Dealing With Dysphagia. October 2. 01. 1 Issue. Dealing With Dysphagia. By Maura Keller. Today’s Dietitian. Vol. 2. 4As health professionals working with older adults recognize, swallowing function can deteriorate with age. Older adults’ teeth are often weak or absent. The mucosal surfaces in the mouth and throat are less moist. But it’s dysphagia, problems with neural control or structures in any part of the swallowing process, that often makes the eating process extremely challenging for elders. Key Concerns. Older patients’ proper nutritional intake is a key concern under normal circumstances. So when normal changes in swallowing are exacerbated by dysphagia, other concerns arise, including poor nutritional status and dehydration, loss of appetite and subsequent weight loss, less enjoyment in eating, and the possibility of food entering the airway and leading to aspiration pneumonia.“The more common causes of mild dysphagia are sensory or motor problems of the pharynx and esophagus,” says Chandra M. Ivey, MD, director of laryngology, voice, and swallowing disorders at Columbia. Doctors Eastside in New York City. More importantly, only half of those with symptoms of dysphagia discuss them with their physician.”Dysphagia in older patients is often mild for long periods of time. Spiegel, MD, medical director of the Jefferson Voice and Swallowing Center in the otolaryngology department at Philadelphia’s Thomas Jefferson University Hospitals, the most life- threatening complication of dysphagia is aspiration (food, liquid, or secretions “leaking” into the lungs).“Because of the high incidence of lung disease and general weakness in the elderly, it’s especially dangerous,” Spiegel says. Aspiration pneumonia is the leading cause of hospitalization and death in nursing home residents. Dysphagia also contributes to malnutrition, which can be found in as many as 5. Dysphagia can also result in patients having improper intake of their medications.”Identifying Contributing Factors. So what are the key indications that an older patient is suffering from dysphagia? According to Claire Kennedy, MS, RD, LDN, a registered/licensed dietitian working at the Norwell Visiting Nurse Association and Hospice in Massachusetts and an outpatient dietitian at Tufts Medical Center in Boston, some observable signs indicating potential problems include coughing while eating or drinking; choking on food, fluid, or medication; a gurgly sounding voice, especially after eating or drinking; difficulty swallowing food or fluid; and pocketing food on one side of the mouth.“Healthcare providers need to be more proactive in looking for swallowing problems, especially in regards to medication review,” Kennedy says. Questions health professionals can ask that offer clues related to potential dysphagia issues include the following. The assessment includes x- ray and video of the swallowing process to determine which stage of swallowing is involved. Esophageal reflux has been found to change sensation at the level of the pharynx and can affect swallowing. While these are less common, they may be serious and require proper diagnostic work- up. Treatment Options. Treatment for dysphagia includes the involvement of both a speech language therapist and a registered dietitian. The Source for Dysphagia Third Edition by Nancy Swigert is excellent because it has a little of everything. It has pre-written inservices with brief tests, FAQ.Dietitians can outline the appropriate consistency of foods that minimizes the difficulties of swallowing and eating. Other considerations include catering to patients’ food preferences as much as possible; providing time for a leisurely, relaxed mealtime without distractions such as TV; and eating with family or friends. Woodruff notes that patients who require soft or pur. The Dysphagia Game is designed to help frontline healthcare staff identify and manage dysphagia more effectively. The game is fun but the issues are very serious. Dysphagia Level 3 – Page 3 Food Groups Recommended Avoid If All Liquids Allowed Meat and meat substitutes (continued) Ravioli with smooth marinara sauce. 2 Diet Manual for Long-Term Care Residents 2014 Revision The Office of Health Care Quality is pleased to release the latest revision of the Diet Manual for. Dysphagia Diet carries the most complete line of dysphagia-friendly products that meet the food texture and nutrition guidelines of the National Dysphagia Diet¹. Number: 0625 (Replaces CPB 439) Policy. Aetna considers speech therapy for treatment of dysphagia, regardless of the presence of a communication disability, medically. Dysphagia, or difficulty swallowing, is a disorder that may be caused by stroke, neurological disease, dementia, or other factors. It poses the danger of aspiration. If oral intake is not sufficient to meet caloric needs, alternative methods for feeding may be considered. Nutrition support can be helpful in constructing a healthy diet for those with restrictive eating needs due to swallowing problems.”Susan I. Wranik, MS, MA, CCC- SLP, president of Susan I. Remember, your mouth is the first and last frontier. It’s the way we, as infants, explore the world around us. It’s also the last decision- making experience for many. The Dysphagia Divas are Dysphagia-Diet's customer service representatives. They are committed to helping and educating people about dysphagia products and how to. The Essential Puree recipes are for the National Dysphagia Diet, with instructions for each level of puree. Here we discuss their guidelines and what they mean. Care guide for Level 3 National Dysphagia Diet. Includes: possible causes, signs and symptoms, standard treatment options and means of care and support. Others can decide when you will go to bed, when you will be changed, and what you will eat, but no one can make another person swallow. Quality of life should be the guiding force in all decision making.”— Maura Keller is a Minneapolis- based writer and editor.
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