Oropharyngeal Dysphagia Case Study

Mary is a 69-year-old lady who has been diagnosed with dementia. She lives in a bungalow with her husband Sam who is 78 years old. Before Mary was diagnosed with dementia she lived a normal lifestyle which involved her going shopping, driving and also caring for her husband. Before Mary Retired she worked in the pottery industry for over 40 years. Marys husband Sam has previously had a stroke so he also struggles to manage as the stroke has affected his left side. They have 3 grown up children who live nearby but are all currently in full time work. Marys children regularly help Mary and Sam when they are not working but due to their own work and family commitments it is not very often. Marys children are also worried as they have seen a dramatic weight loss and change in Mary’s appetite. Mary has recently been admitted to the ward following a fall at home where she will be assessed although Mary is adamant she wants to return home after her hospital stay.

The Glasgow coma scale is the scoring system that monitors and assesses the level of consciousness of a patient that has had a traumatic injury e.g. brain injury, car accident or sports injury (Braine & cook, 2016). The Glasgow coma scale is a score between 3-15 with 3 being the worst and 15 being the best. This scale is composed of 3 sections which are the best eye response this assessment is important to assess the arousal of the patient which reflexes the integrity of reticular activating system of the brain which assesses by 1. No eye opening 2. Opens to pain 3. Opens to voice 4. Opens spontaneously, the best verbal response this assessment reflects the integrity of higher cognitive and interpretive centres of the brain. The verbal response depends on the language centre in the temporal lobe and in the frontal lobe which assess 1. No verbal response 2. Incomprehensive sounds 3. Inappropriate words 4. Confused 5. Orientated and best motor response this assessment check the function ability of the cerebral cortex, the patient has to understand the commands and perform the movement accordingly, they assess the upper extremities by simple orders because they are more reliable than the lower extremities this is assessed by 1. No motor response 2. Extension to pain 3. Flexion to pain 4. Withdrawals from pain 5. Localising pain 6. Obeys commands, these are the three sections that nurses needs to access (Elliot, Aitken & Chaboyer,

Pt is a 84 year old Cascasion female living with her husband in their home. Husband reported the Pts Alzhemers has be pergresing for the last 8-9 years. Pt had open heart surgery in 2012, which contributed to the memory loss decline and increasing level of Alzhemer symtoms, husband verbalized. Husband reports they have been married for 19 years. Pt has a sister living Florda, two daughters living in Texas and Wyoming and one son in New York. The children stay in contact with them every other day. Pt reports she worked as a RN at the VA Hospital in New Mexico. Pt is not independent in the home without the husbands assistance. Pt does ambulate well in the home, but does have a walker in needed. Husband assists the Pt all her ADL's in the home and drives her to the store and for MD appointments. Husband currently suffers from Hemochromatosis (too much iron in one's body). Husband reports he manages well with his illness while taking care of Pt at the sametime. Husband reports the Pt's Alzehmers level appears to be stable at this time, but is quite forgetful at times and needs his assistance. Husband said they are managing

One of the hardest moments for not only the person with dementia, their caretaker, and their family, is deciding the appropriate time to relocate to an assisted living facility or a skilled nursing home. Like the variety of the disease symptoms and durations, the question of when to accept outside help also has different answers depending on the situation and the caregiver’s abilities and resources (Smith, J., 2016). Many caretakers may view the idea of placing their loved one in a home as a sense of failure on their part; however, it does not have to be this way. With the increasing demand for assisted living facilities and nursing homes, improvements in the standards of care for dementia patients as well as a shift towards more “patient-centered

Many caregivers are elderly themselves, and the heavy physical and mental toll of caregiving can compromise their own health, resulting in two elderly persons needing assistance. Several years ago, Mr. and Mrs. C, another couple in their late 80’s, moved to a Senior Living Community offering different levels of care including Independent Living, Assisted Living, and a Dementia Care Unit. They were in an Independent Living apartment and on a waiting list for an Assisted Living apartment to become available. Although they have adult children close by, Theresa was the primary caregiver for her husband who has

Whereas a person that has had a stroke or some traumatic injury such as spinal cord trauma and paralysis they may spend the rest of their lives in a facility due to not being able to do simple activities of daily living(ADL’s) like feeding themselves. These individuals can be cared for at home but it does take a toll on a family if they aren’t committed to that patients care. Children can even be in a facility because the parents can’t give the proper care for them at home. The residents in these facilities do get to experience some independence but there are always some professionals nearby for

