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$49.00 USD

99% rating - reviews

0.25  ASHA CEUs

Dysphagia In The Medically Fragile And Frail Elder: Management And Decision-Making #e106


Presenter: Paula Sullivan, MS, CCC-SLP, BCS-S

Learn a framework to guide the practitioner, team, and family with decision-making that is appropriate and realistic.


"Excellent course! Comprehensive and relevant to today's geriatric population with which we serve. Thank you!"

– L.C., prior course participant

Read more comments about this course!

Problems with swallowing, feeding, diet, and nutrition are common in the medically fragile and frail elder and often emerge during an acute event when prognosis is unclear. Thus, solutions are limited, fraught with emotion, and made with limited evidence regarding the most appropriate goals of care.

This comprehensive presentation will discuss the impact of illness and deconditioning on swallowing, review evidence-based interventions, and provide a clear framework to guide the practitioner, team, and family with decision-making that is appropriate and realistic, and more importantly, patient-focused. Information on how to communicate and document care plans and address challenging situations will be discussed. Case presentation will be an integral part of the presentation to illustrate these concepts.

Course is offered for 0.25 ASHA CEUs – 2.5 Contact Hours.

Course Overview & Run Time

Course Overview – Run Time: 2:38:45

  • Markers of frailty in the frail elder or medically fragile adult.
  • Decision-making tools to guide feeding choices/options for individuals with advanced dementia.
  • Strategies to help families and team members explore a patient's goals of care.
  • Individualized care plans relative to feeding goals.
  • The evidence and feeding tubes in advanced dementia.
"Great course giving a wealth of information as far as how to be an advocate for frail and elderly patients, and supporting families in a very stressful time with their loved ones. Course was very thorough and looking at dysphagia from all angles: medical, speech, educating patient/family members while respecting their values and choices."

– L.D., prior course participant

Read more comments about this course!

Content Disclosures

The content of this online CE course does not focus exclusively on any specific proprietary product or service. Presenter financial and non-financial disclosures may be found in the Presenter & Disclosures area.

Course Format

Video PowerPoint presentation with author narration & downloadable handout. Stop and re-start the course at any point. Learners retain access to course content after completion for ongoing reference and review.

Reviews

Comments From Prior Course Participants

"The decision-making process for a tube - I come across this all the time in my practice. The course was easy to follow along." A.S. (Dec. 2024)

"I found the "Guiding Decision-Making" section to be very informative. I enjoyed the convenience of this online course." A.W. (Oct. 2024)

"Decision support tools were helpful. Practical info and insight into dealing with this population." T.S. (Jun. 2024)

"I appreciate the suggestions and tools to assist with having these difficult conversations with family members. Lots of examples, resources, and tools for decision making." D.W. (Feb. 2024)

"The course content was all great, and I liked the references." C.O. (Nov. 2023)

"Tube feeding decision-making and palliative care were helpful topics. The videos were highly beneficial." R.K. (Nov. 2023)

"Realistic course. The discussion of instrumental assessment, clinical assessment, QOL, and goals of care was beneficial." S.W. (Oct. 2023)

"The decision-making in end-of-life within the hospital setting was a helpful topic. I liked the excerpts and examples of phrasing for documentation." S.C. (Sep. 2023)

"I liked the resources that I can share with patients and their families to aid in decision-making. This course supported my thought that instrumental testing is not always necessary for decision-making unless people are unsure of their decision or need further visual evaluation (visual) education of their actual swallow function and deficits." A.M. (Jul. 2023)

"Practical applications for long-term care settings. Discussion of tube feedings and thickened liquids was beneficial information." T.H. (Jul. 2023)

"The speaker was very clear and interesting to listen to. The handout was very well organized." L.H. (Jul. 2023)

"I liked the pace of course. Discussion of starvation at end of life." R.L. (Jul. 2023)

"Discussion of starvation and euphoria were beneficial topics. I liked the resources for families." E.M. (Jun. 2023)

"This course was informative. I liked the discussion that SLPs should not necessarily offer swallowing recommendations but options instead." G.B. (Apr. 2023)

"Realistic options for advanced dementia patients and the importance of educating family members. I liked the discussion of Palliative Care vs. Hospice and options available related to dysphagia decisions." K.H. (Jan. 2023)

"Very applicable for the acute care SLP. I liked the case studies and the section about communicating when goals of care are unclear." K.N. (Nov. 2022)

"I learned how to carefully hand feed and how to work with families/patients who refuse to accept non-oral feeding." D.O. (Aug. 2022)

"Good discussion of family education. This course was easy to understand." S.J. (Jul. 2022)

"I liked the incorporation of case studies. The session on dysphagia in the end stage dementia population was beneficial." L.G. (May 2022)

"Very empathic approach. I liked the point that feeding tubes can actually detract from patient health." J.D. (Jan. 2022)

Course Objectives

At course conclusion, participants will be able to:
  1. Name three markers of frailty in the frail elder or medically fragile adult.
  2. List the benefits of using decision-making tools or aids to guide feeding choices/options for individuals with advanced dementia.
  3. List three decision-making tools, aids, and educational materials for use in guiding decision-making by family members.
  4. Learn strategies to help families and team members explore a patient's goals of care.
  5. Write individualized care plans relative to feeding goals.
  6. Discuss current tenants of care supported by the evidence regarding feeding tubes in advanced dementia.

