Hong Kong East Community Geriatric Assessment Services ...
Enhancing the Quality of Care for Old-Aged H ome Residents with Dysphagia Through a Com munity Speech Therapy Pilot Project in the Ho ng Kong East Region Speech Therapy Department Ruttonjee and Tang Shiu Kin Hospitals Candy Ngan (Speech Therapist i/c) Rita Wong (Speech Therapist) Christina Chan (Speech Therapist) Jamy Wong (Clerk)
Background Problems encountered at out-patient ST clinic Patient:frail elderly, chair-/bed-bound with transport problem OAH staff: inadequate knowledge on risks prevention and swallowing management Speech Therapist: face with poor carryover, poor compliance and high default rate
Extent of problems A) 24% of out-patient speech therapy referrals are OAH residents (Survey: by ST Department, RHTSK, from Oct, 2000 March, 2001) Extent of problems B) 8.5% (119) OAH residents require non- o ral feeding 9.1% (128) OAH residents (on oral feedin g) were reported to have swallowing diffic ulties
(Questionnaire Survey to 14 OAHs in HKE region) Extent of problems C) Average time spent for transportation by NEATS = 168 minutes (Survey: 1 - 28 February, 2001 in ST Clinic, RHTSK) CST Pilot Project
Community Speech Therapy (CST) service for HKE commenced in May, 2001 Aim: enhance service quality and outcomes to OAH residents with swallowing problems Preparation Work
Liaison work with - CGAT, HKE - OAH in-charges - Medical and Geriatric teams of other hospitals in HKE through our CGAT - Speech Therapy Department of PYNEH/TWEH/WCHH - Finance Department Preparation Work
Educational materials Risk identification and swallowing management protocol Service guidelines Referral guidelines
Programmes Education Educational Talks
Practical training On-site consultation Swallowing Assessment Intervention Swallowing management guidelines
Carer Education CST Coverage 11 Old Aged Homes (6 PNHs and 5 C&AHs) under CGAT coverage 1692 residential places Inclusion criteria: - Patients of the 11 OAHs - Medical referral required
Present Progress (April, 2005 to March, 2006) Manpower: 0.2 speech therapist FTE Total new attendance: 160 Total attendance: 558 No. of residents who had completed
swallowing intervention by ST in April, 2005 to March, 2006 = 137 Outcomes Education 2 major education programs 2002 Train-the-trainer Dy sphagia Managemen
t Enhancement Prog ram 2005 Swallowing Management Refresher Course Outcomes Education - satisfactory results from post-talk questionnaire survey
- increase the level of awareness, risk identification and swallowing management skills " nursing home, , ; . , ." "
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