L&L Therapy Services, LLC

In the coming years, speech-language pathologists (SLPs) can expect the numbers of older patients on their caseloads to increase. Epidemiological data indicate that the elderly represent one of the fastest growing segments of the U.S. population as national life expectancy continues to increase (U.S. Census Bureau, 2011). Unfortunately, as people age, they become more vulnerable to medical conditions and diseases (e.g., hypertension, Alzheimer's disease, Parkinson's disease) that compromise the integrity of their brain structures and functioning (Alzheimer's Association, 2011; Roger et al., 2010). These conditions and diseases negatively affect our cognitive and communication abilities. In this article, I will focus on cognitive assessment, an important component of service provision to older patients. More specifically, I will review the rationale, issues, and procedures pertaining to evaluating attention, memory, and executive functioning abilities in older patients.

Individuals of advanced age may have multiple medical conditions that contribute to their dysphagia symptoms; these cases can present diagnostic challenges for the clinician. To develop an appropriate treatment plan, the clinician must use a swallowing assessment that first identifies all of the factors that could contribute to the individual's dysphagia. In this article, we will discuss the importance of the clinician's having a thorough understanding of the individual's medical history and examine several medical conditions that may contribute to dysphagia symptoms.

In a changing economy and a changing industry, health care providers need to complete thorough, comprehensive, and efficient assessments that provide both an accurate depiction of the patient's deficits and a blueprint to the path of treatment for older adults. Through standardized testing and observations as well as the goals and evidenced-based treatment plans we have devised, health care providers can maximize outcomes and the functional levels of patients. In this article, we review an interdisciplinary assessment that involves speech-language pathology, occupational therapy, physical therapy, and respiratory therapy to work with older adults in health care settings. Using the approach, we will examine the benefits of collaboration between disciplines, an interdisciplinary screening process, and the importance of sharing information from comprehensive discipline-specific evaluations. We also will discuss the importance of having an understanding of the varied scopes of practice, the utilization of outcome measurement tools, and a patient-centered assessment approach to care.

Speech-language pathologists must develop meaningful, objective, and measurable treatment goals. Historically, clinicians developed treatment goals based largely on assessment data in accordance with an impairment-based medical model. Contemporary management focuses on a patient-centered plan of care that addresses activity and participation constructs as well as evidence-based practice, maximizing the appropriateness and meaningfulness of therapy. In this paper, I will review relevant literature and provide case examples to illustrate current treatment planning concepts.