1. Think of a therapy session or event
·
Referral to review a patient’s swallow. The
patient had cerebral palsy. He was found to be at risk of aspiration but did
not aspirate on soft foods and thin fluids during a videofluoroscopy.
·
The patient’s mother refused to let me in to assess
the patient. She reported that the patient was being seen by another SLT team
(information which I verified). She also reported that it was not a good time
to visit the patient since she had a monetary dispute with some other family
and that she was his only carer and spoke to him in Portuguese. I handed over advice
and wrote a letter to the patient’s GP explaining the situation and
recommending a review.
·
Several months later an SLT from the learning
disability team contacted me for information about the patient. She reported
that the patient’s mother refused entry to a physiotherapist and to members of
her team.
·
She reported that the patient was now PEG fed
and that his communication had deteriorated. She agreed to contact the
patient’s GP and to oragnise a professionals meeting regarding the patient’s
care.
2. What did this make you feel?
·
I felt anxious that I could be at fault for not
being more proactive about gaining access to the patient/ contacting the adult
safeguarding team. I had felt that since the patient was being seen by another
team and did not aspirate during his videofluoroscopy that I could handover
advice and discharge.
What would you change and why?
·
I would contact the adult safeguarding lead to
discuss the case.
·
I would ensure that I spoke directly to the
patient’s GP to relay my concerns.
·
I would document my discussion with the
patient’s mother in more detail and explain to her further the risks of
withholding treatment. I would also try to be more persuasive and ask whether
the patient had capacity to make a decision whether or not to accept a visit.
What has this taught you?
1.
To ensure that I speak to a safeguarding lead/
GP if I have concerns about a patient rather than just sending a letter.
2.
To document all discussions thoroughly including
information on risks.
3.
To be more thorough when collecting information
and to consider linking in with hospital/ other therapy teams further.
