[Dysphagia] RE: Influences on swallow assessment decision

[lschmidt at jamestownhospital.com (Lonna.Schmidt)]

Anna:
I am taking your post to mean allowing po intake following an evaluation showing that one is not safe for po intake.  In my experience I have been told by a state agency that I cannot make that decision alone (this was for an ICFMR)no matter what the results of a swallowing evaluation recommends.  It has to be a team decision weighing in many aspects of that person's life.  I have found educating staff regarding what swallowing truly means and what aspiration is really helps the staff in that facility.  Once educating is finished, I felt MUCH less pressure during these team meetings.  
On the other hand, when I have worked in a hospital and nursing home setting, I have felt NO pressure to make any specific decisions at all.  Staff look to me as a professional in swallowing and do what I recommend.  I have made a personal effort to educate myself over the years to make sure I am making the best recommendation possible for that patient and his/her needs considering age, ability, medical needs, and desires. I still attempt to educate staff regarding swallowing as well.

Lonna