Monday, May 22, 2006

May Meeting is a Success!

On Monday, May 22, NSSLHA held its last meeting for the quarter/school year. Congratulations to those who are graduating! We wish you the best in your endeavors!

For the last meeting of the quarter, NSSLHA invited Ms. Melea Balwan from Casa Colina in Pomona, to present her experiences about working in an acute rehabilitation center.

Ms. Balwan has been an SLP in the medical setting for approximately five years now. Upon graduation, she began working at Rancho Los Amigos National Rehabilitation Center in Downey. Last year, she began working at Casa Colina. Casa Colina is well known for its continuum of care, from hospital care to outpatient services to residential programs.

Casa Colina’s inpatient services (hospital) include acute rehabilitation, ventilator weaning, and a senior evaluation program. Ms. Balwan works in acute rehabilitation, where “everyday is different and every patient is different; every time you see a patient it’s a different experience. It makes it exciting, challenging and tough.”

In Casa Colina’s acute rehabilitation hospital, patients come from a variety of injuries, but all are “medically stable.” Because of the setting, the length of stay depends on the diagnosis upon admittance and severity level of the injury. Most patients stay between two and four weeks. Unfortunately, the short stay causes quite a challenge for the teams.

A typical day for SLPs consists of seeing 6 to 7 patients in a very diverse setting. Depending on the patient, SLPs will see patients either individually or in a group setting. SLPs work with patients who have suffered from a wide array of deficits: cognition, speech, language, dysphagia, trachea decanulation, spinal cord injury, ventilator weaning, voice, etc. Because of the variety of patients, SLPs collaborate with teams of professionals on a daily basis. The teams typically consist of medical doctors, occupational therapists, physical therapists, respiratory therapists, nurses, and other specialized clinicians. Although Casa Colina’s inpatient rehabilitation hospital consists of 68 beds, the SLPs are not on all of the cases. SLPs provide services as needed; typically, they carry approximately 75% of the cases. Currently, Casa Colina employs 4 inpatient and 3 outpatient SLPs.

At Casa Colina, dysphagia is a condition that the clinicians place extreme importance on. Each new patient receives a dysphagia evaluation, whether it is a doctor’s order or not. In addition, much treatment centers on dysphagia. For example, there is a daily treatment session at lunch time for patients with a certain severity level of dysphagia (e.g., thin liquid diet). Because most patients have concomitant disorders, one of the challenges for an SLP is deciding how to spend the one hour of treatment. Treatment goals closely relate to the priorities and goals of others involved such as the family, occupational therapist, and physical therapist.

Ms. Balwan concluded that the medical setting is extremely lacking SLPs. If interested in working in a medical setting, Ms. Balwan recommends observing and finding information on cognition and other neuro-trauma topics that are not typically covered in a course

For more information or questions, please contact Ms. Melea Balwan at

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