Dysphagia
Dysphagia describes eating, drinking and swallowing difficulties in individuals. People with dysphagia often have other health conditions that they are being treated for, which can affect their eating, drinking and swallowing abilities.
Clinical dysphagia can be associated with:
- Acute neurological diagnoses
- Progressive neurological diagnoses
- Functional neurological disorder
- Respiratory diagnoses
- Post-acute dysphagia e.g. following traumatic intubation or post ICU sarcopenia.
Evaluation and Diagnosis
A Speech-Language Therapist (SLT) is a crucial member of the team dedicated to evaluating and diagnosing complex eating, drinking and swallowing difficulties.
We offer:
- A comprehensive clinical swallowing evaluation; including cranial nerve examination, oral examination, cervical auscultation and assessment of swallow function with oral fluids and diet. If appropriate, quantitative assessment measures can also be used.
- Assessment of any compounding factors including; oral hygiene needs, positional needs, level of assistance required from others, behavioural factors, environmental factors and laryngopharyngeal reflux.
- Where necessary, we may advise and make onward referral for instrumental assessment such as videofluorscopy.
- Diagnosis and characterisation of eating, drinking and/or swallowing difficulties including recovery or maintenance prognosis.
- Identification and characterisation of any risks associated with eating, drinking and/or swallowing difficulties including airway penetration/aspiration/asphyxiation.
- Identification and characterisation of factors which may indicate increased risk of medical, respiratory, nutritional or quality of life complications.
Rehabilitation and Management
Following a comprehensive assessment by our consultant speech and language therapist, rehabilitation and management needs will be considered. This may include direct therapy, advice and compensatory strategies or training.
We can offer:
- Identification of therapeutic rehabilitation or maintenance needs, including joint goal setting, monitoring of progress and review of goals.
- Development and delivery of personalised therapy programmes including traditional swallow exercises, or expiratory muscles strength training.
- Personalised recommendations with any modifications to diet or fluids delivered in line with the IDDSI Framework (International Dysphagia Diet Standardisation Initiative).
- Education and training for families, carers and settings, including swallowing awareness, IDDSI Framework and practical dysphagia management skills.
Ethical Considerations
Eating, drinking and swallowing decisions can be ethically complex. If mental capacity assessment is indicated, we can support by:
- Discussing all options including oral and non-oral routes for nutrition in detail, using supported communication strategies if you have cognitive or communication needs.
- Conducting assessment of mental capacity for eating, drinking and nutritional decisions, or supporting assessment of mental capacity if you have cognitive or communication needs.
- Advocacy for client goals, values and wishes in relation to eating, drinking and swallowing and working with the multidisciplinary team to achieve these in the context of any swallowing needs.
For more details about this service, contact us and we will be happy to help with your specific requirements.