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 🍎

03/12/2026

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.

03/03/2026

Could playing a video game get a patient off a PEG tube?

Sounds wild, but one study showed that it absolutely can...

First, what’s the biggest obstacle in dysphagia therapy?

You can’t see the muscles working, right?

Without visual feedback, motor learning hits a brick wall.

But when we add visual biofeedback—like a game that responds to exact muscle effort—we can SEE the difference.

In one study of patients who had failed all other therapies, 8 out of 10 returned to full oral intake after using an intensive biofeedback program.

Biofeedback forces the brain to plan with precision, building muscles that are both stronger and smarter.

Want to learn more about biofeedback and to see the research?

Comment “SLP” below to get this week’s full article and a link to a free CEU!

02/26/2026

Dysphagia begins with swallowing but extends to every area of a patient’s life...

Nutrition, breathing, and the simple joy of a meal with someone you love.

Parkinson’s Disease can turn a banal function like swallowing into a painstaking struggle where it takes multiple attempts to clear just one bite.

What works for PD?

EMST: Improving cough force to help patients eject aspirated material.

LSVT: Using the crossover effect of voice therapy to improve pharyngeal function.

Dignity-Centered Care: Prioritizing quality of life for as long as possible.

Because it’s not always about safety. It’s about living a life worth living, too.

What have YOU found works best for YOUR patients with PD?

Reference: Kwon, M., & Lee, J. H. (2019). Oro-pharyngeal dysphagia in Parkinson’s disease and related movement disorders. Journal of Movement Disorders, 12(3), 152–160.

02/25/2026

And there are tons of barriers

They range from too much focus on productivity to the doctor’s unwillingness to listen to your recs to colleague’s outdated use of the evidence…

Nobody is going to solve these things overnight, but addressing them is still important.

I’m toying with a new course on how we can facilitate change in our facilities.

Can you help me?

What are the biggest problems you face as an SLP and what might you need to help solve those problems?

02/24/2026

When it comes to Parkinson’s, we often focus on the most visible symptoms: tremors, slowed movement, and a shuffling gait.

But what about the symptoms we can’t see?

While only about 1/3 of patients with PD report subjective swallowing difficulty, objective testing tells a different story...

82% of patients actually have dysphagia.

Because patients often don’t “feel” the difficulty until late in the disease process, silent aspiration becomes a hallmark risk.

Find out what you need to know to get in early and make a real difference for your patients.

Comment “SLP” for this week’s article.

Reference: Kwon, M., & Lee, J. H. (2019). Oro-pharyngeal dysphagia in Parkinson’s disease and related movement disorders. Journal of Movement Disorders, 12(3), 152–160.

02/20/2026

While we usually attribute dysphagia to neurological disease or injury, those seemingly harmless little pills in your patient’s organizer can quietly worsen a swallowing disorder—or even jumpstart one where it never existed before.

The 4 Ways Medications Impact the Swallow:

🏜️ Xerostomia (Dry Mouth): Anticholinergics can “shut off” the salivary glands, turning a smooth swallow into a tumbleweed in a desert.

🐢 Motor Function: CNS depressants can slow down the precise coordination of the 26 pairs of muscles required for a safe swallow.

🚪 GI Motility: Certain meds “bribe” the stomach’s bouncer (the LES) to stay open, inviting reflux to damage the laryngeal tissue.

🕳️ Mucosal Damage: Some pills can get physically lodged in the esophagus, creating ulcers that make every bite feel like shards of glass.

We have to stop looking at the swallow in a vacuum and start looking at the whole patient.

What medications have your patients recently had trouble with? Share below!

02/18/2026

What’s your approach to documentation? How do you stay efficient AND effective? 👇

02/17/2026

Ever try to go down a water slide without the water? Not quite the ride you’re looking for, is it?

Swallowing with xerostomia is similar.

For a smooth swallow, we need constant lubrication so the bolus can slide effortlessly.

But many of our patients are on medications that “turn the water off” without warning.

Anticholinergics (I.e., antihistamines and antidepressants) cause xerostomia, which may increase the risk of choking, residue, and aspiration.

Want to learn more about how meds impact swallowing? Comment “SLP” for this week’s article.

Happy reading!

02/12/2026

During the height of the pandemic, the internet was flooded with conflicting information.

It was the perfect environment for snake-oil salesmen to thrive.

Today, that same misinformation targets our patients with chronic, complex conditions like dysphagia.

So... How do you know which “breakthrough” is actually credible?

Try the CRABS mnemonic (reference below)

🦀 Conflicts of Interest: Does the author stand to gain financially?

🦀 References: Is there actual data backing the claim?

🦀 Authorship: Who wrote this, and what are their credentials?

🦀 Buzzwords: Are they using “emotional” language to bypass your logic?

🦀 Scope of Practice: Is the creator actually qualified to speak on this?

What approaches do YOU use to tell the nonsense apart from those clinical golden nuggets? Share below!

Reference: Stokes-Parish, J., Habibi, R., & Toomey, S. (2022). Navigating the credibility of web-based information during the COVID-19 pandemic: Using mnemonics to empower the public to spot red flags in health information on the internet. Journal of Medical Internet Research, 24(6), e38269. https://doi.org/10.2196/38269

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