1. health and fitness
2. disorders

CHARTING NEW GROUND:
Interprofessional approaches to dysphagia management
TORONTO, ON
October 4-6, 2015
Toronto Airport Marriott Hotel | 901 Dixon Road
PROGRAM
The Canadian Association of Occupational Therapists (CAOT), Dietitians of
Canada (DC) and Speech-Language and Audiology Canada (SAC) are pleased to
offer this interprofessional workshop intended for experienced clinicians seeking
to advance their knowledge and skills in dysphagia assessment and management.
The workshop will delve into areas of practice that may take you out of your
comfort zone, challenge your assumptions and help you realize the power and
benefits of interprofessional practice. The workshop has been specifically
designed to engage clinicians from different disciplines so that we may all learn
more about the areas of expertise and skills our colleagues bring to the table when
discussing challenging cases. If you are interested in honing your clinical skills and
taking your team contributions to the next level, this workshop is for you.
LEARNING OBJECTIVES
2
At the conclusion of the workshop, participants will be able to:
Identify the impact of dysphagia on the
individual and family.
Identify hydration, food texture and nutrient
density concerns of texture-modified diets.
Articulate the importance and effectiveness
of the interprofessional team on client
outcomes and quality of life.
Recognize the interrelationships between
respiration, positioning and eating.
Explain the unique skills each clinician
brings to the team.
Describe a clear ethical framework to
help guide decision making when ethical
challenges arise in dysphagia management.
Describe various approaches to assessment
for swallowing disorders and the appropriate
use of those approaches in different settings
and for different populations.
An additional objective of this program is
to diversify and strengthen the professional
network of skilled clinicians from across
the country.
Describe the current evidence for use of
adaptive and compensatory strategies in
dysphagia management.
A certificate of completion will be provided
at the conclusion of the workshop.
PROGRAM AT A GLANCE
6:00 p.m. – 8:30 p.m.
SUNDAY,
OCTOBER 4,
2015
MONDAY,
OCTOBER 5,
2015
Welcome and opening remarks
Dinner
The client’s lived experience
8:00 a.m.
Breakfast
9:00 a.m.
What is interprofessional dysphagia practice and
why should we care?
10:30 a.m. Break
10:50 a.m. Case-based discussions
12:30 p.m. Lunch and sponsor showcase
TUESDAY,
OCTOBER 6,
2015
1:30 p.m.
Interactive breakout sessions (2 x 45-minute sessions)
3:15 p.m.
Break
3:35 p.m.
Continuation of interactive breakout sessions
(1 x 45-minute session)
4:20 p.m.
Another brick in the wall – What have we learned?
4:45 p.m.
Concluding remarks
7:30 a.m.
Breakfast
8:00 a.m.
Opening remarks
8:15 a.m.
Ethical considerations in dysphagia management
10:00 a.m. Break
10:20 a.m. Optimizing clinical assessment – What does it involve?
12:30 p.m. Lunch – Meet a mentor
1:00 p.m.
Putting the pieces together – Going back to the real world!
2:30 p.m.
Advocating for interprofessional practice – Wrap-up discussion
3:00 p.m.
Workshop evaluation and closing
3
SESSION DESCRIPTIONS
SUNDAY,
OCTOBER 4,
2015
MONDAY,
OCTOBER 5,
2015
7:00 p.m.
The client’s lived experience
Speakers: TBC
We begin our program with inspirational stories from people living
with dysphagia. Through a guided interview process, we will hear
first-hand from those experiencing or dealing with the consequences
of dysphagia and about their interactions with diverse members
of the professional health care team. By opening our program with
the client’s voice, we ground our next two days of learning in an
empathetic and client-focused perspective.
8:00 a.m.
Breakfast
9:00 a.m.
What is interprofessional dysphagia practice and
why should we care?
This opening address will begin our program with the challenging question:
What does interprofessional dysphagia practice mean and why should
we embrace it? Using evidence-based competencies for interprofessional
education and collaboration, this interactive session facilitated by Lynne
Sinclair will encourage us to explore how effective communication and role
clarity will enable best client outcomes.
10:30 a.m.
Morning break
10:50 a.m.
Case-based discussions
Dysphagia affects individuals across the lifespan living in various settings.
Using multiple cases, our speakers will facilitate small group discussions
through which complex practice issues experienced every day will be
explored. Cases presented will be tailored to various practice settings, age
groups, socio-cultural-educational profiles of clients, urban/rural setting,
availability of resources and professionals on the team. Participants will
be invited to delve into the care plans for the sample clients and consider
innovative approaches to intervention.
