Susan Spiegel, MA, CCC-SLP, has been helping stroke patients recover at Bacharach for 19 years.


Susan says that there are a number of common side effects after stroke, including aphasia, dysphagia, cognitive impairment, and apraxia. Swallowing difficulties have one of the biggest impacts on stroke recovery.  Not being able to eat, eating foods that are pureed and having many of their favorite foods removed from their diet is very frustrating for patients.


“Eating is such a big part of socializing,” said Susan.  “All of our socialization is centered around eating and drinking.  If people can’t swallow or if they have to thicken their foods, they stop going out, they stop visiting friends.  If you have difficulty speaking people still include you in the circle and you can listen and participate in other ways.   When you can’t eat or drink with friends you tend to self-isolate. This then also affects your ability to improve your speech and language.”


Approaches to Improved Swallowing


Susan says there are several approaches to improving swallowing.  There are exercises to strengthen the affected muscles, ViitalStim, a program that uses electrical stimulation for muscle re-education, and trials of different textures of foods and liquids to modify the diet and find what is appealing and safe to eat.


“The patients may be frustrated at the situation, but they are very motivated to get better.  When they see that they are getting better it reinforces what they are doing with us.  When they have a phone call with family and do not have to say something 5 times, it is self-motivating to them and when they can eat a favorite food it makes them happy.”


What makes this job satisfying for Susan?


“Just to see the patients’ reactions when they are getting better and seeing their frustration leave. When I see them answer a call from the dietitian and tell them what they want to eat instead of being assigned a diet, or watching the progress from not eating to eating a regular diet – that is great.”


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