Helen Willis is a Dietitian at Wiltshire Farm Foods: in this blog she looks at caring for older people with dysphagia, and the importance of proper training
It is often the case that with such a media and governmental focus on health issues such as obesity, other nutritional issues get pushed aside and given little focus. One example is the very common swallowing condition, dysphagia.
Dysphagia, difficulty swallowing, is a condition that affects many people, including many within the older population, as it often arises as a secondary symptom of disorders such as stroke – in fact, according to the Stroke Association around 40% of stroke survivors experience dysphagia. As well as stroke, dysphagia can also be caused by dementia, mouth and head cancers and neurological conditions such as Parkinson’s disease, amongst other things.
Dysphagia is a potentially dangerous condition. Most of us probably take the ability to swallow for granted, but problems with swallowing can really harm a person’s quality of life as they can lead to malnutrition, or aspiration of food – which in turn can lead to illnesses such as chest infections and pneumonia. Despite these dangers, as dysphagia typically occurs as a secondary condition of a serious primary illness, it could easily become overshadowed when prioritising care for a patient.
Wiltshire Farm Foods has commissioned an independent survey in order to gauge healthcare professionals’ opinions on the education and help available for those treating patients with dysphagia. This study used a convenience sample, with participants recruited onto an online panel using a postal methodology. The online, self-report survey aimed to quantitatively assess the views of 213 healthcare practitioners (59% Community dietitians; 19% Community nurses; 19% GPs; and 4% Speech and language therapists) who were working within the community from across the UK.
This survey resulted in some surprisingly strong responses from the healthcare professionals, suggesting that much more needs to be done to ensure healthcare professionals feel fully up to date with the latest thinking around treating dysphagia.
The survey found there are two areas in particular which need further attention:
- Training: Nearly half of all healthcare professionals (HCPs) surveyed had not been trained on dysphagia in over 2 years, with 10% having received no training whatsoever. With little training it could be hard for HCPs to keep up to date with the current best practice for managing dysphagia.
- Getting the right nutrition: 73% of the HCPs were concerned about the nutrition or food their dysphagia patients have been eating over the last 12 months, as eating the wrong foods can lead patients to become malnourished, dehydrated or cause aspiration of food. In fact, with 53% of the HCPs seeing consumption of food of an inappropriate texture causing cases of aspiration in their patients in the last 12 months, it suggests that options of properly modified foods need to be made clearer to patients and people who care for them.
Getting the right amount of nutrients, such as protein, vitamins D & B12 and folate is important for healthy aging (Ahmed & Haboubi, 2010). The Stroke Association agrees that proper training and education is needed to ensure that healthcare professionals are able to help patients manage their dysphagia effectively and receive a rich and nourishing diet to aid their recovery.
So, how can we best deal with dysphagia? Keeping up to date with training can allow healthcare professionals to feel confident when treating dysphagia. We should also remember that hydration is just as important as nutrition, which means that some drinks and medicines may also need to be modified. Be aware of all options out there such as products for home thickening and texture-modified frozen meals. With the right support, education and training, both healthcare professionals and carers will be empowered to provide the best possible quality care for people suffering with dysphagia.
References:
Ahmed, T. & Haboubi, N. (2010). Assessment and management of nutrition in older people and its importance to health. Clinical Interventions in Aging. 5 (1), p207-216.
The Stroke Association. (2013). Swallowing problems after stroke.
Photo credit: Infrogmation, via flickr.
British Geriatrics Society 