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1. Identify the foundation for dysphagia treatment by understanding the nature of the swallow disorder(s).
2. Distinguish between structural and functional esophageal dysphagia disorders and discuss treatment interventions.
3. Identify specific neuromuscular disorders that correspond with oral, pharyngeal and esophageal dysphagia.
4. Specify step-by-step directions for all compensatory strategies, postural adjustments, maneuvers and exercises with explanation of purpose and rationale for function.
5. Identify risk factors for aspiration pneumonia and the substantial role of oral hygiene.
6. Discuss the pharmacological impacts of medications on dysphagia and common symptoms of Adverse Drug Reactions.
7. Identify the characteristics of the "Aging Swallow" and the altering physiological changes that place the elderly at risk for life threatening pneumonias.
8. Discuss explicit assessments and treatments for respiratory and pulmonary functions related to dysphagia.
9. Generate patient-centered goals and skilled document notes for specifically-identified dysphagia disorders, meeting Medicare guidelines.

Aspiration / Pneumonia / Oral Hygiene

• Risk factors
• Dysphagia and oral care

Neuromuscular Disorder /Pathophysiologies

• Delayed pharyngeal swallow
• Absent pharyngeal swallow
• Inadequate velopharyngeal closure
• Reduced pharyngeal wall contraction
• Unilateral pharyngeal paralysis
• Upper esophageal sphincter
• Reduced laryngeal elevation
  

Oral Pharyngeal Assessment

• Bedside/screenings
• Clinical examinations
• Modified Barium Swallow Fluoroscopic Exam (MBS)
• Penetration-Aspiration Scale
• Fiberoptic Endoscopic Evaluation of Swallow (FEES)
• Manometry
  

Oral Pharyngeal Treatment

•  Direct treatment techniques & rationale
• Diet modifications
• Electrical stimulation
• Maneuvers
• Enteral Feedings
• Indirect treatment techniques & rationale
• Compensatory strategies
• Postural adjustments
• Facilitating techniques
• Behavioral interventions
• Exercises
  

Esophageal Assessment

• Clinical assessment of esophagus
• Structural abnormalities/disorders
• M obility abnormalities/disorders
• Iatrogenic
• Neuroplastic
• Infectious Diseases
• Congenital Development
• Inflammatory
  

Esophageal Treatment / Options

• Medical intervention
• Endoscopic therapy
• Surgical intervention
  

Respiratory, Pulmonary Diseases & Dysphagia

• Assessment of breathing and swallow patterns
• Respiratory system
• Pulmonary function
  

Neurogenic Conditions with Corresponding Swallowing Disorders

• Cortical Stroke / Subcortical Stroke
• Brainstem stroke
• Head Trauma / TBI
• Amyotrophic Lateral Sclerosis (ALS)
• Multiple Sclerosis
• Parkinson’s Disease
• Alzheimer’s Disease
• Cerebellar Degeneration
  

The Aging Swallow

• Characteristics of the “Old Swallow”
  

Dysphagia & Drugs: Pharmacological Impact on Dysphagia

• Dysphagia symptoms associated with specific medications
• Adverse Drug Reactions (ADR)
• Non-compliance with medications
  

Documentation: Patient-Centered Goals

• Patient-Centered, phase-specific goals
• Skilled Intervention terminology
• ICD codes

Jane Yakel, M.S., CCC-SLP, is a certified and licensed (VA #2202005215) Speech-Language Pathologist with over 40 years of experience in the care of persons suffering from neuropathology disorders. Jane is currently a private contractor and consultant in Virginia and has worked in a variety of settings including acute care, outpatient clinics, home health agencies, skilled nursing homes, independent and assisted living facilities, hospitals and schools. She has taught at the University of Wyoming, Utah State University and DeVry University (Phoenix). She has been a regional clinical specialist and a national trainer for rehabilitation program directors and has served as a director of a community re-entry program for traumatic brain injury survivors. She has shared her expertise as an author and presenter at national and state board continuing education courses on various topics including, Prospective Payment System; Medicare Documentation; Ethics and Professionalism; Comprehensive Assessment of the Adult Patient; Quality Indicators; QA/QI; Customer Service; Nursing Documentation; Managing Dysphagia as well as Cognitive Communication Disorders in the Neurological Impaired; Cognitive Rehabilitation and Dementia.

