Culture Change is a Clinical Skill, Too


Imagination is the highest form of research.

-Albert Einstein

by Heather Jeng

At SLPs in the SNF, we’re always pretty excited about research, and reading other people’s Research Tuesday blogs, and (when we don’t procrastinate too much!) writing our own Research Tuesday blogs. But today we are super-excited. This article is amazing, and we think all y’all need to read it just so we have people to talk to about it with!

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Ethics, Fraud, and Perception of the Value of SLP Services

By Heather Jeng

Lately, it seems like litigation against skilled nursing/long-term care therapy providers is becoming more frequent. See, for example, this recent story about the DoJ pursuing a case against ManorCare (owned by The Carlyle Group) for allegedly providing medically unnecessary therapy. As therapists, we might ask, “How could the company itself provide medically unnecessary therapy? Each plan of care was generated and signed by a skilled, licensed therapist.” Continue reading

Predictors of Speech Outcomes in Parkinson’s Patients with Deep Brain Stimulation


By Heather Jeng

Usually, we SLPs in the SNF find ourselves reading clinical research within the field of speech-language pathology. This month, we’re taking an interdisciplinary perspective by checking out what some of our neurosurgeon & neuroscience colleagues have been focusing on regarding deep brain stimulation (DBS) and speech intelligibility.

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Cognitive Intervention with Individuals with Dementia: Linking Strategies to Targets

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By Nikki Kneale

It is estimated that by 2050 up to 16 million Americans will be living with dementia. This does not mean that this is solely a problem for the future. In a 2013 survey by ASHA, cognitive communication ranked second in percentage of caseload make-up; specifically, cognitive communication for dementia ranked 3rd (ASHA, 2013). There are a number of strategies SLPs working with residents who have dementia can use, each with their own small but growing body of evidence. So, which treatment strategy is a therapist to use? How do we know which one is best?  Continue reading

Cognitive Screens for People with Parkinson’s: All Are Not Created Equal


By Heather Jeng

Do you know what cognitive screening tool is used in your local healthcare community to screen for cognitive deficits in individuals with Parkinson’s disease (IWPD)? Chances are, it’s the MMSE. This tool was suggested for physician office visit screenings for this population by the Task Force on Dementia in Parkinson’s Disease (part of Movement Disorders Society) back in 2007. The general guideline for physicians was not to pursue further cognitive assessment if the patient scored at least 26 on the MMSE.

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Adventures in AAC

by Nancy Reinhardt

So, here’s the case that prompted the fascination: I had a cognitively intact patient who admitted to my nursing home with Progressive Supranuclear Palsy (for those of you who don’t know, this is a disease that results in the gradual deterioration of the brainstem and results in, among other things, decreased speech intelligibility along w/ decreased coordination- for more information, I recommend visiting On admit, this gentleman was able to verbally communicate, although speech intelligibility was markedly impacted to unfamiliar listeners.  Continue reading

Introductions & Venturing Into Blogging…

We’re a trio of speech-language pathologists (Case Western alums, all!) in the SNF setting. We came to the realization that we all rely on social media for multiple professional purposes: finding out about new treatment approaches, hearing about continuing ed opportunities, seeking and giving clinical advice, puzzling over the nuts and bolts of applying research findings to clinical practice, and laughs, venting, and support. In short, community!  Continue reading