12:30 p.m.
Lunch and sponsor showcase
4
1:30 p.m.
Interactive breakout sessions (2 x 45-minute sessions)
Six interactive breakout sessions are available for participants
to have an “up close and personal” view of integral components
of dysphagia care. Each session will be presented twice. Every
participant will have an opportunity to attend three of the six
available 45-minute sessions. Please select your preferred sessions
on the registration form.
A: Health starts with the mouth: Putting theory to practice
Joyce Wimmer, RDH
Oral health is important to overall health. We know the theory behind
providing oral care but do we know how to do it? “Putting theory to
practice” will be a fun and interactive session that will help to answer
some of your questions about providing oral care to your clients.
B: How safe is water? Exploring the evidence for and against
water protocols
Catriona Steele, PhD, CCC-SLP, S-LP(C)
The evidence supporting water protocols has been evolving. Dysphagia
clinicians should be aware of the latest evidence and how to apply
it to the populations they serve. This session will summarize recent
empirical evidence regarding water protocols as applied to people who
aspirate thin liquids. Interactive discussions will be used to identify
ideal candidates and highlight protocol rules that will promote safe
intake of water where possible.
C: “Client has a tracheostomy tube.” What is that and what does it
mean for the client?
Janet Fraser, RRT
Breathing is one of the most important physiological processes in the
body but it is often at odds with the emotional desire to eat orally.
When a client’s breathing has become impaired to the point of needing
a tracheostomy tube, swallowing and oral feeding management needs
special care. The impact of respiratory impairments, shortness of
breath, tracheostomy tubes and mechanical ventilation will be the
focus of this hands-on session.
5
SESSION DESCRIPTIONS
D: The thin and the thick of it: The new International Dysphagia
Diet Standards
Andrea Buchholz, PhD, RD and Peter Lam, RD
Texture-modified foods and thickened liquids are a cornerstone of
dysphagia management but there can be challenges in applying them
in practice. This session will highlight the International Dysphagia Diet
Standards and allow participants to taste, test and explore the many
nutritional considerations of food and liquid modifications.
E: “One position doesn’t fit all”: The role of postural management
in dysphagia
Jan Duivestein, MRSc, OT/PT and Heather Lambert, PhD, erg, OT(C)
Many individuals with dysphagia experience difficulty with posture
and positioning during mealtimes. Posture can affect respiration,
swallowing, GI function and physical function. This session will
provide a review of the literature on posture and positioning, as well
as how it impacts individuals with dysphagia. Participants will have
the opportunity to discuss and experience postural challenges and
potential solutions.
F: Medication: Its impact on swallowing
Nathalie Blouin, MD
Medication is an important issue when taking care of clients
with swallowing difficulties. It can cause dysphagia, complicate a
pre-existing condition and deepen the burden of taking medication.
This session will review the principle categories of medication which
cause dysphagia and discuss management techniques.
3:15 p.m.
Afternoon break
3:35 p.m.
Continuation of interactive breakout sessions
(1 x 45 minute session)
6
4:20 p.m.
Another brick in the wall – What have we learned?
Wrapping up Day 1 will be a facilitated group discussion related
to providing optimal care for people with dysphagia. This will be
an opportunity for questions to the presenters and to reflect on
learnings of the day about the nature of differing scopes of practice,
the interprofessional team or specifics of care as explored in the
breakout sessions.
5:00 p.m.
Close
7
SESSION DESCRIPTIONS
TUESDAY,
OCTOBER 6,
2015
7:30 a.m.
Breakfast
8:00 a.m.
Opening remarks
8:15 a.m.
Between soup and love: Ethical considerations in
dysphagia management
Ann Munro- Heesters, PhD (ABD)
Ethics is an integral part of the practice of all health care
professionals but it typically comes to our attention when we are
confronted with values that conflict with or challenge our own.
End-of-life care and the abortion debate are typically cited as
sources of value disagreement, but the topic of eating can also
elicit powerful responses. Food doesn’t cease to be personally,
socially or culturally significant merely because swallowing has
become unsafe. A range of cases, drawn from real life, will be
used to explore how an ethical lens can help us see what we may
overlook in an effort to provide safe, responsible and professional
care. Participants will be encouraged to share their own cases and
experiences to enhance the learnings of the group.
10:00 a.m.
Morning break
10:20 a.m.
Optimizing clinical assessment – What does it involve?
