Life as an SLP

I love being a Speech Pathologist. I love getting to help people. I love going to work every day. But, my job isn't always easy. I work at skilled nursing facilities for 2 companies around Cleveland. Many of my patients are long term residents, but some are there to get better and return home. It breaks my heart to see patients leave and come back a month or so later due to a fall or mishap at home. The majority of of my patients at older; in their 70's, 80's, 90's, but some of them are much younger. At the inner city facility where I PRN, I see people in their 30's and 40's. Drugs. They will screw your whole life up. A particular resident is now a quadriplegic due to bad choices. He is my age. He lives in a nursing home. In his 20's.

But, that's not the point to this post. The point is to share what I do every day.

Cognition: Memory, Attention, Orientation, Judgment, Insight, Problem Solving, Safety Awareness
Swallowing: Oral, Pharyngeal, Esophageal Dysphagia
Language: Expressive and Receptive Aphasia
Speech and Communication: Dysarthria, Apraxia
Voice

Cognition treatment is the most prevalent speech issue in skilled nursing facilities, followed by swallowing. For cognitive treatments, I use calendars, worksheets, puzzles, games, and functional safety techniques, like wheelchair safety and being attentive around their homes. I LOVE cognitive treatments! I always incorporate my patient's interests and upcoming holidays with my therapy. My patients are usually very receptive to working with me for their cognitive function because I try to always plan fun activities for them.
Dysphagia (swallowing) therapy is a lot of teaching compensatory strategies for a safer swallow. However, this can prove nearly impossible for someone who is also having difficulties with short term memory loss, so teaching the nursing staff strategies for these patients becomes part of my job. For those who don't have memory deficits, teaching strategies and working with them on diet changes is the course of treatment. We have several different diet textures for patients who are exhibiting swallowing difficulties; regular, mechanical soft, chopped meats, and pureed. For liquid textures, we have thin, nectar thick, honey thick, and pudding. After a bedside evaluation, I determine the safest diet for each patient. In treatment, we work on upgrading back to the least restrictive diet. Changing orders aren't just as simple as writing an order and taking a form to the kitchen. Family members have to be called and, sometimes, Hospice is brought in to allow comfort for a patient. 
Language deficits are seen with strokes a lot of times. Strokes can have a terrible effect on speech and language. I see people who are no longer able to identify body parts or objects around their rooms, like the television or the chair. They can't name pictures or find words to communicate their needs. Others can no longer understand what people say to them. They don't process that information. This is such a touchy issue because people get frustrated when they can't get their words out or understand what's happening to them.
Communication and Speech go hand in hand. Dysarthria is a motor speech disorder and is characterized with articulation deficits. A person with dysarthria has problems forming words, so oral motor exercises are used to strengthen the facial muscles and help with articulation.  Dysarthria can also be very frustrating because my patients, being older, don't want to feel like they are in grade school learning to speak. Treatment can sometimes be very challenging!
Voice therapy is not my strong suit. I have only treated one or two people for voice disorders. I don't dislike voice, but I just haven't had the opportunity to work with this population!


I love being a Speech Therapist. Everyday brings excitement and challenges. I have lost 2 patients over the past 2 years, and I think about them and their families all the time. Loosing a patient is hard, but it comes with my career. And, it's a little comforting to know that I was able to increase their quality of life for the last few days of it.

So, this is my life as an SLP. It's easy and hard and challenging and rewarding all at the same time. And I love it.