Sarah Ayer
311 Thornton Drive
Franklin, TX 00000
(000) 000-0000

January 31, 1999

David McMurrey
Elevation Pointe on the Lake
12155 Cole Rd.
Salado, TX 75000
(000) 000-0000

SUBJ: Proposal to develop handbook on communication and swallowing disorders in the elderly for use by nursing staff and aides.

The following proposal outlines the content of the handbook based on your announcement in the American Speech-Language and Hearing Association's newsletter. A description of the handbook, an outline, a list of graphics, information sources, a schedule for completion, and a bid are included in the proposal. Thank you for your time and consideration. I may be reached during business hours at (000) 000-0000.

Sincerely,



Sarah Ayer

Enclosure

Proposal: Handbook on
Communication and Swallowing Disorders in the Elderly



The following is a proposal to develop a handbook on communication and swallowing disorders in the elderly, for use by the nursing staff at Elevation Pointe on the Lake. The proposal is based on the RFP announced in the January issue of the American Speech-Language Hearing Association's newsletter. As I know your primary concern is the well-being of your patients, the information given in the handbook will be a valuable resource for your staff. The proposal will provide information regarding the need for the handbook, a description the proposed handbook, and the benefits of the handbook. An outline, a list of graphics, information sources, a schedule for completion, qualifications of the author, and costs will also be presented.

Need for the Handbook

Recent changes in the healthcare industry, specifically changes that affect long-term care facilities, have resulted in changes in the provision of therapy services. In the past, most long-term care facilities had access to a speech-language pathologist as a full-time employee or full-time contractor. Currently, many companies have been forced to reduce the hours of their therapy staff. As a result, nurses and nurse aides may not have access to someone who can answer questions about communication and swallowing disorders. In turn, patients may have more difficulty expressing their basic wants and needs and may also suffer unnecessarily from swallowing disorders.

Description of the Handbook

The handbook will address communication and swallowing disorders that are commonly found in long-term care facilities. It will provide basic definitions and a brief list of causes for each type of disorder. Signs or symptoms will be discussed to aid the nursing staff in identifying the disorders in their patients. General recommendations will be given to help the nursing staff to communicate with the patients and to assist patients during mealtimes. If patients are suspected to have any of the disorders, it is recommended that a physician and speech-language pathologist be notified.

Benefits of the Handbook

The proposed handbook can be used as a teaching aid in training nurse aides, and as a reference for nurses and nurse aides who have completed training. The handbook can be used as a reference to answer general questions when a speech-language pathologist is unavailable. In addition, it will provide recommendations on communication and swallowing that would be beneficial to all residents of Elevation Pointe on the Lake.

Handbook Outline

The handbook will provide basic definitions of communication and swallowing disorders that are commonly exhibited by patients in long-term care facilities. Common causes of those disorders will be discussed. An extensive list of signs and symptoms will be given with explanations to aid the nursing staff in identifying patients with these disorders. Finally, general recommendations will be given. A tentative outline follows:

  1. Disclaimer This handbook is not meant to be a substitute for, or override a physician's evaluation or recommendations or a speech-language pathologist's evaluation or recommendations. It is meant as a brief introduction to communication and swallowing disorders and to aid nursing staff in identifying those patients who may require evaluation by a physician and a speech-language pathologist.

  2. Introduction
    1. Purpose
    2. Overview

  3. Communication Disorders
    1. Expressive Language Disorders
      1. Definition
      2. Common Causes
      3. Signs or Symptoms
      4. General Recommendations
    2. Receptive Language Disorders
      1. Definition
      2. Common Causes
      3. Signs or Symptoms
      4. General Recommendations
    3. Voice Disorders
      1. Definition
      2. Common Causes
      3. Signs or Symptoms
      4. General Recommendations
    4. Hearing Loss
      1. Definition
      2. Common Causes
      3. Signs or Symptoms
      4. General Recommendations

  4. Swallowing Disorders
    1. Definition
      1. Normal Swallowing Process
      2. Abnormal Swallowing Process
    2. Common Causes
    3. Signs or Symptoms
    4. General Recommendations

  5. Conclusion

Graphics

A variety of graphics will be used to illustrate the concepts discussed in the handbook. A tentative list of graphics follows:

Prevalence of Communication Disorders in Long-Term Care Facilities Pie Chart
Signs and Symptoms of Communication Disorders Table
Recommendations for Communication with Patients with Communication Disorders Table
Prevalence of Swallowing Disorders in Long-Term Care Facilities Pie Chart
Anatomy of the Head and Neck as it Relates to Swallowing Schematic Drawing
Swallowing Problems in the Healthy and Frail Aged Adult Table
Signs and Symptoms of Swallowing Disorders Table
Recommendations for Assisting Patients with Swallowing Disorders Table

Tentative Bibliography

The tentative bibliography will consist of textbooks and clinical manuals for speech-language pathologists. Pamphlets from the American Speech-Language and Hearing Association will also be used. Following is a tentative bibliography:
  1. Andrews, Moya L. Manual of Voice Treatment: Pediatrics through Geriatrics. San Diego, CA: Singular Publishing Group 1995.
  2. Burns, Martha, ed. Clinical Management of Right Hemisphere Dysfunction. Gaithersburg, MD: Aspen, 1985.
  3. Chapey, Roberta, ed. Language Intervention Strategies in Adult Aphasia. Baltimore, MD: Williams & Wilkins 1994.
  4. Cherney, Leora Reiff, ed. Clinical Management of Dysphagia in Adults and Children. Gaithersburg, MD: Aspen,1994.
  5. Nicolosi, Lucille, Elizabeth Harryman, Janet Kresheck, eds. Terminology of Communication Disorders: Speech-Language-Hearing. Baltimore, MD: Williams & Wilkins 1989.

Schedule

The handbook will be completed and delivered to your office on March 16, 1999. The following schedule is a timeline of milestones for completion of the handbook:

Receive permission to begin handbook February 1
Research topics through February 15
Write first draft through March 1
Create graphics finish March 3
Complete first draft finish March 8
Revise first draft finish March 15
Deliver Handbook March 16

Qualifications

As a speech-language pathologist, I have had specialized education and training for assessing and treating individuals with speech, language, and swallowing disorders. A brief summary of my education and experience follows:

Cost

The total cost for researching, writing, editing, binding, and printing 100 handbooks is $4,036. A breakdown of the total expenses follows:

Fee for researching, writing, and editing $3,500
Spiral binding with card stock cover 211
Printing 325
Total Expense $4,036

Conclusion

This proposal is based on the requirements listed in your RFP. If you have any changes or suggestions, please contact me. The information provided in the proposed handbook will be a valuable resource for your nursing staff in enabling them to improve daily communication and safety during mealtimes for all of your residents. I look forward to sharing the information I have gained through my formal education and work experience to benefit the nursing staff and residents at Elevation Pointe on the Lake.

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