Practices for dysphagia clinical assessments are highly varied
among clinicians and professions. The million dollar question:
what components should be part of a practical, holistic dysphagia
evaluation? In this session, participants will have a chance to work
in small interprofessional groups and to discuss and design the
components of a dysphagia evaluation using each other’s
professional perspective and expertise.
8
12:30 p.m.
Lunch – Meet a mentor
Mentorship is a way to grow professionally throughout one’s career.
There is great merit in the mentor-mentee relationship for both
parties. This program is an attempt to bring together those with
diverse skills in dysphagia assessment and management, and it may
be, through conversation and networking, that you will find just the
right contact who will help broaden or deepen your practice skills.
1:15 p.m.
Putting the pieces together: Going back to the real world!
Interprofessional practice is considered best practice in our current
health care environment. Despite this, many challenges still exist
for clinicians in their day-to-day practice. Using a mock case, these
challenges will be explored with the intent of identifying innovative
means of promoting and improving interprofessional dysphagia
practice in your setting.
2:45 p.m.
Advocating for interprofessional practice: Wrap-up discussion
3:00 p.m.
Final remarks
9
SPEAKERS
NATHALIE BLOUIN, MD
Dr. Nathalie Blouin is a family doctor working at the Institut
Universitaire de Gériatrie de Montréal. She is Associate
Professor in the Family Medicine Department of the
Université de Montréal and Director of the Interdisciplinary
Dysphagia Clinic that she helped create in 1997. Her
clinical work is concentrated in geriatric rehabilitation, and
especially dysphagia, following strokes or deconditioning
after acute illnesses.
ANDREA BUCHHOLZ, PHD, RD
Andrea Buchholz is a registered dietitian, and Associate
Professor and Curriculum Chair of the Applied Human
Nutrition program in the Department of Family Relations
and Applied Nutrition, University of Guelph. She teaches
clinical nutrition and applied clinical skills, including
dysphagia screening and dietary management, at the
undergraduate and graduate levels.
JAN DUIVESTEIN, MRSC, OT/PT
Janice Duivestein is a combined trained therapist (OT/PT)
who has worked in the area of eating, drinking and swallowing
with children and adults for over 25 years. She is privileged to
work in team environments and highly values the skills and
knowledge of her fellow team members. As well as her clinical
work, Jan provides education about dysphagia to students in
the occupational therapy program at the University of British
Columbia, as well as to other health professionals.
10
JANET FRASER, RRT
Janet Fraser is a registered respiratory therapist with an
astonishing (but unnamed) number of years of experience
in health care. As a member of the interdisciplinary
Respiratory Services team at West Park Healthcare Centre
in Toronto, she has been involved in the care of hundreds of
individuals with tracheostomy tubes.
PETER LAM, RD, CFE
Peter Lam is the co-chair of the International Dysphagia Diet
Standardisation Initiative working with an interprofessional
team of professionals from around the world to develop
standardised terminology for texture modified diets and
thickened liquids. Peter provides nutrition, food service
and professional practice consultation to health care, food
service and hospitality industry clients. He is an appointed
clinical instructor at the University of British Columbia.
HEATHER LAMBERT, PHD, ERG., OT(C)
Heather Lambert is a faculty lecturer at McGill University’s
School of Physical and Occupational Therapy. Her research
and clinical interests centre on the bedside assessment and
management of ingestive difficulties. She is the author of The
McGill Ingestive Skills Assessment, a quantitative bedside
screening tool for adults. As a private clinician, she assessed
and treated clients with dysphagia from 1996 – 2011.
11
SPEAKERS
ANN MUNRO-HEESTERS, PHD (ABD)
Ann Heesters is the Associate Director of Bioethics at the
University Health Network, Chair of the UHN Rehabilitation
Science and Medicine Research Ethics Board and is a
Bioethicist with the University of Toronto’s Joint Centre
for Bioethics. She has an abiding interest in standards of
practice for health care ethicists and helped to draft a code
of ethics for ethicists with her colleagues on Clinical Ethics
Consultation Affairs, a committee of the a.m.erican Society
of Bioethics and Humanities. She was a founding member of
Practicing Healthcare Ethicists Exploring Professionalization,
which is now a non-profit board called Canadian Association
of Practicing Healthcare Ethicists (CAPHE).
