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[Dysphagia] off-topic: aphasia
-------------------
I would second reviewing the Rosenbek, LaPoint, and Wertz text.
However, this is not just a clinical question, but a legal one (as
Irene points out later in this thread). You might want your facility
to provide you with your Medicare Intermediary's definition of aphasia
to ensure that the request is not overstepping Medicare bounds.
Personally, I have never been comfortable calling the language
deficits of dementia "aphasia" given the prominent cognitive
substrate, but if pushed will use a term like Critchley's "dyslogia".
The arguments about terminology are fierce and unending.
Good luck
Woodford A. Beach, Ph.D., CCC/SP
Senior Speech-Language Pathologist
Adjuct Assistant Professor, Neurology and PM&R
VCU Medical Center
> 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: <BOBGLENSIDE@aol.com>
> To: <dysphagia@b9.com>
> 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
> >
>
>
> _______________________________________________
> Dysphagia mailing list
> Dysphagia@b9.com
> http://lists.b9.com/mailman/listinfo/dysphagia
>
>
Woodford A. Beach, Ph.D., CCC/SP
Senior Speech Language Pathologist
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