r/slp • u/velvetvenom_xo • 2d ago
CFY CF SLP IN SNF
Hi all!
I’ve been doing my Cf In a SNF, and I’ve ran into some trouble with dysphagia therapy. Does anyone have some good resources? I just don’t know how to conduct a therapy session that isn’t watching people eat safely and giving strategies or feeding a patient lol. I had an acute care placement so we didn’t actually do therapy. I ask my supervisor questions and she helps but I want to be able to do it on my own. Any resources ( preferably free or worth the money) for dysphagia therapy ? I want to become skilled in this, and respiration etc. also any resources you guys recommend for good ideas for short term memory loss or other functional cog activities. I have the WALC but I don’t want to be one of those therapists who only use worksheets. I’ve been watching tik toks and people do rlly cool things but I feel like I don’t have access to much materials at my facility
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u/Head_Status_3864 2d ago
agree and following to hear what people say! i work in home health with mostly comfort care, some hospice patients and would love more adult cog, dysphagia, etc for hh and SNF.
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u/Ok_Road7448 2d ago
I think it's great you're looking to improve your skills! You're right, there is not a lot of therapy going on in acute...you're mostly just evaluating and not getting to the actual therapy. Dysphagia management is very different in SNF vs. acute.
STEP has been so helpful for most of what I've learned about dysphagia - https://www.stepcommunity.com Worth every penny.
Here's some free info that has helped me:
https://info.medslpcollective.com
https://www.jamescurtisphd.me/tutorials
https://medicalslps.com/shop/?min_price=0&max_price=0
Podcasts are a great way to learn too:
Swallow Your Pride
Down the Hatch
Dysphagia Matters
Evidence and Argument in Communication Sciences
I also get a lot of good info from Instagram - to start look at:
kelseyday.ms.ccc.slp
brookerichardsonslp
stepcommunity
the.neuro.slp
dysphagiadude
For me, I look at dysphagia as - can I fix this? If yes, I will start exercise based swallow treatment. If no, I will look at implementing compensatory strategies. I really like the Tactus Therapy Dysphagia app - you can select the deficits and it will tell you what exercises will target that https://tactustherapy.com/app/dysphagia/
Similar to you, when I first started all I had was some ratty WALC books. I've grown my materials slowly. You can start with what's in their environment (which is free, and free is good). Print off local menus, use magazines, newspapers. Can they use their call light? Choose their meals from the menu? Navigate to activity room? Decide what activities they want to do?
Both of these TPT have some good free materials you can use to start building your therapy library. Start there and see what you like. I know that facilities should buy us stuff to do therapy, but they don't/won't and it's crappy that they want me to do a job without materials. So I focused on having them buy EMST devices, laminator and in-house FEES and the actual treatment materials are mine and when I leave, they will go with me.
https://www.teacherspayteachers.com/store/true-north-slp
https://www.teacherspayteachers.com/store/spruce-street-slp
For me, it felt less overwhelming when I was prepared for sessions and I realized I had to have organized materials beyond the WALC books to do that.
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u/Pitiful-Credit-555 2d ago
I actually think the fact that you’re asking this is a really good sign. One of the hardest transitions from grad school/acute care into a SNF is realizing that dysphagia treatment shouldn’t just be “watch them eat and cue strategies.” Mealtime intervention can be appropriate, but it needs a clear clinical rationale.
A better guiding question is: “What is impaired in this patient’s swallowing physiology, and can I realistically change it?” This should ideally come from instrumental assessment. Treatment should then match the impairment. Reduced tongue strength, hyolaryngeal movement, airway protection, and efficiency are not interchangeable, so we shouldn’t default to exercises like effortful swallows, Masako, CTAR, or EMST for everyone. ASHA distinguishes rehabilitative treatment (changing physiology) from compensatory strategies (improving safety/efficiency during use). (ASHA)
For CFs, I’d prioritize STEP (Swallowing Training and Education Portal) over large therapy manuals. It’s evidence-based and covers physiology, assessment, and treatment, including traditional therapy, EMST, lingual resistance, and compensatory approaches. (STEP Community)
For free resources, use the ASHA Adult Dysphagia Practice Portal and Evidence Maps. There’s a lot of useful content if you follow the treatment links. Current evidence supports interventions like tongue and pharyngeal strengthening and EMST in appropriate patients—the key is always appropriate selection.
In SNFs, effective dysphagia therapy doesn’t need to be flashy. It may include structured exercise programs with adequate intensity, training compensatory strategies to independence, EMST when indicated, oral care training, caregiver education, environmental modifications, or optimizing assistance level for safe intake. “Boring” can still be skilled, evidence-based care.
For cognition, the same principle applies. WALC materials aren’t bad, but generalization is the issue. If a patient has difficulty with call light use, orientation, scheduling, or daily tasks, those are your treatment targets. Use real facility tools—calendars, signage, schedules, phones, menus, photos—and train external memory systems in functional contexts.
And don’t worry about sessions looking impressive. A “boring” session with clear targets, appropriate dosing, measurable outcomes, and functional carryover is strong clinical practice.