<> I think ultimately, the greatest satisfaction for me is in seeing benefit to patients. All were happy to join the evaluation, which took place in two stages: data was collected over three days during which the residents used their current starch-based thickener followed by three days when they used the gum-based thickener.
Has a medicines review been carried out to make sure that medicines are necessary and can be taken safely?
Indeed, in acute settings, early identification and management of dysphagia is crucial and can reduce the risk of pneumonia three-fold (Hinchey et al, 2005). I sure wish those already-thickened liquids youll find below were around when Mom was alive.
**This post may contain affiliate links. Any other browser may experience partial or no support. An online app version is also available and can be played anywhere on any device. This is especially important when we think about the people who are administering thickener or blending a meal; it is often a busy carer or nurse who requires clear, specific guidance to prepare appropriate food and fluids. of those living in a care home have inadequate fluid intakes.
How can we bring that ultimately to the patients benefit, sooner rather than later? A key element in reducing the risk of choking and aspiration when drinking is to modify the texture of the fluid consumed by people with dysphagia.
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Use of a gum-based thickener is safer as it does not become thinner over time in the presence of saliva.
This recipe is both sweet and energizing, so it's perfect for a morning snack. As care home manager Jemma Robinson explains, preparing thickened drinks incorrectly can be just as dangerous as not having the thickener at all.
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The Francis Report highlighted the importance of giving people food and fluid in a form they can safely consume.
If people have swallowing difficulties, do you have guidance and care plans on how to administer oral medicines safely and effectively, for example crushing a tablet? Strawberry Smoothie Thickeners: The evidence for their appropriate use in dysphagia management Research OUTREACH. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari.
Thickened fluids are easier to swallow as they enter the pharynx slowly, allowing time for the pathway to the lungs to be closed off to avoid aspiration and choking.
Different patients will make different choices depending on their level of concern but for some patients, thickeners can empower them to manage their own health conditions.
Doctors did a swallow study on Mom, and decided that she needed liquids thickened to the consistency of honey.
A holistic approach The latter could even increase risk of malnutrition and dehydration if a patient avoids eating and drinking.
While this treatment is effective, some seniors dislike the texture of thickened beverages.
This means an increase in the cost of their admission and an increased likelihood of experiencing complications secondary to prolonged hospital stay, such as hospital acquired infections. Directions These handy already-thickened drinks would be great to take along on outings! If you're a big fan of fruit juice, you may be upset to learn that this thin liquid isn't an option for dysphasia patients.
Swallowing difficulties are common among care home residents, and increase their risks of a range of conditions. As research has shown, there is a place for thickeners in dysphagia, but only if used correctly, monitored, reviewed and used in conjunction with other approaches such as swallowing rehabilitation and use of appropriate drinking vessels (Lippert et al, 2019). Staff also reported being happy with the gum-based product and said residents preferred the texture, taste and appearance of that over the starch-based alternative.
Altman, K. W., Yu, G. P., & Schaefer, S. D. (2010).
The NHS is currently developing The Dysphagia Game, a new game-based learning programme to help improve dysphagia care.
This included changing the thickeners used and ensuring there was some consistency with regard to the terminology used related to food textures, as well as undertaking staff training.
The majority had been prescribed a starch-based product by their GP and had been using this for some time. This would involve extensive staff training in the correct use of products to ensure residents safety. The focus on safety and palatability are two key areas that staff discuss with stakeholders in an attempt to maintain the quality of life of our residents.
Thickeners come in different strengths; nectar or honey are two of the most common food or beverage thickeners.
The gum-based thickener is of a comparable cost to one that is starch based. Moving away from an acute setting, care home manager Jemma Robinson feels thickened fluids offer many benefits to her residents, particularly as safety is a priority in this vulnerable population.
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Archives of otolaryngology--head & neck surgery, 136(8), 784789.
Implementation of change within any organisation must have the support of key people to drive it forward (Barnett, 2014) so it is crucial to select the right people to attend the training sessions.
Dysphagia - difficulty in swallowing - puts people at high risk of malnutrition, dehydration, aspiration pneumonia and choking.
Suite 20 Westend Office Suites The Francis report (Francis, 2013) states people must have access to food and drink that is palatable and in a suitable form for them to consume. Barchester Healthcare has actively worked in partnership with the following organisations to develop this unique game-based training tool: The Dysphagia Game is a board game for face-to-face engagement in healthcare.
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The drink uses natural thickeners to create a tasty mixed fruit juice that doesn't require any commercial thickener. We felt that GP support for the evaluation was important to ensure continued use of the most suitable product after the evaluation; most GPs were happy to support the evaluation.
We are committed to staff development and this is crucial to the success of any new initiative. Simply combine these ingredients in a blender and process until smooth. This is crucial to changing the culture around the use of thickeners, ensuring that it is not seen as the easy option, but is delivered by qualified professionals who understand the influence that thickener can have on gastric emptying times and other variables.
We're as dedicated to our team members as we are to our residents.
Individuals with dysphagia and their relatives were informed of the evaluation and had the opportunity to decline to participate if they wished.
