SLP-RehabEd-Dysphagia Pathways Program: Palliative dysphagia management and ethical considerations

This course will equip speech-language pathologists to navigate complex clinical situations when conventional recommendations for dysphagia management are not preferred by a patient or inadvertently cause harm to the patient, necessitating a different plan of care. This course will discuss medical ethical principles in depth, and their application to the management of dysphagia. It will challenge clinicians to consider the impact dysphagia recommendations, including modified texture diets and alternative means of nutrition and hydration, can have on patient quality of life and psychosocial well-being. This course will teach clinicians how to discuss goals of care with patients and caregivers, and how to document these conversations, including assessment of informed consent and counseling skills to promote positive shared decision-making. This course will outline a decision tree that designates procedural steps and concludes in two plan of care pathways: Common Dysphagia Management and Palliative Dysphagia Management. The speech-language pathologist will learn what can be offered to patients who prefer palliative management of dysphagia, and changes to swallowing at end-of-life.

1. Outline four key medical ethical principles and explain how they relate to dysphagia management
2. Define informed consent and shared decision-making
3. Identify factors that indicate need for a dysphagia goals of care discussion
4. Utilize the Dysphagia Pathways Program decision tree to navigate complex clinical scenarios
5. Conduct a dysphagia goals of care discussion
6. Identify factors that indicate need for a palliative care and/or clinical ethics referral
7. Describe treatment techniques for palliative dysphagia care and changes to swallowing at end-of-life

“This activity has been approved by the Ohio Speech and Hearing Professionals Board for 1.5 clock hours of continuing education in ETHICS specific to the clinical practice of speech-language pathology, for the 2023-2024 and 2025-2026 practice period, running from January 1, 2023 through December 31, 2026.”