LYNNE SINCLAIR, MA
Lynne Sinclair is an educational consultant, physiotherapist and
the Innovative Program and External Development Lead at the
Centre for Interprofessional Education, University of Toronto
(U of T). She holds an Assistant Professor position with the
Department of Physical Therapy at University of Toronto and
has been in the Faculty of Medicine, University of Toronto for
over 20 years. Lynne is widely invited as a keynote speaker for
conferences, educational events and courses. She has taught
all over Canada, the USA, Australia and Saudi Arabia.
Lynne’s passion for physical therapy and interprofessional
education was ignited during her 7 years at Toronto
Rehabilitation Institute where she was the Director of
Education for twelve health disciplines.
12
CATRIONA STEELE, PHD, CCC-SLP, S-LP(C)
Catriona Steele is a speech-language pathologist and
scientist at Toronto Rehabilitation Institute. She also
teaches in the Masters of Health Science program in
Speech-Language Pathology at the University of Toronto.
Her primary research interest is in the rehabilitation of
oropharyngeal swallowing disorders (dysphagia). Her research
explores both basic principles underlying clinical interventions
for dysphagia and clinical outcomes following rehabilitative
treatment. She has a special interest in the use of surface
EMG biofeedback as a tool in dysphagia rehabilitation.
MELANIE TAPSON, S-LP(C)
Melanie Tapson is a speech-language pathologist who works
primarily in dysphagia and voice therapy. Melanie’s extensive
experience as a professional performer combined with
her training as a teacher, researcher, and speech-language
pathologist provides her with a unique perspective on
client care. She believes that treating voice and swallowing
disorders require a holistic, team-driven approach, and she
is a fierce advocate for prehabilitation, or preventative voice
care, to keep artists and voice users in top form.
JOYCE WIMMER, RDH
Joyce Wimmer has worked as a dental hygienist since
1995 and was recently appointed clinical instructor at
George Brown College. Throughout her professional career,
as a clinician and educator, she has demonstrated her
commitment by showing the importance of oral health as
it is related to overall health to not only clients of all ages,
but also on interprofessional care teams.
13
WORKSHOP REGISTRATION
REGISTRATION FEES (PLUS TAXES):
(Includes dinner on October 4, breakfast, lunch and breaks on October 5 and 6 and workshop materials)
Registrations received by September 7, 2015
$435 for members of CAOT, DC or SAC
$650 for non-members
Registrations received after September 7, 2015
$535 for members of CAOT, DC or SAC
$795 for non-members
Registrations will not be accepted after Friday, September 25, 2015 at 5:00 p.m. (Eastern Time).
PAYMENT RECEIPT:
Upon registering, you will receive an email confirmation and statement. The statement is
your receipt.
REGISTRATION CANCELLATION:
Written notice of cancellation is required by September 7, 2015 and is subject to an
administrative fee of $100 plus taxes. For cancellations received after this date, no refund
will be provided.
EVENT CANCELLATION:
We reserve the right to cancel this workshop should the number of registrations not reach
minimum requirements.
PHOTO RELEASE:
Photography may occur during this event for use on association promotional materials,
websites and social media. By virtue of your attendance, you give permission to use
your likeness.
14
REGISTRATION CONTACT:
FRANCES SCOVIL Tel: (416) 642-9308
[email protected]
BOOK YOUR HOTEL ROOM
Make your hotel reservation by using the Toronto Airport Marriott Hotel’s online group
reservation system at Marriott Reservations or by calling Marriott’s Reservations tollfree number (800) 905-2811.
The Group Rate of $139 plus applicable local taxes is guaranteed for reservations
made on or before the cut-off date of Monday, September 7, 2015. If using the tollfree number, specify that you should be included under the Canadian Association of
Occupational Therapists room block. Any reservations made after the cut-off date shall
be at the Hotel’s then current available rate.
SPONSORSHIP CONTACT:
CHRISTINA LAMONTAGNE
[email protected]
GEORGETTE HARRIS
[email protected]
MICHELLE JACKSON
[email protected]
PROGRAM PLANNING SUBCOMMITTEE
ANDREA BUCHHOLZ
HEATHER LAMBERT
CATRIONA STEELE
JAN DUIVESTEIN
PETER LAM
MELANIE TAPSON
EVENT MANAGEMENT GROUP
JOANNE CHARLEBOIS
CARLA DI GIRONIMO
CORINNE EISENBRAUN
JANET CRAIK
JAN DUIVESTEIN
PETER LAM
15
OCTOBER 4 - 6, 2015
Toronto Airport Marriott Hotel
901 Dixon Road
Toronto, ON
CHARTING NEW GROUND:
Interprofessional approaches to dysphagia management