You are a sole practitioner paid to work with clients in a nursing home with dysphagia as required. You like this role as you are able to get out of the office and it makes you feel part of a team when you are on site at the home. When you see a patient you write in the clinical notes, chat with the Director of Nursing if she is available, then leave and follow-up as appropriate. You are usually on site 1-2 times every fortnight around meal-time
Over the past few months you have noticed the following
- Some patients with dysphagia are not being referred to you (you note this while you are consulting with other patients)
- Families visiting patients under your care, bring in food from home causing issues with feeding
- Two patients in palliative care want to eat normally because they do not have much longer to live and they want to have some quality of life.