Presenter & Disclosures

Paula A. Sullivan, MS, CCC-SLP, BCS-S

Paula A. Sullivan, MS, CCC-SLP, BCS-S, currently is a Senior Speech-Language Pathologist in the Department of Neurology/Speech Section, North Florida/South Georgia Veterans Health System in Gainesville, FL. Paula's clinical expertise and research are focused on swallowing disorders in head and neck cancer and at end-of-life. She has been affiliated with numerous comprehensive cancer centers, including H. Lee Moffitt Cancer Center, Tampa, FL, Sylvester Cancer Center, Miami, FL, and the University of Wisconsin, Madison, WI. Paula also has participated as part of numerous clinical research trials in swallowing.

Paula served as a co-regional primary investigator for the largest controlled, randomized research trial in oropharyngeal dysphagia funded by the National Institutes of Health (Protocol 201). Protocol 201 examined the effectiveness of chin down and thickened liquids in individuals with dementia and Parkinson's disease both with and without dementia. Additionally, Paula has published numerous articles, book chapters, and co-authored books, including Swallowing Intervention in Oncology and the Easy-To-Swallow, Easy-To-Chew Cookbook. She also has co-authored multiple national guidelines, directives, and policies relating to oropharyngeal swallowing disorders for both the Veterans Health Administration and the American Speech-Language-Hearing Association (ASHA). She is a board recognized specialist in swallowing and swallowing disorders. Paula is an ASHA Fellow and former coordinator of ASHA's Division 13, Swallowing and Swallowing Disorders. She was named "2013 Clinician of the Year" by the Association of Veterans Affairs Speech-Language Pathologists. 

Speaker Disclosures:

Financial — Paula Sullivan is a coauthor of the text, "Easy-To-Swallow; Easy-To-Chew Cookbook"; receives royalty payments.

Financial — Paula Sullivan is a presenter of online CE courses sponsored by Northern Speech Services; receives royalties.

Nonfinancial — Paula Sullivan has no relevant nonfinancial relationships to disclose.

Intended Audience / Accreditation

Intended Audience/Accreditation
asha ce approved provider

This program is offered for 0.25 ASHA CEUs (Intermediate Level; Professional Area).

Intended Audience

  • Speech-Language Pathologists

ASHA CEUs: NSS online courses are registered with ASHA and are offered for ASHA CEUs. The number of ASHA CEUs is noted above. Note that 0.1 ASHA CEU = 1 contact hour = equals 1 CEE.

ASHA CE Registry: During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). This submission happens once per month, during the first week of the month. For example, if you complete your course on November 7th, NSS will submit all November online course CEUs to ASHA during the first week of December. When ASHA inputs the information into their database, they will mark the course as completed on the last day of the month in which it was completed, so November 30th using this example. The certificate of completion available for you to print immediately, however, will reflect the actual completion date, November 7th in this example. Due to ASHA processing procedures please allow 2-3 weeks, from the submission date, for the course to appear on your ASHA transcript.

ASHA CEUs: Attendees must meet at least one of the following conditions in order to be eligible to earn ASHA CEUs:

  • Current ASHA Member
  • ASHA Certificate of Clinical Competence (CCC) Holder
  • Licensed by a state or provincial regulatory agency to practice speech-language pathology (SLP) or audiology
  • Credentialed by a state regulatory agency to practice SLP or audiology
  • Credentialed by a national regulatory agency to practice SLP or audiology
  • Engaged in a Clinical Fellowship under the supervision of an individual with their ASHA CCC
  • Currently enrolled in a master's or doctoral program in SLP or audiology

If an attendee is not an ASHA member or CCC holder but meets any of the above criteria, they may inform the ASHA CE Registry of their eligibility by visiting this site.

Licensing Boards: Most state licensing boards DO accept CEUs earned online (usually classified as home-study credits). Some state boards do, however, place a limit to the number of credits that can be earned via home study/online courses. For the most current information, we suggest that you contact your licensing board or agency to verify acceptance policies and/or any credit limits related to home-study courses prior to registering for this course.

Additional accrediting agencies by which Northern Speech is an approved CE provider:

  • California: NSS is approved as a provider of continuing education by the California Speech-Language Pathology & Audiology Board. Provider #PDP4. Online CEU limits may apply; please contact SLPAHADB for current online CEU acceptance policies.
  • Iowa: NSS is approved as a provider of continuing education by the Iowa Board of Speech Pathology and Audiology Examiners. Provider #169.
  • Kansas: NSS is approved as a provider of continuing education by the Kansas Department of Health and Environment. Provider #LTS-S0005.

