22a. Provide an example of how to empower and support

An 80-year-old patient with an anterior cervical disc fusion (ACDF) was referred to you for a clinical swallow evaluation at home (via home care). During your clinical swallowing evaluation, you observe the following: . He can follow multi-step commands and is cognitively intact. . He coughs every time he swallows any liquids. . He has a feeding tube that was placed when he was in the hospital because he “failed” his swallow test. . He has experienced recent unintentional weight loss. . He does not have a history of recurrent upper respiratory infections. . He has a history of depression and anxiety and takes medications for these conditions. . While hospitalized, he also was diagnosed with lung cancer You have already completed your clinical assessment. Discuss whether or not you would complete an instrumental assessment, and which one, or if not, why not? What might be your next steps in this patient’s plan of care? Include any applicable ethical, cultural and end-of-life considerations in your plan.

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