Currently i am working with a patient who has profound cognitive impairments, is non-verbal, largely non-responsive and requires hand over hand facilitation and prompting to follow instructuions e.g. to brush her teeth/wash her hands. She has a PEG feed and in the handover was getting trialed on grade 2 thickened fluids.
What i have learnt
The patients family are extreamely stressed about her communication and cognition. I have assessed the patient's swallow using observation and cervical auscultation (as she can't vocalise after swallowing). No abnormalities were noted except for a delayed oral stage and an effortful swallow. The patient was able to eat a yogurt and to drink thin fluids when given hand over hand facilitation. She is dysphraxic so responded best to hand over hand feeding and to thin fluids as this was more natural for her. Her family appreciated being handed over tangible feeding/drinking tasks to do with her.
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