Integration of a Team Approach to Hypertension Treatment

Pharmacological intervention for depressive symptoms in institutionalized elderly is higher than the population average. Among the patients on such medications are those with a puzzling mix of symptoms, diagnosed as “dementia syndrome of depression,” formerly termed “pseudodementia”. Cognitive-communicative changes, potentially due to medications, complicate the diagnosis even further. This discussion paper reviews the history of the terminology of “pseudodementia,” and examines the pharmacology given as treatment for depressive symptoms in the elderly population that can affect cognition and communication. Clinicians can reduce the risk of misdiagnosis or inappropriate treatment by having an awareness of potential side effects, including decreased attention, memory, and reasoning capacities, particularly due to some anticholinergic medications. A team approach to care should include a cohesive effort directed at caution against over-medication, informed management of polypharmacology, enhancement of environmental/communication supports and quality of life, and recognizing the typical nature of some depressive signs in elderly institutionalized individuals.

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Dysphagia Assessment and Treatment Planning—A Team Approach

Perspectives on Swallowing and Swallowing Disorders (Dysphagia) ◽

10.1044/sasd9.1.9 ◽

2000 ◽

Vol 9 (1) ◽

pp. 9-10 ◽

Cited By ~ 1

Author(s):

Kelly Brewer ◽

Leonard ◽

Kendall

Keyword(s):

Treatment Planning ◽

Team Approach ◽

Assessment And Treatment

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Pediatric Benign Vocal Fold Lesions: A Team Approach

Perspectives on Voice and Voice Disorders ◽

10.1044/vvd19.3.105 ◽

2009 ◽

Vol 19 (3) ◽

pp. 105-112 ◽

Cited By ~ 3

Author(s):

Geralyn Harvey Woodnorth ◽

Roger C. Nuss

Keyword(s):

Vocal Fold ◽

Evaluation Process ◽

Team Approach ◽

Speech Language Pathologist ◽

Benign Vocal Fold Lesions ◽

Different Types ◽

Team Evaluation ◽

Surgical Treatments ◽

Review Current ◽

Vocal Fold Nodules

Abstract Many children with dysphonia present with benign vocal fold lesions, including bilateral vocal fold nodules, cysts, vocal fold varices, and scarring. Evaluation and treatment of these children are best undertaken in a thoughtful and coordinated manner involving both the speech-language pathologist and the otolaryngologist. The goals of this article are (a) to describe the team evaluation process based on a “whole system” approach; (b) to discuss etiological factors and diagnosis; and (c) to review current medical, behavioral, and surgical treatments for children with different types of dysphonia.

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The Interaction of Pulmonary Physiology and Swallowing: A Juggling Act for the Physician and Speech-Language Pathologist

Perspectives on Swallowing and Swallowing Disorders (Dysphagia) ◽

10.1044/sasd18.1.34 ◽

2009 ◽

Vol 18 (1) ◽

pp. 34-40

Author(s):

Karen J. Dikeman ◽

Marta S. Kazandjian ◽

Elbert Tun ◽

Panina Niyazova ◽

Tien-Tsai Tsai ◽

...

Keyword(s):

Health Care Providers ◽

Medical Condition ◽

Team Approach ◽

Care Providers ◽

Geriatric Population ◽

Pulmonary Physiology ◽

Speech Language Pathologist ◽

Ventilator Dependence ◽

Clinical Case Studies ◽

Single Disease Entity

Abstract Patients who are dependent upon tracheostomy and/or ventilator use present a particular challenge to health-care providers. The interaction of pulmonary physiology and deglutition is complex, as illustrated in the course of patients who are in the weaning process. Speech language pathologists (SLPs) should work closely with their physician colleagues to understand the influence of multiple medical co-morbidities on intervention. In traditional medicine, the clinician's objective is to connect a patient's many symptoms and complaints to a single disease entity. However, in caring for the ventilator dependent geriatric population, a symptom such as dysphagia typically results from the interplay of various, multi-organ symptoms, and conditions. This article strives to demonstrate the “juggling act” that the physician and SLP must balance between the patient's current medical condition, pulmonary dysfunction, and disordered swallowing. Clinical case studies illustrate the benefit of swallowing intervention on quality of life. While the care of patients with tracheostomy and ventilator dependence requires a team approach, with respiratory therapy and nursing vital members, this article emphasizes the roles of the SLP and physician.

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