This course combines knowledge of feeding tubes in dementia with informed consent and decision making. Discussed are the requirements for informed consent, and how knowledge of ethical principles and research evidence can support clinicians and families in making better decisions. Comparison of student and clinician knowledge of how feeding tubes help and hinder does not always align with the evidence. This has implications for student education and early clinical training. Even when clinicians are aware of the evidence, personal bias may influence our contributions to decision making. If we are aware of this we can do something about it. This leads to advance care planning and formats for formalizing discussions. Offered for 0.1 ASHA CEU – 1 contact hour.
This course was included in the material of a previously offered eCourse – #e108: Charleston Swallowing Conference Home Study: Evidence-Based Dysphagia Management.
Run Time: 1:13:13
• Feeding tubes and dementia: knowledge of what they can and cannot do compared between students, clinicians, and the evidence
• Advance care planning to aid with decision making
• Formalizing care planning and discussions
• Requirements for informed consent
• Mediating family goals
The content of this online CE course does not focus exclusively on any specific proprietary product or service. Presenter financial and non-financial disclosures may be found in the Presenter & Disclosures area.
Video PowerPoint presentation with author narration & downloadable handout.
Paula Leslie, PhD, FRCSLT, CCC-SLP, is a professor and director of the Doctor of Clinical Science in Medical Speech-Language Pathology. She maintains full clinical licenses in the USA and UK where she is a Specialist Adviser to the Royal College of Speech & Language Therapy in swallowing disorders. She provides support to researchers and provides continuing education from grassroots to international level and across the health professions on complex clinical decision making, ethics, and end of life decisions in vulnerable populations. Her honors include the Honors of the Association Southwestern Pennsylvania Speech-Language-Hearing Association, the American Speech-Language-Hearing Association DiCarlo Clinical Achievement Award, the Pennsylvania Speech-Language-Hearing Association Clinical Achievement Award, and Fellow of the Royal College of Speech & Language Therapists (UK).
Financial — Paula Leslie is a presenter of online CE courses sponsored by Northern Speech Services; receives royalties.
Nonfinancial — Paula Leslie has no relevant nonfinancial relationships to disclose.
This program is offered for 0.1 ASHA CEUs (Intermediate Level; Professional Area).
ASHA CEUs: NSS online courses are registered with ASHA and are offered for ASHA CEUs. The number of ASHA CEUs is noted above. Note that 0.1 ASHA CEU = 1 contact hour = equals 1 CEE.
ASHA CE Registry: During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). This submission happens once per month, during the first week of the month. For example, if you complete your course on November 7th, NSS will submit all November online course CEUs to ASHA during the first week of December. When ASHA inputs the information into their database, they will mark the course as completed on the last day of the month in which it was completed, so November 30th using this example. The certificate of completion available for you to print immediately, however, will reflect the actual completion date, November 7th in this example. Due to ASHA processing procedures please allow 2-3 weeks, from the submission date, for the course to appear on your ASHA transcript.
ASHA CEUs: Attendees must meet at least one of the following conditions in order to be eligible to earn ASHA CEUs:
If an attendee is not an ASHA member or CCC holder but meets any of the above criteria, they may inform the ASHA CE Registry of their eligibility by visiting this site.
Licensing Boards: Most state licensing boards DO accept CEUs earned online (usually classified as home-study credits). Some state boards do, however, place a limit to the number of credits that can be earned via home study/online courses. For the most current information, we suggest that you contact your licensing board or agency to verify acceptance policies and/or any credit limits related to home-study courses prior to registering for this course.
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However, completion dates are based on Eastern Standard Time. Therefore, if you need your CEUs by a certain date, be sure to complete the course test before 11:59pm EST on that date. For example, if you need CEUs before January 1st, you will need to complete the course test before 11:59pm EST on December 31st.
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ASHA CE Registry Submission:
During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). This submission happens once per month, during the first week of the month. For example, if you complete your course on November 7th, NSS will submit all November online course CEUs to ASHA during the first week of December. When ASHA inputs the information into their database, they will mark the course as completed on the last day of the month in which it was completed, so November 30th using this example. The certificate of completion available for you to print immediately, however, will reflect the actual completion date, November 7th in this example. Due to ASHA processing procedures please allow 2-3 weeks, from the submission date, for the course to appear on your ASHA transcript.
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Each online course concludes with a post test consisting of multiple choice or true & false questions. Scores of 80% or greater are required for successful course completion and awarding of CEUs. You may revisit course materials and retest as needed to achieve a passing score.
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State licensing boards and online CEUs:
NSS is an ASHA CE Provider and most state licensing boards DO accept ASHA CEUs earned online (usually classified as home-study credits). Some boards do, however, place a limit to the number of CEUs that can be earned via home study/online courses. For the most current information, we suggest that you contact your licensing board or agency to verify acceptance policies and/or any CEU limits related to home-study courses prior to enrolling in an online course.
