[Dysphagia] End of life issues

[chcky619 at bellsouth.net (Ralph and Patti)]

I would suggest that when we are faced with tough management decisions related to end stage dementia that we should seek a Hospice consult which provides support for the family and critical documentation to address "comfort" issues.  This individual will have an expected weight loss and staff needs to be reassured that to "offer" food and liquid is the expectation.  The definition of offer is NOT forced feeding.  I view my role as a supportive professional who validates the CNA that it is okay to attempt to feed, terminate the meal, provide oral care, report it to the charge nurse and know you have done the job expected.  CNAs believe if they don't complete the meal with adequate intake that they have failed.  These are random thoughts based on 13 years of dealing with the issue on a daily basis.  An SLP's role in the arena of end-of-life is still ill-defined.  As a member of Division 15's task force, I hope we will open a forum to allow us to define parameters that includes Division 13's input.  Hang tough Stacy.  We continue to be in our infancy.  Patti