Please help me make sense of another clinician's findings/recommendations

I'm about 6 years into this career and finally at a point where I don't get stuck on things very often but this one threw me for a loop.

I work in a SNF and recently got a new admit straight from acute. She had a FEES done while there which revealed profound pharyngeal impairment and unilateral VF paralysis. The SLP wrote that she suspects RLN involvement, specifically that the lymph nodes are compressing the RLN (they were bilaterally enlarged on chest CT). She was very clear that the pt was not expected to improve with swallow therapy and recommended non-oral feeding if the GOC is prolongation of life, soft + bite-sized solids if the pt wants to prioritze QOL with the understanding that she will continue to aspirate. The pt opted to have a PEG tube placed.

The same SLP saw this patient two days later and introduced an aggressive swallow exercise regimen. She also recommended that the pt pursue outpatient treatment with a voice specialist. These recommendations seem to directly conflict with those from her FEES writeup. I don't know how to interpret this. Is there anything we can accomplish with swallow/voice therapy if the primarily problem is RLN compression?

The SLP who wrote these notes is someone I have worked with in the past and have a lot of respect for. I generally regard her as a much more experienced and knowledgeable clinician than I am. That's why I feel like I must be missing something here.

I would be forever grateful for any insight anyone might have on this. I'm a little disappointed in myself for resorting to Reddit for answers but I'm just really confused and I need to make sure I'm doing right by this patient.