So I work for the an organization that supports individuals with both mental and physical disabilities and mostly are adults, at least I where I have been. With anyone, aging may cause other health issues like dementia, Alzheimer's.  I worked with a man, who was on a chopped diet, ( food cut no more the 1 inch and eliminating foods that could cause choking) and I would explain to him that I also had issues with swallowing too. Well, I got moved to another program in since December, he had to go on Puree   and just the other day I heard he started to asperate on Ice Cream. Firstly, I would have never given him ice cream but we have to follow a doctor prescription.

Well, it happened, he was eating ice cream and was trying to cough then, he was in an altered state.   Thank goodness there was a  staff there that is an ex-EMT  that this staff called and she ran there and the staff who was working the apartment with him, gave him the hardest thrust on his back and it was just enough to jolt him to alert and the he was able to swallow and get air again. 911 was called and he is set to have a gtub installed 4/12. But my point is the 'nurse' ( I think of her like an Rn who became a school nurse and isn't up to date with nursing education) said that until , after he came home from the hospital, to resume his chopped diet until he sees his PCP. I mean yes this is on his RX but...but... if the doctors at the ER says that wouldn't be  a good idea so it took the Staff ( former EMT, to get loud and stating, have the Doctor at the ER to write a script to stay on Nectar consistency liquid until seeing his PCP. Now , we, as staff, have brought up his ( individual) issues with swallowing. We all know a speech therapist is the one who assess our ability when it comes with swallowing. Yes, I understand that the men and women who reside in the program do have their individual rights and some have guardians but I believe that  having a therapist there can assist in their own lives. It's not taking away their right nor would it cause them not to have their independence instead affirm their ability to have the tools to live that life. I know the organization I work for truly cares for the men and women that are in the program but sometimes the macro shows a perfect view when the micro is where the heart is.