Jane is the author of two comprehensive manuals and informative guides in the field of Dysphagia and Cognitive Rehabilitation. Jane’s book, Dementia: Interventions for Severe Cognitive Impairments, gives detailed intervention strategies for professionals working with patients who suffer from significantly decreased cognitive status. The book is tailored for multiple disciplines within the healthcare field as well as caregivers.

Jane is a member of the American Speech-Language-Hearing Association, served as a representative for the People to People Ambassador Program for America Speech and Hearing Association and is a prior member of the Wyoming Board of Examiners for Speech-Language Pathology and audiology. She completed her undergraduate and graduate studies at the University of Wyoming, specializing in neuropathology. Jane currently owns ProStar Communications, LLC, a professional communications company, and Yakel Educations, LLC, a professional publishing company.

Speaker Disclosures:

Financial: Jane Yakel is the owner of ProStar Communications, LLC and Yakel Educations, LLC. She receives a speaking honorarium from PESI, Inc.

Non-financial: Jane Yakel is a member of the American Speech-Language-Hearing Association.

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CE Information Coming Soon
Continuing education credit information is coming soon for this non-interactive self-study package.

CEs may be available for select professions, as listed in the target audience. Hours will be dependent on the actual recording time. Please check with your state licensing board or organization for specific requirements.

There may be an additional fee for CE certificates. Please contact our Customer Service at 1-800-844-8260 for more details.

**Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners. For speaker disclosures, please see the faculty biography.

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Registered Dietitians & Dietetic Technicians

PESI, Inc., PE001, is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR) from July 1, 2019 through June 30, 2022. Registered dietitians (RDs) and dietetic technicians, registered (DTRs) will receive 6.0 continuing professional education units (CPEUs) for completion of this program/materials. Continuing Professional Education Provider Accreditation does not constitute endorsement by CDR of a provider, program, or materials. This self-study program/material is designated as LEVEL 2.

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Nurses/Nurse Practitioners/Clinical Nurse Specialists - Credit Expired: 11/21/2017
No CE available for this board.

California Nurses: PESI, Inc. is a provider approved by the California Board of Registered Nursing, Provider #:17118 for 6.0 self-study contact hours.

You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Nurses: PESI, Inc. is an approved provider by the Florida Board of Nursing. Provider #: FBN2858. These materials qualify for 6.0 self-study contact hours.

Iowa Nurses: PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 6.3 self-study contact hours.

Copies of the evaluation may be sent to the IBON. You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Occupational Therapists & Occupational Therapy Assistant: PESI, Inc. is an approved provider with the Florida Board of Occupational Therapy. Provider Number 50-399. This self-study course qualifies for 6.3 continuing education credits.

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Speech-Language Pathologists & Audiologists
This course contains 6.0 hours of self-study continuing education. It was not offered for ASHA CEUs. Please retain your certificate of completion. If audited for ASHA Certification Maintenance, you can submit this certificate of completion at that time. For state licensure, teacher certification renewal, or other credential renewal, contact those agencies for information about your reporting responsibilities and requirements.

California Speech-Language Pathologists/Audiologists: PESI, Inc. is an approved provider with the California Speech-Language Pathology and Audiology Board, #PDP 319. This course meets the qualifications for 6.0 hours of self-study continuing professional development credit for Speech-Language Pathologists or Audiologists, as required by the California Speech-Language Pathology and Audiology Board.

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Other Professions
This self-study activity qualifies for 6.25 clock hours of instructional content as required by many national, state and local licensing boards and professional organizations. Retain your certificate of completion and contact your board or organization for specific filing requirements.

Disclaimer: **Information obtained in this course should be used within your scope of practice.
**It is your ethical responsibility to report accurate hours to your licensing board.
**All self-study participants must complete and pass (80% or better) a post-test and evaluation prior to receiving a certificate of completion. If you require a copy of the test/evaluation for CE purposes, please print at the time you take the test. Or you may call our customer service department and a copy of your test/evaluation will be emailed to you. Please allow 30-45 days.

Speech-Language Pathologists, Nurses, Rehabilitation Nurses, Occupational Therapists, Occupational Therapy Assistants, Respiratory Care Practitioners, Dietitians