SALT ASSESSMENTS

[Sigricb]

Hi Mum is in the later stages of Alzheimers and has been on pureed food for some time now. She can't feed herself or hold a cup so has a beaker with a spout which we slowly dribble into her mouth. She often has TIAs so the right sude of her mouth us often down making liquids difficult. She was referred to SALT ( speech and Language service) by the home. They saw her via video link!! Recommended thickener in her drinks which is fine but then a week later we are told she can't have a lid on the beaker anymore! Why? because SALT have said to tge home anyone who needs assisted to drink can't have a lid!! Result twice we have found mum in a wet bed from drinks and clearly she isn't getting much fluid which is exactly what we told the home would happen.
SALT are visiting mum in person next week so we intend to challenge this instruction.
Does anyone else have any experience of a blanket policy like this?

 

[Enzo309]

We had a similar issue with mam in hospital and at care home. Your mam needs to be supervised now when eating and drinking and the wet bedclothes suggest this isn't happening. You could raise your concerns with care home manager. We were fortunate that a consultant at hospital decided mam's 'quality of life' overrode the SALT Team's views - she would not drink the thickened liquid or eat the minced food. She was put back on normal water (with a beaker) and normal food and she actually put weight on and drank more which helped her low blood pressure.Good Luck going forward.

 

[nitram]

They saw her via video link!!

Things have changed a lot, legacy of covid?

Twelve years ago first SALT visit included feeling and listening to throat with stethoscope whilst swallowing yoghurt,
Correctly used lid was OK as long as no spout, carer has to be able to see amount going into mouth to prevent flooding at back of mouth.

 

[MowgliGirl02]

When mum was put on thickened liquids the hospital told me she couldn’t have a cup with a lid as this would likely cause her to aspirate. We ended up what little fluids she had was given to her through spoon. Mind you mum had completely forgotten how to swallow at that point.

 

[Louise7]

Hello @Sigricb you may find that whoever you spoke to at your mum's home who mentioned a 'blanket policy' for those needing assistance with drinking might have got the wrong end of the stick, so it's good that SALT are visiting again in person so that you can find out the actual position. You mention that the right side of your mum's mouth is sometimes 'down' due to TIA's, so that might also be something that the SALT team have taken into account in relation to fluid intake/swallowing. My mum is also at late stage and has had several SALT assessments over the last 6 months or so, and one assessment referred to her mouth not always forming a 'seal'. The SALT team recommended thickener and no lid on the beaker, so the nursing home staff now provide fluids using a spoon. This ensures that only a little fluid is given at a time to reduce potential aspiration/choking risks, and staff say that mum is drinking well, it just now takes longer. The staff at your mum's home should still be able to provide her with fluids without leaving her in a wet bed.

The SALT team should have provided a copy of their initial assessment report to the home and your mum's GP, so maybe ask to see this so that you are clear about what has actually been recommended. We found that in mum's previous care home quite often the staff were saying/doing one thing but the GP / medical records were saying something different, so it's worth getting a copy of any assessment reports if you can. Hope the assessment next week goes OK, let us know how you get on.

 

[Enzo309]

Same thing happened to my mam. Went into a care home for rehab and they'd put her on the Level 5 SALT recommendations again. We made a complaint to PALs service and received a response in which they claimed the home and the hospital had a 'different database' and info had not gone across. Took 3 days for us to sort it out and get mam back on normal food. The lack of communication is the most frustrating part of being a carer.