Have you been noticing cognitive changes in Covid-19 patients at your skilled nursing facility? Speech language pathologists are used to having a body of literature to refer to while selecting the best evidence-based treatment approach. So, what happens when you are treating something novel? While we cannot know for certain the long-term effects Covid-19 will have on our patients, your findings and intervention will become part of the body of literature that will be referred to in the future.
Prolonged intubation, ICU delirium, Hypoxic Encephalopathy are not new to us; however, we have never treated a patient with any of these diagnoses’ secondary to Covid-19. There is a good chance you have been noticing cognitive communication impairments in your previously independent patients. This may not come as a huge surprise when we already know as many as 60-80% of critically ill patients receiving mechanical ventilation will demonstrate some degree of delirium. What we do not know is if these cognitive changes following a diagnosis of Covid-19 are transient, recurrent, or permanent. Unfortunately, it could be years before we can conclude reversibility vs. static vs. progressive nature of the deficits.
An intervention by speech therapy could be necessary more now than ever. Speech Therapy may be the only discipline actively attempting to evaluate and rehabilitate cognitive changes.
Below are some things to keep in mind as we move forward to provide restorative speech therapy services to patients recovering from Covid-19:
1. Use patient specific assessment and treatment approaches given any decline from the prior level of function.
2. Clearly document family report of prior level of functioning, current level of functioning upon evaluation, and staff reports supporting the change in cognition.
3. Remember, you are apart of an interdisciplinary team! Endorse your findings, recommendations, and help the staff to understand the best method to communicate and encourage a generalization of skills.
4. Document the successes when trialing therapeutic interventions.
You and your colleagues have and will continue to play a crucial role in helping our nation recover from the pandemic that has rocked the world, THANK YOU.
About the Author:
Originally from Port Jefferson, New York, Jennifer Baquet Maher, MA, CCC-SLP is the Regional Manager for Language Fundamentals in Long Island, NY. She holds a Master’s Degree from St. John’s University Communication Sciences and Disorders program. In her spare time, Jen enjoys cooking, traveling & family.