In hospital or home environments, the diet by nasoenteral tubes should be prescribed and administered by a multidisciplinary team, with the collaboration of nursing professionals with expertise in nutritional therapy, after evaluation of the clinical condition of the patient presenting dysphagia resulting from trauma or pathology, always giving priority to effective implementation of the procedures and care of personal and environmental
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The more nurses use this method, the more accustomed they will be to it and they may be able to even reduce the time of the education session due to its increased effectiveness. The incorporation of the Teach-back method would not only enhance the client’s education, but also give the nurse an opportunity to assess any learning obstacles or health illiteracies. As a result, the patient could request a consultation with a nutritionist if more education or understanding is needed. The patient would have more one-on-one time to discuss the reasoning behind the diet and to ensure a basic understanding on how to successfully continue their diet in their daily life. The patient would also have the opportunity to express any concerns or fears concerning their new diet. By expressing their emotions concerning the subject, the patient can grow more comfortable as the education session goes on and can gain an understanding of the subject, especially when asked to reiterate the information to the nurse to indicate comprehension on the information. Communication between the patient and nurse can improve and be the basis of a healthy relationship that can be beneficial for both parties during the client’s hospital
Passing out the individual trays presented no issue, but my CNA commanded me, “Feed this resident for me. By the way, she can’t eat solid food, so you’ll have to use this device to feed her.” I was definitely at a loss. The device resembled a cylinder tube with a nozzle at the bottom. One would deposit food in the tube and compress it with the cap to squeeze the food through the nozzle. I struggled at first, but I soon acclimated to feeding the resident with the apparatus. And out of nowhere she choked. She spouted a
A dysphagia diet is provided to those patients who are having difficulty eating and drinking foods safely. These patients who are on a dysphagia diet while admitted in the hospital may be discharged on the same diet. Therefore, it is important to educate these patients on how to safely eat at home. This handout explains the dysphagia diet, common causes for dysphagia, signs and symptoms, and tips on how to swallow safely. The handout also list different diet level and food consistency within a dysphagia diet so, the patient is aware of which level he or she is under. This handout can be provided to any individual of any culture or ethnicity because it focuses on the diet alone (Veterans Affairs, 2017).
The speech-language pathologists (SLPs) at Martin Health System (MHS) evaluate, diagnose, and treat a diverse patient population who present with a myriad of medical issues, the most common of which is a condition known as dysphagia. More than 80% of patients referred to an SLP at our facility present with this diagnosis. Broadly characterized by trouble swallowing, dysphagia includes everything from painful swallows, to coughing or choking while eating and drinking, or even a sensation of a lump in throat, . Complications of dysphagia can lead to dehydration, malnutrition, and respiratory problems such as aspiration pneumonia, fatigue, cognitive confusion, decreased quality of life, or even death.
found that many patients experience feeding problems from gastroesophageal-reflux caused by a hiatal hernia - possibly associated with surgical repair of gastroschisis6. Due to loss of intestine from dysmotility, patients may suffer from short-bowel syndrome which can require extensive Total Parenteral Nutrition (TPN)6. Other potential complications with nutritional implications can include necrotizing enterocolitis or post-operative ileus6-7. Traditionally, the infant is first started on TPN and then advanced to enteral feedings once GI function starts to normalize and there is minimal gastric drainage is observed6-7. However, there is no standard protocol for assessing gastric residuals and introducing
Research has highlighted that stroke is one of the primary causes of dysphagia in the elderly population (Christmas 2002). Physiological implications such as aspiration are some of the difficulties that stroke-induced dysphagia can cause. Thickening-liquids, a form of intervention involving modification of the bolus, is frequently mentioned in the literature for reduction of the risk of aspiration in dysphagic post-stroke patients. Despite being a popular compensatory method of intervention, research has shed light on some of the potential disadvantages of thickeners usage such as increased dehydration (which is likely due to decreased fluid intake) and the impact on the patient’s quality of life. This leads health professionals
Dysphagia in the Elderly is about how and why people, when they age, come about having difficulty swallowing. With a recap on how normal swallowing works to some common causes of dysphagia such as oropharyngeal or esophageal dysfunction. The tables show the different dysphagia and how the patient may feel with associated symptoms. Research on how oropharyngeal dysphagia should be treated is reported to help those with swallowing difficulties.
Dietitian consulted after entriflex tube insertion. ST consulted, intake fair according to her daughter, no choking but spillage on thin liquid, recommend: puree congee diet, mildly thick liquid.
Controlled Trial, Looked into hospitals in Perth, Australia that had older adult patients recovering from a recent stroke, causing different levels of dysphagia. This study attempted to see how different intensity treatments would affect a patients ability to return to a pre-stroke diet within 6 months. As well, whether or not it lowered the patients risk of dysphagia related conditions such as malnutrition or death.
Elderly residents living in residential aged care facilities (RACF) are entitled to receive appropriate nutrition and hydration, along with a pleasurable mealtime experience. Mealtimes and eating are a fundamental aspect of daily activity. Apart from providing nourishment, mealtimes allow for social interactions and communication with other residents and care staff (Barnes, Wasielewska, Raiswell, & Drummond, 2013). However, dysphagia is a common occurrence in RACF residents (Speech Pathology Australia., 2015). The condition is defined as a delay or misdirection of food or fluid swallowed, or put simply ‘swallowing difficulties’(Groher, 2010). Dysphagia has been reported in 50 to 75% of elderly residents living within RACF (Cichero, 2013; DeFabrizio & Rajappa, 2010; O'Loughlin & Shanley, 1998). In addition, communication and mealtime difficulties may increase in older people due to chronic or degenerative conditions.
Patients in the intensive care unit (ICU) often require enteral feeding due to their inability to consume nutrition naturally. Nutrition in the critically ill patient remains a controversial topic. Most clinicians have viewed nutrition as part of patient care but not as a therapeutic intervention
Mr. Basset is an 80 year old man who is widowed. His wife did most of the cooking and now with no one available to cook meals for him, he is not receiving his daily average of vitamins and nutrients. Also, due to the chemotherapy and medications Mr. Basset is receiving, the interaction of food and drugs is contributing to his malnutrition. There are multiple effects with food and drug interactions that can affect elderly patients for example, loss of appetite, prevent medications from working, cause a side effect to get worse or cause new side effects. Lastly, because Mr. Basset has complained about his ill-fitting dentures, this as well is a reason to his malnutrition. It makes it harder for Mr. Basset to chew and swallow his food.
The psychologist would be consulted to make sure that Tracy and her family are handling the stresses and changing circumstances throughout the dysphagia process. The neurologist is in charge of noting the neurological causes of this dysphagia. The occupational therapist is important in helping with the sensory and motor impairments that are connected to the current issues. The physical therapist is a vital member of the team in helping with the posturing of the individual and maintaining safe swallowing. The dentist would be beneficial in helping to address the sulcus pocketing that is occurring with her swallows and making sure that her oral health is up to functional standards. The nutritionist can make sure that Tracy is receiving the adequate nutrition she needs that follows the prescribed bolus modifications. The nurses are vital in her taking meals and medication within the rehabilitation center and maintaining Tracy’s quality of life. The social worker may be needed as well to help Tracy and her family adjust to these changes that have occurred in their lives. The patient’s family are vital in making sure that Tracy is taken care of and can use these modifications and exercises. And ultimately, Tracy is the essential member of this team. She is the one who has to follow all of these guidelines and express her wishes. Without her input, this team will not be functioning