clinical focus
W
Chew on this
Dysphagia care gives
all staff plenty to think
about; only through highly
co-ordinated efforts can
residents be well served.
By Samantha Murray and Kelly Rodgers
22 agedcareinsite.com.au
hat is dysphagia? It’s a term
that means ‘swallowing
problem’. It has numerous
causes, including stroke, head and neck
cancer, dementia and Parkinson’s disease. It
can also affect the otherwise healthy elderly.
About 67 per cent of residents within
residential aged care have dysphagia. Take
a moment to consider the enormity of this
number. In a dining room that seats 30
residents, 20 of them will have dysphagia.
The mismanagement of dysphagia can
result in these residents facing potentially
life-threatening consequences, as well as
poor quality of life.
After falls, choking is said to be secondhighest cause of preventable death within
residential aged-care facilities. Did you know
that someone on a soft diet cannot safely
eat a meat pie or toast? And that jelly is not
suitable for residents on thickened fluids?
So how do you know if someone has
dysphagia? There are signs you can look
and listen for that might lead you to believe
someone has dysphagia; however, it should
be diagnosed by a speech pathologist (SP).
Some signs to look for include:
• Coughing during or after eating/drinking
• Not finishing meals or taking a long time
to consume a meal
• Spitting out food
• Reports of feeling full quickly
• Wetness in vocal tones
• Temperature spikes and/or recurrent
chest infections.
An SP will conduct an assessment
to enable the least restrictive diet
modification that can be offered. When a
diagnosis has been made, it is essential to
follow the texture modification and fluid
thickness recommendations made by the
speech pathologist. Of residents that do
have dysphagia, 50 per cent may show no
visual or audible signs that food or fluids
have entered their airway (silent aspiration).
Upgrading and downgrading diets and
fluids without a recommendation from an
SP can have negative consequences.
Texture-modified diets enable residents
to consume adequate nutrients and
fluids to maintain nutritional status,
while reducing the risk of choking and
aspiration. Once the SP has provided
recommendations for texture modification
of the diet and thickened fluids, an
accredited practising dietitian (APD)
can work with individual patients or an
institution as a whole to ensure nutrition
and hydration requirements are met, within
guidelines set by the SP.
Residents with swallowing difficulties