Abstract
Rehabilitation professionals find themselves working with increasing numbers of medically complex geriatric patients in a wide variety of settings. An especially difficult and challenging portion of this population are geriatric patients with tracheostomy tubes, some of whom require mechanical ventilation. Significant impairment in communication and swallowing function is prevalent in the tracheostomized/ventilator-dependent population. This article presents an overview of the purpose and basic function of tracheostomy tubes and mechanical ventilation, the resultant impairments in communication and swallowing, and intervention approaches to these impairments, with a focus on the multidisciplinary team and the special needs of the older patient.