For Patti’s who's advanced MS symptoms prevent her from directing her own care, I really have to randomly and unannounced ‘drop in’ to check on certain aspects of care.
Swallowing and choking have plagued mealtime with progression in recent years. Patti’s meals have to be cut into tiny pieces to facilitate chewing or lack thereof and swallowing. Foods have to be equally ‘soft’ in texture. Drinks have to be in small glasses that she can hold and so on.
Heimlich maneuvers have been too frequent and a near fatal incident occurred at her parents’ home involving loss of consciousness and an EMS team not too many years ago. Patti’s meals MUST be pre-prepared and monitored. You can NEVER let down your guard.
In an institutional setting with revolving staff it does not take too much imagination to see how easily and quickly it could all go wrong.
From the National Multiple Sclerosis Society “Speech disorders are fairly common in MS. Lesions—damaged areas—in different parts of the brain can cause several types of changes in normal speech patterns. …Long Pauses … Words are Slurred … Swallowing Problems …”
Speech therapists have unsuccessfully evaluated and attempted to work with Patti. In her case not only is dysphagia a factor but mental confusion and memory literally cause her to forget what she is doing while in the middle of swallowing.
Yesterday I ‘dropped in’ just before lunch. I was most pleased to find Patti chatting and giggling away at a table with two other residents. The facility dinning room is restaurant like in appearance and atmosphere. Patti’s juice, milk, and ice tea were all in small perfectly sized glasses for her. Her lunch of sweet and sour chicken and side dishes were served cut into tiny pieces. .
Not only did her table mates ‘remind’ her to eat slowly but a dinning room staffer asked me how much longer I would be staying because she monitors Patti and another couple residents at lunch.
As a surprise 'plus' when asked about physical therapy, Patti though begrudgingly complaining about it <grin> admitted she had participated that morning in exercising her legs.
Randomly and unannounced, ‘inspecting what I expected’ had the most pleasant of results.