The year is 2016
Mr. Smith, a 72-year-old man who recently had a stroke, is sitting in a recliner. He presents with moderate to severe oropharyngeal dysphagia. Because of this, he is unable to eat by mouth and must rely on tube feedings to sustain adequate nutrition/hydration. His inability to eat is causing him a great deal of anxiety and depression. He no longer eats with his family or goes to family gatherings. He feels it embarrasses his family and makes them uncomfortable. He has tried to find a speech and language pathologist (SLP) in the rural south where he lives, but there is a shortage of SLPs in this area, and none are available. His phone rings, and he pushes the green button on his special monitor. Suddenly, he is connected to an SLP on the East Coast. "Hello, Mr. Smith," she says. "Are you ready for your swallowing therapy?"