George Barnes MS CCC SLP

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Rochelle Park, NJ
George Barnes MS CCC SLP

Med SLP specialist in MBSS, trach/vent, and aspiration pneumonia management. Mobile FEES provider. Making Swallowing Simpler

📍Greater NYC 🍎

03/31/2026

What if the oxygen keeping your patient alive is the very thing putting them at risk for aspiration?

Meet Alan, a 72-year-old with COPD on 60 liters per minute on High-Flow Nasal Cannula (HFNC).

HFNC saves lives by delivering significant positive airway pressure to keep the lungs open.

The problem?

That tornado airflow can push things OTHER than oxygen toward the airway as well.

It isn’t just about the mechanical act of swallowing here; it’s about the patient’s functional reserve.

Can Alan tolerate a full meal? What might happen if he tries?

Find out in this week’s article by commenting “SLP” below.

03/27/2026

Meet Miguel. During his MBSS, he did great, following every direction and using all the recommended compensatory strategies without a hitch.

The result? A recommendation for a diet upgrade.

But as soon as he returned to the nursing home, the impulsivity and over-stuffing returned—and so did the signs of aspiration.

This is the Hawthorne Effect in action... Being observed alters behavior.

During a five-minute study in a quiet suite, a patient can often marshal the cognitive resources to remain safe.

But during a 30-minute meal in a noisy, distracting environment, the outcome can totally change.

Comment “SLP” to read the full case study and learn how we managed his case. You’re not going to want to miss this one.

03/26/2026

“I can eat however I want to eat!”

This was the cry of a patient I saw recently. And, to be honest, I agreed with him.

But in Miguel’s case, his eating habits were risky, and we were all concerned he was going to choke.

The solution is to meet patients where they actually are.

Preventing a choking event is paramount, but so is respecting a patient’s right to decline a pureed diet and live a life they wish to live.

Our role is to be the translator between physiological safety (what the patient can do) and functional safety (what they actually do).

This might look like...

Training staff to help with strategies vs policing food intake.

Focusing on oral health to reduce risk.

Having the hard conversations about risks vs. benefits.

Comment “SLP” to see how our team managed Miguel’s case in this week’s article.

03/25/2026

I know I know you always need to confirm it. But I CALLED that.

Better feeling? Eliminating the aspiration with a cued head turn to the left after a right hemisphere CVA. Boom. 💥

Tell us about a time YOU called it 👇

03/20/2026

Ask more questions.

You aren’t expected to know everything. So ask. Be curious.

Show up to team meetings and learn more about the fascinating fields of our expert colleagues.

It’s as simple and as hard as that.

It feels like you’re putting others out and on the spot. You’re not.

If you don’t know. Ask. And if you know... ask anyway.

Everyone in the world knows more than you about something.

You’re not showing ignorance by asking. You’re showing intelligence in your eagerness to learn and your trust in others.

What question will you ask today? 👇

03/18/2026

How do we get our interdisciplinary colleagues to listen to our recommendations? Really listen and embrace them, as if they were their own.

I’ve been thinking about his for years and decided to build a new course dedicated to facilitating change in our facilities. Hoping to have it ready by next month!

What do you find works best with educating our colleagues? 👇

03/17/2026

I WISH it was that easy. Oh truth is, interdisciplinary collaboration sounds great on paper but it is HARD.

I have a new course coming out in a few weeks (date TBD) which addresses how we can facilitate changes in our facilities. A roadmap of sorts that I’ve found helpful in my practice.

Stay tuned for more info.

What have YOU found helpful in facilitating BIG changes in your facility? 👇

03/12/2026

One of the hardest things for a family to watch is a loved one pushing a plate away during an end-stage disease process.

If we don’t encourage them, are we starving them?

We equate food with love, so when a patient stops eating, we assume they are suffering.

But the biology of the dying body tells a different story...

Research shows that as the body begins the natural process of shutting down, the sensation of hunger actually diminishes.

More importantly...

The dehydration that occurs in this terminal phase can have a natural analgesic effect.

Instead of causing pain, this natural shift can actually increase comfort and provide a mild sedative effect.

Want to learn more about end-of-life care? Comment “SLP for this week’s article.

Thank you to Irene Gofman Brettman and Amanda Warren for sharing their knowledge and helping to edit and approve the contents of this article!

03/10/2026

It’s a common misconception that palliative care is a “death sentence.”

Turns out, it can actually do the opposite.

Research proves it...

Patients who receive palliative care early in the diagnostic process often experience better quality of life, improved mood, and live LONGER.

Rather than expediting death, this layer of support focuses on symptom relief and comfort.

This can actually extend life by reducing the physiological stress of the disease.

What does this look like in dysphagia management?

3 things...

1. Stop fighting a battle of wills over caloric intake.

2. Prioritize the joy of social dining over the mechanics of a “perfect” swallow.

3. Meet the patient where they are instead of providing strict restrictions.

Comment “SLP” for the full article.

Thank you to Irene Gofman Brettman MS, CCC-SLP & Amanda Warren MS, CCC-SLP for sharing their knowledge and helping to edit and approve the contents of this article.

03/05/2026

Don’t worry. What we do is very important. But it’s times like these that give me IMMENSE respect for our nurses.

Side note: if there’s a moment where you can get involved, please do! This not only supports the team, but it also builds rapport with your colleagues.

At any point in at any time, there’s always something we can do to contribute.

03/04/2026

You’re working with a patient with severe dementia who is holding food in their mouth.

Traditional cueing, stimulation, and support is doing absolutely nothing...

For one 90-year-old patient, the progress didn’t come from better instruction—it came from a simple picture.

Bice & Galek, 2016 decided to bypass her cognitive deficits and used sEMG visual biofeedback instead.

When the patient swallowed, a blue bar shot up, and a bell dinged.

The instruction was simple: “When the bar goes up and you hear the bell, you’re the winner!”

After just five sessions, she went from chronic oral holding to independently consuming a regular diet.

If you’ve ever worked with this population, you know how HUGE that is.

Comment “SLP” if you want an article to learn more about this topic. Plus a FREE CEU.

Reference: Bice, E., & Galek, K. E. (2016). The use of neuroplastic principles affects the swallow motor plan of a patient in severe cognitive decline: a case study. Perspectives of the ASHA Special Interest Groups, 1(15), 79–83.

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96 Parkway
Rochelle Park, NJ
07662

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https://www.feesibleswallowsolutions.com/

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