[Dysphagia] OT: dysphagia patient with deafness & sign languagequestion

[Heidi.Bassani at amedd.army.mil (Bassani, Heidi D Ms WRAMC-Wash DC)]

Many signs for drinks are made with hand to the cheek (i.e. water is a
"w" to the cheek).  Perhaps that is what that sign was is her motor
skills are poor?  Hard to tell without seeing her.  How is her vision?
Could she use a picture board?  Best of luck. 

-----Original Message-----
From: Bonnie Heintskill [mailto:bonnieh4455 at sbcglobal.net] 
Sent: Tuesday, January 16, 2007 10:01 AM
To: dysphagia
Subject: [Dysphagia] OT: dysphagia patient with deafness & sign
languagequestion

I was seeing a patient that was cognitively delayed (age 63), profoundly
hard hearing/deaf, is now PEG tube fed due to aspiration pneumonia.  PMH
includes seizures, agitation, was on psychotropic medications. Ended up
dehydrated and aspirated.  She is also non-verbal. Lived in a SNF for 25
years which closed then went to a residential group home where she got
very ill.  Her case worker said she knew some sign language but the
records never got transferred to the group home.   She is now at a
sister group home.  When I initially saw her, she only made one sign
which was hitting one closed fist to the other palm repeatedly.  Looking
in sign language dictionaries I found what she may have been doing - cup
- in a modified way. She also was repeately doing a forefinger in the
air (I understand?).  I tried a binaural amplification system with her
without any apparent success.  

Yesterday she was doing 2 -3 more signs. One she was taking her right
fist and hitting her left cheek or chin so hard that she turned the skin
red, taking her left fist and hitting her head, and then doing some
finger signing.  She was getting very frustrated with the caregiver and
I, which I don't blame her since I'm not a signer.

She was also doing closed fist to closed fist (more?).


Anyone have a clue as to what she may be signing?

She only likes applesauce and refused to eat anything after one bite
yesterday.  The caregiver stated she had been crushing up her meds and
putting them in apple sauce.  She used to drink out of a sippy cup but
when I tried one with her (tupperware) she refused. Group home is
getting a new one on Wednesday and will trial it with her (nectar thick
liquids).

I put together common signs for ADL's and gave them to the group home.
They didn't know that another resident had been using sign language so
at least this helped the caregivers.

I am looking in my sign language dictionaries and don't see anything
comparable. She may have adapted a sign or two.

Any suggestions?