Interventions for Nursing Home Residents with Dysphagia—A Scoping Review

Abstract

Oropharyngeal dysphagia is common in nursing home residents. The objective of this scoping review was to summarize and disseminate the findings from the literature on interventions for dysphagia in nursing home residents. Searches were conducted in four databases. The criteria for including the studies were nursing home residents, dysphagia, interventions, original research, published in English, Danish, Norwegian, or Swedish with no restriction placed regarding publication date. Excluded were literature reviews, editorial comments, conference abstracts, protocols, papers not available in full text, and studies with a mixed population, for example, geriatric patients and nursing home residents and where the results were not separated between the groups. A total of 14 papers were included and analyzed. The included papers represented interventions focusing on feeding intervention, oral hygiene, caregiver algorithm, stimulation (taste and smell), teaching the residents what to eat, mobilization of the spine, exercises/training, and positioning. This scoping review identifies sparse knowledge about interventions affecting nursing home residents’ dysphagia. But the results indicate that multi-component interventions, including staff training, training of residents, and/or next of kin, might be successful. This scoping review clarifies that there is a need for well-designed studies that uncover which specific interventions have an effect in relation to nursing home residents with dysphagia and can serve as a guide for designing multi-component person-centered intervention studies. Future studies should implement high evidence study designs, define the measures of dysphagia, and quantify the severity of dysphagia, its underlying diseases, and comorbidities.

Modifying Puree Meals in Residential Aged Care Facilities: A Multi-Centre Feasibility and Acceptability Study

“…TMD as the sole form of intervention for dysphagia in RACFs has shown promise for improving body mass index [ 37 ]. The studies that produced this positive outcome provided TMDs for periods of 3 to 6 months [ 38 , 39 ], which indicates the need for longer-term implementation of TMDs for nutritional and oral intake effects to be observed.…”

Neurostimulation in People with Oropharyngeal Dysphagia: A Systematic Review and Meta-Analysis of Randomised Controlled Trials—Part II: Brain Neurostimulation

“…To be eligible for inclusion in this systematic review, studies had to meet the following criteria: (1) participants had a diagnosis of oropharyngeal dysphagia; (2) the study included non-invasive neurostimulation interventions aimed at reducing swallowing or feeding problems; (3) the study included a control group or comparison intervention group; (4) participants were randomly assigned to one of the study arms or groups; and (5) the study was published in English language.…”

“…Oropharyngeal dysphagia (OD) or swallowing problems is highly prevalent among stroke patients, people with progressive neurological diseases, patients with head and neck cancer, and in frail older persons [1,2]. Prevalence estimates of OD may vary depending on underlying medical diagnoses, but have been reported as high as 80% in stroke and Parkinson's disease [3], and 70% in oncological populations [4].…”

Screening Tools Designed to Assess and Evaluate Oropharyngeal Dysphagia in Adult Patients: A Scoping Review

“…Furthermore, OD is particularly common among frail older people, being described by the European Society for Swallowing Disorders (ESSD) as a geriatric syndrome [ 6 ], usually presenting multiple age-related changes, like loss of muscle mass and sarcopenia [ 7 ]. Additionally, critical complications may arise from dysphagia, namely aspiration pneumonia [ 7 , 8 , 9 ], one of the most prominent death causes in older adults, associated with mortality rates up to 50% [ 10 ].…”

“…Furthermore, OD is particularly common among frail older people, being described by the European Society for Swallowing Disorders (ESSD) as a geriatric syndrome [ 6 ], usually presenting multiple age-related changes, like loss of muscle mass and sarcopenia [ 7 ]. Additionally, critical complications may arise from dysphagia, namely aspiration pneumonia [ 7 , 8 , 9 ], one of the most prominent death causes in older adults, associated with mortality rates up to 50% [ 10 ]. Recently, a case report focused on OD and related pneumonia aspiration, following infection by SARS-CoV-19, and it concluded that the patient developed impaired pharyngolaryngeal sensation, mesipharyngeal contractile dysfunction and silent aspiration in the recovery phase [ 11 ], thus eliciting the need to early detect and prevent OD events.…”