Olivia Ferrari, hospital director at St Peter’s Hospital, Newport, which provides treatment and care for patients with complex dementia or ABI, talks about the importance of effective dysphagia management
Dysphagia, a condition that affects the swallowing of certain foods and liquids, is something we see often, and the importance of managing it cannot be underestimated for the health and wellbeing of our patients.
Although commonly associated with older people, dysphagia can be caused by conditions that affect the nervous system such as Acquired Brain Injury (ABI), stroke, multiple sclerosis (MS), dementia or cancer.
According to the Royal College of Speech and Language Therapists, which continually highlights the importance of maximising access to support, it has been estimated that between 50-75 per cent of nursing home residents suffer with dysphagia, along with between 40-78 per cent of stroke survivors, 33 per cent of people with multiple sclerosis, five per cent of adults with a learning disability, five per cent of community-based individuals with learning disabilities and 36 per cent of hospital-based individuals.
If not managed appropriately, the condition can lead to weight loss, dehydration, poor oral hygiene, choking and aspiration pneumonia.
An effective dysphagia management plan can help patients maintain energy levels and muscle mass, supporting a healthy immune system as well as the individual’s wellbeing and mental health.
Here at St Peter’s Hospital in Newport, patients are given dietetic assessments on arrival to ensure that all their nutritional and hydration needs, including dysphagia, are identified and met by the in-house catering team from the outset.
Dysphagia can be treated with careful management, often utilising special exercises created by speech and language therapists or changing the consistency of food and liquid to make it easier to swallow.
One of the main things advocated by the catering team at St Peter’s is texture modified meals, where foods may be pureed, chopped, mashed, minced or made soft to reduce the likelihood of choking. Dysphagia management really does require a team approach. The complexity and inter-related nature of the needs involved mean that a lot of input is required.
Our patients with dysphagia are offered texture modified meals from our external specialist suppliers, with different meals given to different patients as needed.
If people feel that they are going to choke when they’re eating or drinking, the most likely scenario is that they will stop eating, or at the very least do so with great trepidation.
The negative impact this can have on people’s health – through malnutrition and dehydration – can be debilitating. By identifying issues early and starting off with slightly softened food and gentle exercises, we are able to address the issue before it gets worse.
A staff member at St Peter’s Hospital shared with me recently her own personal experience of why it is so important to recognise and treat dysphagia, saying: “It was only lately, whilst caring for our patients with dysphagia, that I realised that my mother may have suffered from it for years. She had daily choking fits and was very underweight; every winter she had bronchitis or pneumonia.
“It severely affected her quality of life, yet no one ever thought to question whether she needed a modified diet. It’s sad to think that some simple changes to her diet might possibly have improved her life.”
For anyone who is concerned that a family member might be struggling with dysphagia, the first step is to speak to their doctor. They might even refer them to a speech and language therapist who can identify exercises for them to try, or could try texture modified food at home.
St Peter’s Hospital is owned and run by healthcare specialists, Ludlow Street Healthcare. Established in 2005, Ludlow Street Healthcare has supported and cared for over 800 people with complex mental health conditions. More information about St Peter’s Hospital and Ludlow Street Healthcare’s other services is available on their website https://www.lshealthcare.co.uk
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