Lindsay Block is a Master’s-prepared Pediatric Speech Pathologist who has worked for St. Mary’s Home Care for two years. She began her career in the nursing facility setting but found she missed working with children, and so she transitioned to St. Mary’s Home Care. She is particularly gratified when she is able to help a child grow and progress — children like two-year-old Lily Lingner.
Lily was born with gastroschisis, a rare abdominal wall defect that occurs in only 1 of every 2,500 children born in the U.S. The disorder causes the digestive organs to form outside of the abdomen. Lily spent the first months of her life in specialized children’s hospitals in both Philadelphia and New York. She was then referred to the Inpatient Intensive Feeding program at St. Mary’s Hospital where she spent another three months before becoming strong enough to be discharged with a referral for further treatment at home. At that time, she was eleven months old and still solely being tube fed.
Lily’s mom, Meghan, was determined to have Lily continue the intensive feeding therapy she had received in the acute and inpatient facilities, so that Lily would continue to make progress at home. She was referred to an Early Intervention (EI) program, but the program was not able to provide the intensive and specific feeding-focused therapy Lily needed, which is why she was referred to St. Mary’s Home Care for speech therapy.
At start of care, in August 2018, Lily weighed 16 pounds, 12 ounces. Lindsay started working with her five times a week, slowly gaining her trust while she introduced Lily to the experience of eating food by mouth. Lindsay also helped Lily’s caregivers by suggesting helpful changes to reduce distractions. She showed them how to encourage Lily to eat, as well as how to increase the quantity and variety of food types she would eat.
Home Telehealth
In December 2018, Lindsay also began to use St. Mary’s Telehealth Feeding platform (see related article).
Using a company-issued iPad, Lindsay was able to record Lily’s food intake, including data on textures, types of food, and Lily’s acceptance rate of foods she liked and those she disliked.
By the end of December, Lindsay was able to assist in increasing Lily’s overall intake which then led Lily’s physician to reduce her tube feeds. By February 2019, Lily was able to eat regular food, started gaining weight, and was fully weaned off her feeding tube. By July of this year she weighed 22 pounds and was able to have her feeding tube completely removed.
“The platform has allowed me to track patient status, appropriately document amounts of food consumed during sessions, and observe patterns of both food intake and negative behaviors associated with particular food items,” says Lindsay about the platform.
“It’s a more precise way of documenting and reporting. Since I am able to work in conjunction with Lily’s mother and father and additional caregivers, we have a protocol in place that has allowed Lily to have consistency in her feeding experience.”
The home care program is expanding use of the platform to connect with caregivers through video visits so that home care therapists can remotely watch and support caregivers when they are on their own at home conducting feeding sessions. The technology also provides a way for caregivers and therapists to stay in touch in between visits through the use of “push notification” reminders and text messaging, essentially allowing caregivers to reach out at the touch of a button.