Interdisciplinary management of dysphagia following stroke

Abstract

Dysphagia (difficulty swallowing) is common following stroke. It significantly affects quality of life and places patients at risk of pneumonia, malnutrition and death. An interdisciplinary approach is necessary to ensure patients with dysphagia remain safe. This paper provides a review of current practice in the UK and current evidence in the management of dysphagia following stroke. The roles of the dietitian, nurse, pharmacist and speech and language therapist in dysphagia management are discussed. The article focuses on the acute phase of stroke management and short-term management of swallow safety as well as nutrition, hydration and pharmaceutical needs.

The impact of modification techniques on the rheological properties of dysphagia foods and liquids

“…This framework is suitable for all ages, all care settings, and all cultures (Cichero et al, ; Lam, Stanschus, Zaman, & Cichero, ). Prethickened or preprepared dysphagia foods also exist to reduce mixing or preparation errors, primarily in the form of supplementary food prescribed by dieticians, such as sip‐feeds or nutritionally dense puddings (Brook, ; McFarlane, Miles, Atwal, & Parmar, ). These products have been designed, because swallowing disabilities often lead to malnutrition (Cichero et al, ) and individuals often require supplementation.…”

“…These products have been designed, because swallowing disabilities often lead to malnutrition (Cichero et al, ) and individuals often require supplementation. There are other food products designed by food scientists and technologists that are not specifically for individuals with swallowing disabilities but that could be used as dysphagia foods, such as infant fruit purees, yogurt, smooth jams, cream cheese, and mousse pudding (McFarlane et al, ). Commercial bulk texture‐modified foods have been developed (Landry, ); however, these foods do not necessarily improve the nutritional status of individuals with dysphagia even though it improves intake (Keller, Chambers, Niezgoda, & Duizer, ).…”

The impact of aspiration pneumonia and nasogastric feeding on clinical outcomes in stroke patients: A retrospective cohort study

“…Dysphagia is a common complication following stroke with reported incidences around 20%–78% however varying greatly in the literature, depending on assessment process (Arnold et al., ; Flowers, Silver, Fang, Rochon, & Martino, ; Martino, Martin, & Black, , Martino et al., ; National Stroke Foundation., ). The management of poststroke dysphagia is multidisciplinary with nurses playing a key role in screening for dysphagia risk, monitoring tolerance of food and fluids and providing feedback regarding current status to other team members (McFarlane et al., , Hines et al., , Bird, , Cichero et al., , Daniels et al., , Kertscher et al., , Smithard, , Speyer, , Trapl et al., ). Despite the efforts of the multidisciplinary team, dysphagia following stroke is often associated with a number of clinical complications including aspiration pneumonia, dehydration, malnutrition and subsequently the need for non‐oral feeding (Arnold et al., ; Dziewas et al., ; Foley, Martin, Salter, & Teasell, ).…”