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Speech and Language Therapist Template

Dysphagia Assessment - Note

A professional Speech and Language Therapist template for healthcare professionals.
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Specialty

Speech and Language Therapist

Used

73 times

Type

Note

Last edited

6/19/2025

Created by

rachel moir

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About this template

The Dysphagia Assessment Note template is a comprehensive tool used by Speech and Language Therapists to document the evaluation and management of swallowing disorders. This template guides clinicians through capturing essential information such as the reason for referral, assessment findings, and detailed recommendations for managing dysphagia. It includes sections for oro-motor skills, food and drink assessments, and personalized intervention plans. This template is ideal for ensuring thorough documentation and effective communication of care plans, making it a valuable resource for clinicians specializing in speech and language therapy.

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Reason for Referral: - The patient was referred due to persistent coughing and choking during meals, raising concerns about potential dysphagia. Background Information: - The patient is a 72-year-old male with a history of stroke six months ago, which has affected his swallowing abilities. Summary of Assessment: - The assessment revealed moderate dysphagia with difficulties in managing both solids and liquids, particularly thin liquids. Case History: - The patient has a history of hypertension and type 2 diabetes, and he experienced a left-sided stroke, which has impacted his speech and swallowing. Oro-Motor Skills Assessment: - The assessment showed reduced tongue strength and coordination, with delayed swallow initiation. Food Assessment: - The patient struggled with chewing and swallowing solid foods, requiring multiple swallows per bite. Drinks Assessment: - The patient exhibited coughing and throat clearing with thin liquids, indicating aspiration risk. Recommendations: - Environment: Ensure a quiet and distraction-free environment during meals. - Positioning: The patient should be seated upright at a 90-degree angle during meals. - Food and Texture (IDDSI level): Recommend soft and moist foods (IDDSI Level 5) to facilitate easier swallowing. - Drinks (IDDSI level): Recommend thickened liquids (IDDSI Level 2) to reduce aspiration risk. - Assistance: Supervision during meals to ensure safe swallowing practices. - Communication: Use simple, clear instructions to guide the patient during meals. - Oral Hygiene: Encourage regular oral hygiene to prevent infections. - Sensory Issues: Monitor for any changes in taste or texture preferences. - Cognitive Issues: Provide reminders and cues to aid in meal completion. Intervention Plan and Next Steps: - Initiate a swallowing therapy program focusing on strengthening exercises and safe swallowing techniques. Schedule follow-up in four weeks to reassess swallowing function and adjust the care plan as needed.

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