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“I liked that it raised my awareness of the disparity that exists between what SLP's know about feeding tubes, our decision making. And that although we wouldn't want one for ourselves, we frequently support the decision for feeding tubes for our patients. I will definitely consider this more in the future.” – R.K. (Feb. 2021)
“I found this course very interesting, and the speaker spoke at a nice pace. The case study provided a good example. I don't usually enjoy ethics courses, but this was pretty good.” – C.C. (Dec. 2020)
“I liked the concept of using art to engage with adults with dementia. Also, the information on how to create an environment for creativity that is adult-friendly was great!” – S.M. (Dec. 2020)“The additional explanations relating to legal terminology such as advanced directives, living will, etc. were very helpful.” – K.S. (Aug. 2020)
“I like the emphasis on considering personal values and biases and how these might impact on my delivery of advice/information. The reassurance that it is not within our professional boundaries to be making decisions regarding feeding tubes.” – R.B. (Jun. 2020)
"The vocabulary discussion regarding autonomy and beneficence in regards to clinical work and our scope of practice was very beneficial. I liked the patient scenarios presented at the end of the seminar." – K.M. (May 2020)
"I like that this material applies to my daily work. The discussion on ethical practice related to feeding tubes was most beneficial." – K.F. (Mar. 2020)
"All of the information was applicable to my current caseload. The course was easy to follow." – Y.C. (Feb. 2020)
"The info was good - especially the portion on feeding tubes and ethical considerations." – S.B. (Feb. 2020)
"The info re: Living Wills and Autonomy vs/Beneficence was most beneficial. I liked the speaker's accent and thoroughness." – G.S. (Jan. 2020)
"Her case studies were realistic and the discussion of the legal and professional effects on decision making was helpful." – K.N. (Dec. 2019)
"I appreciated the thought provoking information and going over how to deliver information to our pts without being outside our scope of practice. I liked the speaker's presentation style and information given. The course was thorough for the length of the presentation." – D.C. (Dec. 2019)
"I liked the discussion of the difficulty of making the decision for feeding tubes in certain populations and how it will impact the patient and their families. Very useful information in order to facilitate better understanding with my patients to help guide them through this process." – J.N. (Nov. 2019)
"Learning the differences in PoA and medical PoA; the differences in advanced directives and living will were especially helpful. I enjoyed the soothing voice of Paula." – S.P. (Oct. 2019)
"Gaining understanding of advanced directives and the role of the SLP in conversations/decision-making was most beneficial." – A.B. (Sept. 2019)
"I liked the overview of living wills, advanced directive, etc. as I work with pediatrics and not adults and do not come across this often i practice. I thought it was a great course." – M.M. (Aug. 2019)
"I enjoyed the discussion about Diet "Waivers" being coercive as well as the case studies." – M.H. (July 2019)
"I appreciated the discussions on advanced directives and informed consent and how well she explained the differences between the types of advance directives." – E.C. (June 2019)
"I liked more clarification on durable power of attorney, living will, health care proxy, and informed consent." – K.S. (May 2019)
"The course work was well organized and easy to understand. I work in acute care with a large NH population. This patient population is a large percentage of my caseload. I liked that this course discussed a topic that many ST's are afraid to approach." – O.R. (Feb. 2019)
"I enjoyed the discussion of our scope in practice when it comes to g-tubes - SLPs recommending them but not wanting a g-tube for themselves was interesting. I appreciated the discussion of the legal forms and what they meant to us in the profession. I appreciated that the physician leads the way on the decision but we have information to provide. The presenter was very thought provoking." – B.N. (Feb. 2019)
"Great course with logical presentation and excellent review of research along with good case histories. This course exceeded my expectations for this area." – J.T. (Feb. 2019)
"I found the discussion on initiating conversations about conditions to anticipate with associated decisions that patient/family can begin discussing most helpful." – K.B. (Dec. 2018)
"Going over the use of feeding tubes with various populations and how others view it was most beneficial." – A.R. (Dec. 2018)
"I thought it was interesting to learn about our role as an SLP to assist the family with decisions regarding feeding tubes." – J.S. (Dec. 2018)
"I appreciated the information regarding feeding tubes in patients with advanced dementia. I liked the case study information." – S.B. (Nov. 2018)
"Good discussion on the health care power of attorney in relationship to differing opinions of family members." – M.G. (Oct. 2018)
"I appreciated the review of autonomy and informed consent. In addition, I thought the point about waivers being a form of coercion a valid point. I liked the ease of access and the pertinent information to my daily practice." – M.W. (Sept. 2018)
"Going over the aspects of autonomy and inclusion of entire team in process with patient/family was very helpful. I liked the focus on prior discussion." – M.K. (July 2018)
"The instructor was clear and not rushed. She provided up to date information and serious ethical topics that we as SLPs need to consider." – J.M. (June 2018)
"The case examples were particularly helpful given that we often face conflicting views among family members of a patient when making critical treatment/health care decisions. The true definitions of key terms were excellent (e.g. advanced directive, living will, etc.)." – S.K. (May 2018)
"I found the legal background informative and helpful. I liked that the teacher provided good examples and was easy to follow." – R.S. (Mar. 2018)
"The topic, in general, was interesting. It is something I deal with often at work, and it was good to listen to another discussion regarding the difficulty of the situation. I liked how the course was short, simple, and to the point. It was a good general discussion." – S.D.A. (Dec. 2017)
"The portion on informed consent was most beneficial. I liked that I could complete the course at my own pace." – C.S. (Dec. 2017)
"I enjoyed the discussion on feeding tubes, and I liked that the course was short." – M.M. (Dec. 2017)
"The discussions on informed consent and how to help patients/family understand the risks/benefits of various courses of action were most beneficial. The course was easy to understand with clear direction in how to at least get started having difficult conversations with patients/family. However, I was expecting more of the ethical 'grey' areas to be covered." – A.G. (Dec. 2017)
"I often discuss feeding tubes with families in my day to day care. I liked that the course is concise." – S.C. (Dec. 2017)
"Excellent overview of the information, clearly presented. Very important topic, highly recommended for all clinicians working in dysphagia." – C.B. (Sept. 2017)