role
u Recognize diet modifications available and the    u Radiologist role
  importance of correct diet                        u Study guidelines
u How to increase calories, not volume of food      u Tray preparation
  consumed                                          u Presentation
u Explain compensatory strategies and rationale     u Landmarks
  behind them                                       u Terminology
u How to deal with sabotage of the treatment plan
                                                    u Review of MBS studies
u Define exercises to target specific areas of
  weakness                                          RECOMMENDATIONS
                                                    u  Diet levels/modifications
What to Bring                                       u
                                                       How to increase calories, not volume
u   Large towel                                     u  Thickeners
u   Stethoscope
                                                    u  Compensatory strategies
u   10 tongue depressors
u   Nickel-size button—2 holes                      u  Adaptive equipment
u   Round lollipop—Dum Dumr variety                 u  Independent vs. dependent feed
u   Dental floss                                    u  Therapeutic feeds vs. pleasure/
u   Paper plate                                        recreational feeds
u   Fruit Rollupr or balloon                        u NPO recommendations
u   Scissors
                                                    THERAPY RECOMMENDATIONS
u   Lifesaversr—any flavor
u   Cloth tape                                      u Oral motor exercises lab
                                                        - lip exercises

Dates & Locations                                       - tongue exercises
                                                        - cheek exercises
CHARLESTON - February 18, 2010                          - laryngeal exercises
Holiday Inn Charleston House                        u   Shaker
600 Kanawha Blvd. E., Charleston, WV 25301          u   Therabiter
304-344-4092                                        u   VitalStimr
                                                    u   Deep pharyngeal neuromuscular
COLUMBUS - February 20, 2010
Crowne Plaza Columbus North                             stimulation
6500 Doubletree Ave., Columbus, OH 43229            u   Therapy tools/products
614-885-1885                                        u   Patient and family education
                                                    u   Mouth care and xerostomia
CINCINNATI - March 9, 2010
Embassy Suites Hotel Northeast                      HOW TO DEAL WITH SABOTAGE OF
4554 Lake Forest Dr., Cincinnati, OH 45242          THERAPY
513-733-8900                                        u Family
                                                    u Staff
LOUISVILLE - March 11, 2010
                                                    u Patient
Holiday Inn Hurstbourne
                                                    u Dietary
1325 S. Hurstbourne Pkwy., Louisville, KY 40222
502-426-2600                                        u Physician

INDIANAPOLIS - March 13, 2010                       KEY POINTS
Crowne Plaza Indianapolis Airport
2501 S. High School Rd., Indianapolis, IN 46241

                                                                    Register online at
                                                        Use Express Registration Number: 135763
Course Director
DENISE DOUGHERTY, MA, CCC-SLP, MFT, is a Speech-Language Pathologist with over 30 years of
experience. Ms. Dougherty owns and operates a private practice in Indiana, Pennsylvania, where she
conducts therapy with both children and adults. Additionally, she consults and provides therapy for clients
throughout the United States and overseas. Ms. Dougherty has spent the majority of her career in long-
term care facilities, hospitals and home health. She has worked for United Cerebral Palsy and Easter Seals,
and previously served as secretary of the Corporate Speech Pathology Network (CORSPAN). Ms. Dougherty
has also served as an adjunct faculty member at York College of Pennsylvania and Wesley College in
Dover, Delaware. She is currently a board member and Vice President of the American Academy of Private
Practice in Speech Pathology and Audiology (AAPPSPA), serves as the AAPPSPA liaison for ASHA Health
Care Economics Committee and received the Academy’s 2007 Honor Award for her achievements. Ms.
Dougherty is also a member of the Expert Work Group for Quality of Insights of Pennsylvania, working
on initiating quality measure for improving effectiveness, efficiency, economy and quality of services
delivered to Medicare beneficiaries. She received her bachelor’s degree in communication disorders from
Marywood University in Scranton, Pennsylvania, a master’s degree in communication disorders from St.
Louis University and has completed postgraduate courses at Johns Hopkins University and the University
of Phoenix. Ms. Dougherty is certified in VitalStimr therapy and serves as a VitalStimr instructor, has
completed additional training in myofunctional therapy, is a member of the Pennsylvania Speech and
Hearing Association, the American Speech and Hearing Association and has received numerous ASHA ACE
Awards. For more information on her, please visit

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 Register Today!                                             Bedside Evaluation                           Total Registration Fee:
                                                                                                                                           ONE DAY           BOTH DAYS
 f       ONLINE                                  q Charleston - February 17
                                                                                                          Single Registrant                $189 ea.           $339 ea.               q Columbus - February 19
                                                 q Cincinnati - March 8                                   2 or more registering            $179 ea.           $319 ea.
 Program one: express number: 125762
                                                 q Louisville - March 10                                  at the same time                 Includes all course materials
 Program two: express number: 135763
                                                 q Indianapolis - March 12
                                                                                                           10 or more registrants call for pricing.
 % PHONE (800) 397-0180                         I am registering and would like to order an audio
                                                set for $59 plus S&H $8US/$30CAN: q audiotapes q CDs
                   (615) 331-4422               Audio/course manual package: $189 plus S&H $8US/$30CAN
                                                                                                          Method of Payment:                          Amount $___________
         FAX (615) 346-5350                     No. of copies ___ q audiotapes q CDs              #2371
 l                                                                                                        q Check Enclosed      q Purchase Order #___________
 S       MAIL this form                                    The Dysphagia Patient                                    Payable to: Cross Country Education
         with payment to:                        q Charleston - February 18
                                                                                                          Credit Card: q Visa / MC q Discover q AmEx
                                                 q Columbus - February 20
            CROSS                                q Cincinnati - March 9                                   CREDIT CARD NUMBER                      EXP. DATE
           COUNTRY                               q Louisville - March 11
                                                 q Indianapolis - March 13
          EDUCATION                             I am registering and would like to order an audio         NAME ON CARD
            P.O. Box 200                        set for $59 plus S&H $8US/$30CAN: q audiotapes q CDs
        Brentwood, TN 37024                     Audio/course manual package: $189 plus S&H $8US/$30CAN
                                                No. of copies ___ q audiotapes q CDs              #2372   AUTHORIZED SIGNATURE

                                                                                                                                                                    PRESORTED STANDARD
                                                                                                                                                                      U.S. POSTAGE
REGISTRANT NAME 1 (as it will appear on certificate)                                                                                                                       PAID
                                                                                                                                                                     NASHVILLE, TN
                                                                                                                                                                     PERMIT NO. 3373
REGISTRANT NAME 2 (as it will appear on certificate)



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