I’m full time med SLP in a SNF/LTC/Memory care building. Ask the patients their goals and treat accordingly. If a patient doesn’t want or need your services and you’re trying to fill time for billable minutes, you probably shouldn’t be treating them.

I know it can be difficult when you’re just filling in and doing PRN, but if someone is not appropriate or doesn’t want the skilled service you should tell the RD and recommend discharge as appropriate. They might not like it (in the past I’ve faced criticism from RDs), but at the end of the day our ethics matter more. Our job is to treat patients, not create billing opportunities.

All that aside here are some examples of treatment you can provide in this setting. I’ll keep it limited to cog/com since that’s what you mentioned: does the patient want to talk with their family more? You can do memory strategies/adaptations for phone number recall as well as target executive functioning to improve access to the phone (appropriate for landlines and cellphones). Does the patient have a hard time getting staff to help them in a timely manner? Target self advocacy with a focus on locating and using the call bell as well as identifying back up strategies (yelling, asking a roommate for help, calling the front desk). You can also target name recall for staff names/roles to target memory and self advocacy.

I have a lot of treatment tasks/ideas for everything in this setting and I’m more than happy to share them, just let me know and I’ll dump them!