Speech Therapy in Home Health

Home Health speech therapy services cover a diverse set of challenges including those of swallowing, speech, language, voice, and cognition. People may need these services for a variety of reasons ranging from having experienced a stroke or car accident, to families caring for an elder with dementia, struggling with some behavioral challenges.

A swallowing disorder is also called 'dysphagia'. This can include difficulties chewing food, getting a swallow started, coughing while eating (aspirating), or food/liquids getting stuck in the throat. A speech therapist will watch a patient eat and drink different textured foods and determine which textures are causing difficulties, and if positioning will reduce the problem. Recommendations might include doing swallowing exercises, eliminating various foods, or special positioning. Speech therapists work closely with caregivers to teach ways to prepare foods/drinks or teach the recommendation. The goals of home health speech therapy are to assure the patient can eat sufficient amounts of food with the least risk of having foods go 'down the wrong tube,' which can lead to aspiration pneumonia and/or death. Daily tooth brushing, soaking dentures, and use of mouthwash are one of the most important ways to combat aspiration pneumonia, as it reduces the amount of bacteria that often causes pneumonia. Pneumonia accounts for 50% of all infectious illness for people in care facilities, and therefore it is essential that a speech therapist evaluate someone who is showing signs of swallowing difficulties to minimize this risk.

Speech therapists can help people improve their ability to talk. For example, if a patient has had a stroke and can't speak clearly, a speech therapist can provide exercises for the tongue and lips that will strengthen those muscles.They also provide education to family members on ways that they may improve their interactions with the patient so that successful communication is achieved.

Language is different from speech in that it is the ability to think of the words and create logical statements, rather than how the words get articulated. The most common thing I hear from my patients is, “I just can't think of the right word.” Although the brain is NOT a muscle, it responds like a muscle in that you 'use it or lose it'. For that reason, I recommend that ALL people do brain exercises. These can be fun activities like playing cards, participating in a book club, playing an instrument, or doing crossword puzzles. Still, some people need more than just keeping an active brain to be able to say what they want effectively. In this case, a speech therapist can provide exercises that help people more easily retrieve those words.

Voice means the quality of sound a person produces. For example, a person's voice might be described as hoarse, too quiet, or too loud. Often a voicing problem needs to be first evaluated by an ear-nose-throat physician to assure there is no anatomical or medical problem. If not, then a speech therapist can provide recommendations and exercises to improve the quality of speech. The most common patient I see for voice therapy is someone with Parkinson's Disease whose voice is too quiet.

Cognition is a huge field which includes problem solving, organizing a set of sequences for a task, memory, and any other issue in the thought process. A speech therapist can work on improving those areas as well as develop a system to cope with living with cognitive deficits.

Cascade Home Health is committed to helping people lead as meaningful, healthy, independent lives as is possible in their current living situation. By providing suggestions and education, the speech therapist can help patients and their families reach their goals.