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.
Additional accrediting agencies by which Northern Speech is an approved CE provider:
Course Completion Timeframe:
You have unlimited time to complete our online courses. You may log off and log on as often as you’d like to in order to complete all sections of a course.
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.
Access to course materials and content does not expire, even after completing the post test. You may continue to review course material by logging into your NSS account, clicking the My Online Courses tab, and then viewing your desired course.
Certificate of Completion:
On successful completion of the post test (80%), a certificate will be immediately available for download and/or printing. This certificate will include your name, date of completion (based on Eastern Time Zone, USA/Canada), and number of contact hours (CEUs / CEEs). Please note that CEUs are awarded on the date of successful test completion, not the date of course enrollment. Please ensure that you successfully complete the post test prior to any licensure renewal dates.
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.
Purchase orders are NOT accepted when registering for online courses. Payment must be made online in the form of a credit or debit card payment.
What is an Online Course?
Our Online Courses consist of video, audio, and/or text content and are offered for ASHA CEUs. Unlike a webinar, which requires participants to be logged on and at a computer at specific times, our Online Courses are available to you at any time, from any device, via your NorthernSpeech.com online account. You may work at your own pace and start and stop your course as you wish. Your course will conclude with a short post test. On successful completion of the post test (>80%), a printable certificate of completion is presented to you.
Northern Speech is an ASHA CE Provider and our online courses are registered with ASHA and offered for ASHA CEUs. Please note that successful completion of the online post test is required prior to the awarding of CEUs. Please contact your state licensing board for acceptance policies related to CEUs earned online.
Registering for an online course:
You may browse all online courses by clicking the Continuing Education tab above, then Online Courses. Once you find a course, click Enroll Now, and you will be asked to either log into your existing Northern Speech account or create a new online account. Once you’ve entered your account information and provided your credit card payment, your course will be immediately available to you.
Accessing your purchased course or returning to a purchased course:
You will be able to access your online course by logging into your Northern Speech account and then clicking the My Online Courses tab on your profile screen. Click the course you would like to start or to resume. From there, proceed through the course sections until you are ready to complete the post test. You do not have to complete your course all at once. You may log on and off as you wish.
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.
Number of CEUs offered:
We offer courses from 1 to 21 contact hours. Each course will note the number of CEUs offered. Please note that 0.1 CEU = 1 contact hour = 1 CEE.
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.
Our course formats include: text, audio, video, and PowerPoint with author narration. Each course will note the format on the course description page.
Most of our online courses provide a link to download the accompanying handout as a PDF file.
Groups of 3 or more are eligible for a 20% discount on each registration on most of our online courses. To receive this discount, registrations need to be processed together via the "Group Rates" tab on the Online Course of your choice.
For our online courses to function best, we recommend that you update your computer to include the newest version of your Internet browser (Safari, Chrome, Firefox, Edge, Internet Explorer, etc.) and newest version of your computer's operating system. Also a high-speed Internet connection is recommended (cable or DSL). Speakers or headphones will be required for many of our courses as many contain audio components.
Course Cancellation Policy:
A purchased online course can be exchanged, refunded, or transferred to another individual if contact is made with NSS (via phone or email) within 30 days of purchase and the course materials have not been viewed or downloaded.
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"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)