In neropsychology, there are many assessments and tests such as the Glascow Coma Scale, the NAART, the Weschler WTAR, all of these and more can be used to assess Mary’s premorbid abilities and compare them to after her accident. In the Glascow Coma Scale, one of the assessed on the following functions, eye opening, verbal response, and motor response (Tsdale, Jennett. 1974). Eye opening can be spontaneous, to the sound of a voice, and response to pain, or not at all (Tsdale, Jennett. 1974). Verbal response can be normal conversation, disorientated conversation, words, but not coherent, no words, only sounds, or none at all (Tsdale, Jennett. 1974). Motor response can be normal, localized to pain, withdrawal to pain, abnormal posture, or none (Tsdale, Jennett. 1974).

Dysphagia is defined as a difficulty moving food from the mouth to the stomach. Dysphagia can come and go or slowly worsen over time depending on the other disorders present. When a person has a cerebrovascular accident (CVA), dysphasia can appear and later go away. If a progressive neurological impairment is the cause of the dysphagia, the swallowing problems can worsen over time and never go away (Logemann, 1998). Dysphagia is a commonly diagnosed for at least a short time after a CVA has occurred and individuals are more likely to aspirate liquids with a lower viscosity (Murray et al. 2016).

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

Declining health and depression are two of the largest reasons families look into assisted living homes for aging loved ones. Making sure that the healthcare needs of the elderly are met becomes a priority for every family as the roles begin to reverse from the parent being the primary caregiver of their children to the children being responsible for meeting the needs of aging parents. Diseases such Alzheimer’s and dementia are very difficult for not only the

The fluoroscopy and the upper gastrointestinal endoscopy are different, but remarkable diagnostic methods used for the people suffering from dysphagia. Dysphagia is a medical term that means difficulty swallowing due to abnormal contractions of the esophageal muscles. It is important to find a quick evaluation that will lead to a better diagnosis and recovery with lesser complications. This research paper will discuss the appropriate diagnostic method by comparing between the fluoroscopic unit, and the UGI endoscopy. Data will be collected from King Abdul Aziz University hospital, the sample will be a large diverse patients with dysphagia as the main complaint.

In the first category of dysphagia, “individual have a decreased ability to accomplish the initial steps of swallowing in an orderly sequence” (Copstead & Banasik, 2013, p. 721). The normal process of swallowing starts with the contraction of pharynx, which then leads to the closure of the epiglottis and results in the relaxation of the upper esophageal sphincter (Copstead and Banasik, 2013). After the relaxation of the upper esophageal sphincter, there is an “initiation of peristalsis by contraction of the striated muscle in the upper portion of the esophagus is altered, or the certain steps in the sequence may be absent” (Copstead & Banasik, 2013, p. 721).

This report shows the case that a demented patient with severe dysphagia kept on ingesting food orally and being put on a drip till the last.

Nicholas is a72 year old male, who has been referred to me at Communify, a community organization which provides services and activities to enhance quality of life to both individuals and families (Communify, 2014). Nicholas’ quality of life is diminishing, and has reported issues such as loneliness, depression and dementia, which has caused severe mood swings, difficulty in personal care, incontinence, forgetfulness, confusion, leg weakness and loss of mobility. These issues are in fact, all symptoms of vascular dementia – a condition which Nicholas has been diagnosed (Alzheimer’s Society, 2014). Nicholas has also been diagnosed with a progressive heard problem, to which he has recently had surgery.

Dysphagia is a term used in health care to define the symptom of difficulty swallowing. It is defined as any impairment in drinking, eating or swallowing ( Lewis, 2014). It occurs when there is any change in the neural functioning or any weakness of muscles that help us to swallow the food, most commonly the esophagus and the facial muscles. However, sometimes it is the tongue that is unable to push the food posteriorly towards the pharynx for further digestion. Studies have shown that approximately 53%–74% of long-term care facility residents have dysphagia (CAN training advisor, 2014). It is more common in older clients and the ones who have experienced stroke at some point in their lifetime. In Canada, approximately half of all new stroke