I first became familiar with food thickeners when my elderly Mom was hospitalized with aspiration pneumonia. Are staff (including kitchen staff who prepare foods), trained on the use of thickeners, and on any food modifications required by individuals? Just because you can't drink thin liquids doesn't mean you can't enjoy a caffeineboost.
Have all people who have dysphagia had an appropriate assessment? While thickeners are widely used, best practice involves using fluids as close to normal as possible. Observation of the use of prescribed thickeners has highlighted variations in how they are used and in the terminology used to record individual required consistencies (McCormick et al, 2008). If you have any questions about how we handle your data, please review our privacy notice.
These results support the use of thickeners in the context of a wider support strategy.
Such as: These can include, but are not limited to: Dysphagia is usually assessed and treated by Speech & Language Therapists.
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The role of Speech and Language Therapists It forms part of NICE Guideline NG128. I dont think we can get results without each other. Medicines: information for adult social care services, For further advice, contact firstname.lastname@example.org, IDDSI: Complete IDDSI framework - Detailed definitions (PDF). The need for modified food and fluids was discussed with our central hospitality operations manager, who confirmed that catering and hospitality staff were not always aware of the correct use of thickeners, which may increase risk for residents with dysphagia.
Lets find new ways of working together and help give patients exactly what they want.
However, you can still get the taste you love and all the beneficial nutrients of fruit with this recipe from UPMC. Stonehouse
Directions Many seniors experience dysphasia, or difficulty swallowing, as they get older. The safety of our residents is paramount and we felt that if staff were using thickeners incorrectly, this safety could be compromised. Cooking a Low Sodium Oven Fried Chicken Recipe, Pureed Food For Adults With Dysphagia (Difficulty Swallowing), My Moms Death A Personal Account Of A Life Well Lived And Gently Died, How To Pack A Beach Bag For A Senior Citizen. There is evidence to suggest that people with severe dysphagia who are worried about drinking thin fluids may appreciate the greater control over aspiration risk that thickened fluids allow (Schindler & Kelly, 2002). A whole-home approach to this initiative means all stakeholders can get involved with the provision of food and fluid, including managers, clinical staff, catering and hospitality staff, people with dysphagia and their relatives and friends. Treatment may include: Other people who also provide help for people with dysphagia may include: It is important to always follow the advice given by clinicians for people with dysphagia.
This will help us to influence the prescribing of gum rather than starch-based products. Teamwork is essential at mealtimes so residents with dysphagia can enjoy their meals safely. Were welcoming brighter days while continuing to promote health and safety. Rather than a one-size-fits-all solution, thickeners are a useful tool as part of a broader approach.
Effective communication within the homes; Examination of the variety of meals and drinks that can be produced using a thickener.
Dysphagia can have profound impacts on social and psychological aspects of a patients life, particularly when it comes to fear of choking.
Although this was a small and non-scientific evaluation, the input from staff teams was consistent and professional.
Just as weve noticed that industry has moved on, lets also move on.
Fluids thickened with a starch-based product have also been shown to become thinner over time as the thickener is broken down by amylase, the enzyme found in saliva, posing a potential safety risk.
They are also less grainy and are said to be more palatable when mixed in fluids (Mills, 2008). We found this one to be very easy to use.
She treats adult clients and provides dysphagia consultancy to business. I either served her food pureed or liquids were thickened to honey consistency. less distractions), how others might be able to help at meal and drink times, Physiotherapists for advice about posture, positioning and chest care, Occupational therapists for advice about aids, adaptations and utensils at mealtimes, Dietitians for advice about nutritional intake, and. Each session was divided into an informative and lively overview of dysphagia, a comparison of starch-based and gum-based products with a practical demonstration, and tasting session. Box 1 outlines correct use of fluid thickeners.
If individuals are using thickener, are hydration levels monitored? Snippet for ASC medicines information - find out more, Snippet for residential ASC assessment framework pages: this page is for, Adult social care: information for providers, pharyngeal stage of swallowing (in the throat), oesophageal stage of swallowing (in the tube leading to the stomach), inability to control food or saliva, drooling, Exercises to help improve the efficiency of the swallow, Strategies to follow when eating and drinking to improve safety and/or comfort, the rate of presentation of food or liquid, how the environment might help at meal and drink times (e.g. The training sessions are viewed as essential for staff - although the numbers of residents using thickeners remains low, their safety and quality of life is paramount.
Particles of food end up in the lungs and, as we all know, thats not where it should be. https://doi.org/10.1001/archoto.2010.129. Phrases such as just add enough until it looks right or add some more if it looks too thin have been heard. I wish I had known these existed when Mom was with me! She says, Thickener means that residents can take their usual fluids, it reduces the risk of aspiration which can cause complications, or it means they do not need to have any other interventions like IV fluids: they can live a normal life. It is not only nursing home residents whose lives are impacted; over half of head and neck cancer patients report reduced quality of life due to dysphagia (Garcia-Peris et al, 2007). Common symptoms of dysphagia can include dribbling, coughing or choking, pouching or storing food in the mouth, and avoiding mealtimes. Enjoy your frappe with a spoon! Its the whole point.
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