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[Dysphagia] off-topic: aphasia
Whatever the definition of "aphasia" used, your administration and physicians should know that you are not allowed to diagnose anything, simply to describe something as being consisten with something else. The only people who can diagnose are physicians and, in some jurisdictions, psychologists. Patients who carry the label of "demented" are in enough trouble, as it is frequently incorrect but, once applied has all of the permanence of a tattoo. Specific abnormalities of language are the hallmark of Alzheimer disease but not of other, more common dementias and it has long been a pet peeve of mine that terms such as "aphasia, agnosia" etc are used in the context of dementing illness. It leads, among other things, to fuzzy thinking and incorrect identification.
JoAnn Eaon <joanneaton@charter.net> wrote:Dear Bob,
I hope you are prepared for a diversity of opinion here. From my reading
that is the case in defining aphasia.
A resource for you might be "Aphasia: A Clinical Approach" by Rosenbek,
LaPointe & Wertz.
It includes a good discussion of what is aphasia and what is not aphasia in
the third chapter. And also looks at various attempts to define aphasia.
In this chapter, it defines "disorders that resemble aphasia" "which
include the language of confusion, dementia, communication deficit
subsequent to a right hemisphere lesion, schizophrenia, environmental
influence on the language of the normal aged, apraxia of speech, and
dysarthria." It continues to expand upon each of those topics of what is not
aphasia.
Hope this helps.
JoAnn
----- Original Message -----
From:
To:
Sent: Tuesday, June 08, 2004 6:51 PM
Subject: [Dysphagia] off-topic: aphasia
> We - a team of SLPs working in the nursing home - have been approached by
the
> RNAC to evaluate all patients with communication deficits to give them a
> diagnosis of aphasia. Apparently, the MDS's vague definition of aphasia
is
> "disorder of language," which would include those folks who have
dementia-related
> deficits while we feel aphasia is more specifically related to a neuro
event
> such as a CVA or TBI.
>
> Her feeling is that with the diagnosis of aphasia the nursing home stands
to
> financially benefit by way of a higher case mix. While we wish to be
> supportive of the nursing home's attempts to (appropriately) capture as
much revenue
> per patient as possible, we do not feel that we as SLPs and these demented
> patients are the most appropriate avenue by way of the diagnosis of
aphasia.
>
> Anyone else have this experience? Any personal insights or
> authors/text/articles you can direct us to that support either case would
be helpful.
>
> Bob
> _______________________________________________
> Dysphagia mailing list
> Dysphagia@b9.com
> http://lists.b9.com/mailman/listinfo/dysphagia
>
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