Management of Dysphagia in Nursing Homes: A National Survey

Engh, Mina C. N.; Speyer, Renée

doi:10.1007/s00455-021-10275-7

Cited by 33 publications

(32 citation statements)

References 29 publications

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“…However, as an observational study, it is not possible to determine whether the outcomes were coincidental. Though nutritional status was found to be routinely screened in nursing homes, diet quality is one of the biggest challenges of clinical management which can result in malnutrition [ 68 , 69 ]. The previous review summarised that the positive improvement in nutrition intake was found using fortification and shaped TMDs [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Texture-Modified Diets, Nutritional Status and Mealtime Satisfaction: A Systematic Review

Miles

Braakhuis

2021

Healthcare

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While the association between dysphagia and malnutrition is well established, there is a lack of clarity regarding the nutritional status and mealtime satisfaction of those consuming texture-modified diets (TMDs). This systematic review summarises and critically appraises the nutritional status and mealtime satisfaction of adults consuming TMDs. A systematic database search following PICO criteria was conducted using Cochrane Central (via Ovid), MEDLINE, CINAHL, EMBASE and Scopus. Nutritional status, mealtime satisfaction and costs were identified as primary outcomes. Eligible studies were grouped according to outcome measurement. In total, 26 studies met the inclusion criteria. Twenty studies evaluated the nutritional status by weight change or using malnutrition screening tools and found the consumption of TMDs correlated with weight loss or malnutrition. Nine studies evaluated mealtime satisfaction, with two reporting poor satisfaction for people on thickened fluids (TFs). Nutrition intervention through adjusting texture and consistency and nutrition enrichment showed positive effects on weight and mealtime satisfaction. The majority of the studies were rated as ‘neutral’ quality due to the limited number of experiments. TMD consumers had compromised nutritional status and poor mealtime satisfaction. More research input is required to identify promising strategies for improving the nutritional status and mealtime satisfaction of this population. Food services need to consider texture, consistency and fortification in designing menus for people on TMDs to avoid weight loss and malnutrition, and to enhance mealtime enjoyment.

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Section: Discussionmentioning

confidence: 99%

Texture-Modified Diets, Nutritional Status and Mealtime Satisfaction: A Systematic Review

Miles

Braakhuis

2021

Healthcare

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“…Common signs of oropharyngeal dysphagia include coughing and wet or gurgly voice (signs of impaired swallowing safety) and drooling or food getting stuck in the throat (signs of impaired swallowing efficacy) before, during, or after swallowing. Although oropharyngeal dysphagia is a known risk factor for nursing home-acquired pneumonia [ 6 ], nursing homes often lack protocols for diagnosing and routinely screening for swallowing problems [ 7 ]. Identifying and managing oropharyngeal dysphagia and its associated factors are essential for establishing better healthcare policies for the aging population in nursing homes.…”

Section: Introductionmentioning

confidence: 99%

Oropharyngeal dysphagia and associated factors among individuals living in nursing homes in northern Sweden in 2007 and 2013

2022

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Background Swallowing difficulties in the oral cavity or pharynx (i.e., oropharyngeal dysphagia) are a common problem in the aging population, which may result in severe consequences, such as malnutrition, aspiration pneumonia, and mortality. Identifying oropharyngeal dysphagia and its associated factors is essential for establishing better healthcare policies in nursing homes. In this study, we aimed to describe the oropharyngeal dysphagia prevalence among nursing home residents, and to investigate the association between dysphagia and potentially related factors in a large survey of nursing home residents in Sweden, including individuals with various degrees of cognitive impairment. A secondary aim was to compare findings between years on oropharyngeal dysphagia and its associated factors. Methods This study is based on two cross-sectional surveys performed in 2007 and 2013, including 4,995 individuals living in nursing homes in the Region of Västerbotten, Sweden. Data were collected from caregivers’ reports regarding swallowing ability, nutritional status, chewing ability, and other baseline characteristics, such as cognitive function and activity of daily living (ADL). Data were analyzed using logistic regression models to calculate the odds of the association between oropharyngeal dysphagia and associated factors. Results Oropharyngeal dysphagia was reported in 14.9% (95% CI: 13.9–16.0) of the nursing home residents. An adjusted model revealed that oropharyngeal dysphagia was associated by severe cognitive impairment (OR: 1.56, 95% CI: 1.14–2.12) and ADL independence (OR: 0.81 95% CI: 1.82–2.66) among nursing home residents. We also identified the following as independently associated factors of dysphagia: reduced nutritional status (OR: 1.84, 95% CI: 1.49–2.27), artificial nutrition (OR: 6.33, 95% CI: 2.73–14.71), and clinical signs of aspiration (OR: 10.89, 95% CI: 8.40–14.12). Conclusions Oropharyngeal dysphagia was reported among approximately 15% nursing home residents and was associated with cognitive impairment and ADL capability. Furthermore, reduced nutritional status and artificial nutrition were also associated with oropharyngeal dysphagia. Implementing routine protocols in nursing homes may help detect oropharyngeal dysphagia and manage oropharyngeal dysphagia among residents.

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“…In the literature, the need for education on the diagnosis, treatment, and possible complications of dysphagia is a general problem; moreover, all experts strongly accepted the recommendation for more education on this issue. 52 , 53 )…”

Section: Discussionmentioning

confidence: 99%

Best Practice Recommendations for Geriatric Dysphagia Management with 5 Ws and 1H

Umay

Eyigör

Bahat

et al. 2022

Ann Geriatr Med Res

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Background: Dysphagia is a geriatric syndrome. Changes in the whole body that occur with aging also affect swallowing functions and cause presbyphagia. This condition may progress to oropharyngeal and/or esophageal dysphagia in the presence of secondary causes that increase in incidence with aging. However, no study has been published that provides recommendations for use in clinical practice that addresses in detail all aspects of the management of dysphagia in geriatric individuals. This study aimed to answer almost all potential questions and problems in the management of geriatric dysphagia in clinical practice. Methods: A multidisciplinary team created this recommendation guide using the seven-step and three-round modified Delphi method via e-mail. The study included 39 experts from 29 centers in 14 cities.Results: Based on the 5W and 1H method, we developed 216 detailed recommendations for older adults from the perspective of different disciplines dealing with older people. Conclusion: This consensus-based recommendation is a useful guide to address practical clinical questions in the diagnosis, rehabilitation, and follow-up for the management of geriatric dysphagia and also contains detailed commentary on these issues.

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Management of Dysphagia in Nursing Homes: A National Survey

Cited by 33 publications

References 29 publications

Texture-Modified Diets, Nutritional Status and Mealtime Satisfaction: A Systematic Review

Texture-Modified Diets, Nutritional Status and Mealtime Satisfaction: A Systematic Review

Oropharyngeal dysphagia and associated factors among individuals living in nursing homes in northern Sweden in 2007 and 2013

Best Practice Recommendations for Geriatric Dysphagia Management with 5 Ws and 1H

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