Food for Thought

Abstract

Speech-language pathologists have little, if any, formal training in counseling during graduate school. Working with neurodegenerative diseases such as amyotrophic lateral sclerosis (ALS) requires more listening than talking and direct therapy. Knowing what to say and how to address patient emotions about loss of speech and swallowing function can be difficult. We share an patient with ALS's perspective of her experiences in life as she lost her ability to go out to lunch with her coworkers and fought to maintain her weight. We introduce the SPIKES protocol (Baile et al., 2000) for delivering “bad news” as a format for speech-language pathology sessions when broaching difficult topics such as percutaneous endoscopic gastrostomy (PEG) tube placement.