I had an incredible opportunity to work with the speech therapist at our clinic today. His name is Brian and he was so great about teaching me things and being patient while I was following him around.
So speech therapy, especially in a nursing home setting, works a lot with patients on their ability to swallow foods and drinks. This is to prevent the patients from choking on their meals. Now, I’m going to attempt to explain these exercises to you, but they are interesting so we’ll see what I can do. For the first two patients we saw, Brian would take a ball (the stiffness of the ball would depend on the level the patient is at) but for now, I want you to make a fist with your hand. Take your fist and place it underneath your chin. Now press down onto your fist so your fist is trapped between your chin and the upper part of your chest. Does this make sense? Now picture that your fist is the ball- that’s what Brian was doing with these patients; placing a ball in this same spot. Now, as you are pressing down with your chin (make sure to keep the pressure on your fist) I want you to <loudly> repeat the sound “GAH.” GAH-GAH-GAH-GAH-GAH-GAH over and over. Good. Now take a small break. We’re not done yet… not even close. You should feel the muscles deep within your throat working. Now place your fist (or the ball in the case of the patients we were working with) back under your chin and apply that same pressure. Now repeat the word “GAY.” GAY-GAY-GAY-GAY-GAY-GAY. Good. Now repeat this with the words “go,” “cooking,” “getting stronger” and “growing stronger.” Patients were also taught some compensation techniques to help them while dining. These include tucking the chin down while eating, taking smaller bites of food and alternating a bite of food with a sip of water.
Some of the other things the speech therapist worked on with patients throughout the day was actually speech related. One of the patients we saw had a stroke in the past and as a result had a difficult time with slurred speech (dysarthria). These exercises were spent working on pronouncing words and syllables that the patient may have particular difficulty with. This patient had issues specifically with the sounds that are pronounced at the front of the mouth. Sounds like “T” and “CH”.
One last patient that we saw today that I thought was really interesting was a patient that is a quadriplegic after suffering a head injury a little while back. She was a younger woman; maybe in her 40’s and she was being set up with a communication device. You have seen or heard of those computers that people use to communicate when they have lost their ability to communicate, right? Well this patient was set up with one of these devices maybe two weeks ago and is being trained on how to use it. I got to sit in on the session today which was really cool. She has some movement of her right thumb so she operates the computer through a switch that she can click with her thumb. The computer will highlight different words and when it highlights a word she wants to say, she clicks and the computer will speak the word for her. It seems like a very tedious process but compared to not being able to communicate at all, I’m sure it’s a small inconvenience. It was really rewarding to get to see her practice this and begin to communicate with her parents and the speech therapist. This is the kind of impact I hope to have on patients in the very near future!
I’m looking forward to other Fridays where I am able to shadow other disciplines and learn about what they do!