Aphasia and Dysphagia in a Resident of a Skilled Nursing Facility
Each practice setting comes with a unique set of challenges and limitations. It is critical for speech-language pathologists (SLPs) to provide in-service education to staff when faced with complex cases in the skilled nursing, subacute, and/or long-term care rehabilitation settings.
MM, a 75-year-old man, was admitted to an acute care hospital following reports from his long-time girlfriend that “after breakfast, he couldn’t speak” and “couldn’t move his right arm.” A computed tomography of the brain at admission (~4 hours after symptoms began) revealed a left middle cerebral artery ischemic cardiovascular accident (CVA) in the posterior distribution. MM was not a candidate for tissue plasminogen activator, as his symptoms began more than 3 hours prior to admission and he presented with other contraindications. Following admission, MM was transferred to a specialized inpatient rehabilitation institute (IRI) for 4 weeks to receive intensive physical, occupational, and speech therapy. MM was then transferred to a subacute rehabilitation center/skilled nursing facility (SNF), approximately 6 weeks after his CVA.