Frequently Asked Questions

Online Course FAQ — Click Here

Customer Support: Please phone 888.337.3866 or email info@northernspeech.com.

Course Completion Timeframe:

You have unlimited time to complete our online courses. You may log off and log on as often as you’d like to in order to complete all sections of a course.

However, completion dates are based on Eastern Standard Time. Therefore, if you need your CEUs by a certain date, be sure to complete the course test before 11:59pm EST on that date. For example, if you need CEUs before January 1st, you will need to complete the course test before 11:59pm EST on December 31st.

Content Access:

Access to course materials and content does not expire, even after completing the post test. You may continue to review course material by logging into your NSS account, clicking the My Online Courses tab, and then viewing your desired course.

Certificate of Completion:

On successful completion of the post test (80%), a certificate will be immediately available for download and/or printing. This certificate will include your name, date of completion (based on Eastern Time Zone, USA/Canada), and number of contact hours (CEUs / CEEs). Please note that CEUs are awarded on the date of successful test completion, not the date of course enrollment. Please ensure that you successfully complete the post test prior to any licensure renewal dates.

ASHA CE Registry Submission:

During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). This submission happens once per month, during the first week of the month. For example, if you complete your course on November 7th, NSS will submit all November online course CEUs to ASHA during the first week of December. When ASHA inputs the information into their database, they will mark the course as completed on the last day of the month in which it was completed, so November 30th using this example. The certificate of completion available for you to print immediately, however, will reflect the actual completion date, November 7th in this example. Due to ASHA processing procedures please allow 2-3 weeks, from the submission date, for the course to appear on your ASHA transcript.

Purchase Orders:

Purchase orders are currently not accepted for online orders, if you wish to submit a purchase order please do so at info@northernspeech.com or fax to 888-696-9655.

What is an Online Course?

Our Online Courses consist of video, audio, and/or text content and are offered for ASHA CEUs. Unlike a webinar, which requires participants to be logged on and at a computer at specific times, our Online Courses are available to you at any time, from any device, via your NorthernSpeech.com online account. You may work at your own pace and start and stop your course as you wish. Your course will conclude with a short post test. On successful completion of the post test (>80%), a printable certificate of completion is presented to you.

Receiving CEUs:

Northern Speech is an ASHA CE Provider and our online courses are registered with ASHA and offered for ASHA CEUs. Please note that successful completion of the online post test is required prior to the awarding of CEUs. Please contact your state licensing board for acceptance policies related to CEUs earned online. Please note that courses offered for university students are not applicable for CEUs.

Registering for an online course:

You may browse all online courses by clicking the Continuing Education tab above, then Online Courses. Once you find a course, click Enroll Now, and you will be asked to either log into your existing Northern Speech account or create a new online account. Once you’ve entered your account information and provided your credit card payment, your course will be immediately available to you.

Accessing your purchased course or returning to a purchased course:

You will be able to access your online course by logging into your Northern Speech account and then clicking the My Online Courses tab on your profile screen. Click the course you would like to start or to resume. From there, proceed through the course sections until you are ready to complete the post test. You do not have to complete your course all at once. You may log on and off as you wish.

Testing requirements:

Each online course concludes with a post test consisting of multiple choice or true & false questions. Scores of 80% or greater are required for successful course completion and awarding of CEUs. You may revisit course materials and retest as needed to achieve a passing score.

Number of CEUs offered:

We offer courses from 1 to 21 contact hours. Each course will note the number of CEUs offered. Please note that 0.1 CEU = 1 contact hour = 1 CEE.

State licensing boards and online CEUs:

NSS is an ASHA CE Provider and most state licensing boards DO accept ASHA CEUs earned online (usually classified as home-study credits). Some boards do, however, place a limit to the number of CEUs that can be earned via home study/online courses. For the most current information, we suggest that you contact your licensing board or agency to verify acceptance policies and/or any CEU limits related to home-study courses prior to enrolling in an online course.

Course formats:

Our course formats include: text, audio, video, and PowerPoint with author narration. Each course will note the format on the course description page. Most courses include closed captioning.

Course handouts:

Most of our online courses provide a link to download the accompanying handout as a PDF file. 

Group discounts:

Groups of 3 or more are eligible for a 20% discount on each registration on most of our online courses. To receive this discount, registrations need to be processed together via the "Group Rates" tab on the Online Course of your choice.

Computer requirements:

For our online courses to function best, we recommend that you update your computer to include the newest version of your Internet browser (Safari, Chrome, Firefox, Edge, Internet Explorer, etc.) and newest version of your computer's operating system. Also a high-speed Internet connection is recommended (cable or DSL). Speakers or headphones will be required for many of our courses as many contain audio components.

Course Cancellation Policy:

A purchased online course can be exchanged, refunded, or transferred to another individual if contact is made with NSS (via phone or email) within 30 days of purchase and the course materials have not been viewed or downloaded. 

Special Needs:

Please click here for any special needs requests, and we will do our best to accommodate them. 

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