Treating Cognitive Deficits that Impact Safety with Oral Intake: A Primer Beyond Dysphagia Management

Credit

Handouts/Brochure

Speaker

Jerome Quellier, MS, CCC-SLP Related seminars and products

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Mr. Quellier is a retired clinical specialist in traumatic brain injury and communication disorders from a 450+ bed level 1 trauma hospital in Saint Paul, MN with over 28 years of acute, residential, and outpatient rehabilitation experience. Throughout his career, he focused on neuro-based diagnostics and intervention for dysphagia, cognitive-linguistic deficits, head and neck cancer management, patient advocacy, and curriculum development. Mr. Quellier completed advanced training in brain dissection at Marquette University, actively engaged in curriculum creation and staff development training, and collaborated with a neurosurgery team in preserving language function during tumor resections.

Mr. Quellier is excited to bring this topic to the forefront after working with the interdisciplinary team’s challenges in understanding the “what and why” of aberrant cognitive control that places patients at heighten dysphagia risk.

 

Speaker Disclosures:
Financial: Jerome Quellier receives a speaking honorarium and recording royalties from PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Jerome Quellier is a member of the American Speech-Language and Hearing Association.

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Objectives

1. Explore the neurology of appetite by defining neurotransmitter systems that drive our desire to eat and drink.
2. Discuss how alterations to the visual system can affect the patient’s ability to self-feed and thus increase dependency, as well as provide low cost/tech solutions that are readily implemented
3. Outline how medications, tube feedings, and environment can dimmish patient’s drive toward oral intake and identify key healthcare team members for collaboration and resolution of barriers.
4. Differentiate cognitive behavioral controls that affect eating behavior while examining clinical solutions to progress the patient towards improved intake and focus to task.

Outline

• The physiology of appetite and the role of serotonin/dopamine drivers to “eat”
• Factors that alter appetite and eating experience after brain injury (hyper, hypo): ageusia/anosmia, salivation, GERD and esophageal dysmotility

• Visual changes to locating food
• Clinical compensations and environmental modifications for success

• Pharmacology’s affect upon appetite: bowel meds, sedation, analgesics
• Tube feeding schedules and potential for glucose intolerance/reduced metabolic rate
• Lack of movement/bedbound status changing appetite
• Changes in upper extremity function: reduced ROM and stiffness
• Limitations of the research and potential risks for commonly used medications

• Affect of altered attention to task/visual organization
• Environmental distraction and the role of a chaotic room upon focus
• Degrees of supervision and cuing needed to balance safety and independence
• Returning to the Rancho Levels and applying appropriate expectations at each level

Target Audience

• Speech Language Pathologists 
• Speech Language Assistants  
• Physical Therapists 
• Physical Therapist Assistants 
• Occupational Therapists 
• Occupational Therapy Assistants 
• Respiratory Therapists