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There are many things we can do to improve a patient’s food and fluid intake and help address and manage swallowing problems. Here are some recommendations. “Managing dysphagia is a balance between quality of life, dignity and taking small risks.” Senior speech pathologist Refer to health professionalsWhen we have identified that a patient may have a swallowing problem, we should refer them to a Speech Pathologist and other health professionals who will work with you, the patient and their family and carers to inform the development of a comprehensive and consistent assessment and intervention plan. Speech pathologist to:
Pharmacist to:
Occupational therapist to:
Mealtime assessmentMealtime assessment provides us with the opportunity for ongoing observation and evaluation.
Be familiar with the procedures and terminology used to prescribe food and fluid in your health service. We need to be familiar with the specific food and fluid modification terminology and procedures used in our health service. Follow your health service procedures and policies, which in many cases will include placing an alert on the person’s electronic record, in their medical history and above their bed. Examples of terminology for food include:
Some health services supply pre-packaged modified food and fluids and some add thickeners and modify their meals on site. If we understand our local procedures we are more likely to ensure the patient receives the right meal. Mealtime interventionsMealtime management interventions assist us to respond to existing swallowing problems and to prevent them occurring in older patients who are at risk of developing them during hospitalisation. It is essential that all staff, volunteers and family and carers, who play a role in food preparation, delivery and assistance at mealtimes are aware of the risks and signs of dysphagia, and what to do if there is a problem. Work closely with your team to:
Assess the patient’s oral healthAssess the patient’s oral cavity to see if dentures, poor oral hygiene or loss of dentition is affecting chewing, speech or swallowing. In particular, look for:
Encourage patients to keep good dental hygiene while in hospital:
1. Wieseke, A., Bantz, D, Siktberg, L, Dillard, N, Assessment and Early Disgnosis of Dysphagia. Geriatric Nursing 29(6): p. 8. 2. Parker, M., Power, D, Management of swallowing difficulties in people with advanced dementia Nursing Older People, 2013. 25(2): p. 5. 3. Kelly, J., D'Cruz, G, Wright, D, A Qualitative Study of the Problems Surrounding Medicine Administration to Patients with Dysphagia Dysphagia, 2009. 24: p. 7. Reviewed 05 October 2015 |