Appraisal and diagnosis of neurogenic communication disorders in remote settings


Patients who suffer neurogenic communication disorders and reside in remote settings either do not receive services or they must travel long distances or become inpatients for extended periods. No services is unacceptable, because all patients merit appraisal and a diagnosis, and many respond to treatment with improvement in their communication. Traveling long distances for services is unacceptable, because it is expensive, inconvenient, may be contraindicated by the patient's medical condition, requires a means of transportation which often does not exist, and must be frequent and protracted. Hospitalization is also unacceptable, because the communication disorder does not necessitate hospitalization, it usurps a bed, carries a patient beyond DRG length-of-stay criteria, removes him or her from the home environment, and is expensive. There is a need to develop means for managing patients who live in remote settings.