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Etta Rose (assessment (feeding trial (excessive coughing during pharyngeal…
Etta Rose
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Etta values her independence and hopes to return to living independently in her home and return to work.
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Goals:
2 LTG
In 2 weeks client will, modified independently self feed for 10 minutes sitting in a chair with back and arm support utilizing built up spoon while taking 2 self initiated rest breaks.
In 2 weeks client will, independently participate in 6 minute conversation during mealtime to improve social participation.
2 STG
In 1 week client will, self feed for 8 minutes while sitting in a chair with back and arm support using built up spoon with min assist and 2 verbal cues for rest breaks.
In 1 week client will, participate in 4 minute conversation during meal time with 2 verbal reminders of effortful swallow and proper positioning with min assist to improve social participation.
occupational performance Deficits: Etta's poor endurance, impaired ability to self pace, and reduced strength impair her ability to participate in work and social participation
It also impairs man ADL, and IADLs, such as grooming, bathing, feeding, cooking, home maintenance,dressing
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intervention
VitalStim
Vitalstim is known to benefit patients with low sensation and those at risk of aspiration (Benavente,2018)
it aids in strengthening weak muscles and improving motor control (Benavente, 2018).
research shows that those with COPD often have decreased sensitivity of laryngopharynx((Clayton, Carnaby, Peters, & Ing, 2014)
Due to Etta's decrease In sensitivity the Vitalstim will aid in increasing the strength of her swallow
Grading up is utilizing this technique until she builds the strength to participate in eating without the use of vital stim, or using a lower setting on the machine.
Grading down would be increasing the assistance she received through the vitalstim