Reduce the risk of dehydration for people requiring thickened fluids; Train staff in the correct use of thickeners; Ensure that residents with dysphagia were receiving palatable fluids; Find out whether starch-based or gum-based products were preferred. Practical education will help increase staff awareness and ensure thickeners are used consistently, thereby helping to improve safety. Thickeners and thickened liquids meet the requirements of Food for Special Medical Purposes in the EU (Cichero, 2019), highlighting the need to use thickeners under medical supervision. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. The first step in creating this common taxonomy was to examine the existing data. The NHS moves at a very, very slow pace, as do a lot of higher education institutes. Westend All home managers were asked to discuss the evaluation with local GPs and given a pro-forma letter to send to them. The role of Speech and Language Therapists Dysphagia can have profound impacts on social and psychological aspects of a patients life, particularly when it comes to fear of choking. We incorporated the Dysphagia Diet Food Texture Descriptors (National Patient Safety Agency et al, 2012) into our nutrition strategy to standardise terminology used by staff, but recognised that we needed to take a structured approach to education to ensure consistently high-quality care for people with dysphagia in all our homes. Dysphagia - difficulty in swallowing - puts people at high risk of malnutrition, dehydration, aspiration pneumonia and choking. Im happy to have that, just as Im happy to unlearn. These handy already-thickened drinks would be great to take along on outings! This is crucial to changing the culture around the use of thickeners, ensuring that it is not seen as the easy option, but is delivered by qualified professionals who understand the influence that thickener can have on gastric emptying times and other variables.
The concern around inhaling food or drink is that aspiration pneumonia may develop as a result. Thickeners are a useful tool as part of a broader approach. Archives of otolaryngology--head & neck surgery, 136(8), 784789. Dysphagia can be short term, for example while recovering from a stroke, or more long term, for example in dementia or with neurological conditions. Petty rules on nurses stations seem absurd and dangerous, People with swallowing difficulties are at risk of choking, dehydration and aspiration. The latter could even increase risk of malnutrition and dehydration if a patient avoids eating and drinking. We chose to work with Nutricia and developed a plan to introduce its gum-based thickener (Nutilis Clear). Many seniors experience dysphasia, or difficulty swallowing, as they get older. Below you can select how youd like us to interact with you and well keep you updated with our latest content. Mixed Fruit Juice We're as dedicated to our team members as we are to our residents. United Kingdom
This means an increase in the cost of their admission and an increased likelihood of experiencing complications secondary to prolonged hospital stay, such as hospital acquired infections. I either served her food pureed or liquids were thickened to honey consistency. Thickened fluids are easier to swallow as they enter the pharynx slowly, allowing time for the pathway to the lungs to be closed off to avoid aspiration and choking. Snippet for ASC medicines information - find out more, Snippet for residential ASC assessment framework pages: this page is for, Adult social care: information for providers, pharyngeal stage of swallowing (in the throat), oesophageal stage of swallowing (in the tube leading to the stomach), inability to control food or saliva, drooling, Exercises to help improve the efficiency of the swallow, Strategies to follow when eating and drinking to improve safety and/or comfort, the rate of presentation of food or liquid, how the environment might help at meal and drink times (e.g. Sunrise Senior Living We are able share your email address with third parties (such as Google, Facebook and Twitter) in order to send you promoted content which is tailored to your interests as outlined above. Its the whole point. The workshops were all well received. We are committed to staff development and this is crucial to the success of any new initiative. Just because you can't drink thin liquids doesn't mean you can't enjoy a caffeineboost. Sign in or Register a new account to join the discussion. Consequence of dysphagia in the hospitalized patient: impact on prognosis and hospital resources. Notify me of follow-up comments by email. By clicking below to submit this form, you acknowledge that the information you provide will be transferred to MailChimp for processing in accordance with their Privacy Policy and Terms. In addition to powder-based thickeners which are added to fluids to achieve the correct consistency, it is possible to use ready-made nutritional supplements which are pre-thickened. Your email address will not be published. Lets find new ways of working together and help give patients exactly what they want. Thick It Instant Food and Beverage Thickener, 0.17 Ounce 200 per case. GL10 3FA Foley et al (2008) found that using a combination of texture-modified diet, thickened fluids and intensive support from speech and language therapists resulted in reduced risk of aspiration for the first seven days after a stroke. By submitting this form, you acknowledge that the information you provide will be transferred to MailChimp for processing in accordance with their Privacy notice and Terms, and to Salesforce Marketing Cloud in accordance with their Privacy notice and Terms. Browser Support Physical impacts The below food and drink thickeners all get good reviews on Amazon.com. The NHS is currently developing The Dysphagia Game, a new game-based learning programme to help improve dysphagia care. This was followed by a hands-on practical cooking and tasting workshop to discover how thickeners can be used in food to enhance the palatability of modified diets. Share: You can copy and redistribute the material in any medium or format, Your email address will not be published. This is where the role of producers in supporting the use of their thickeners is so paramount. If you have any questions about how we handle your data, please review our privacy notice. Although there is little research evidence to demonstrate a link between dysphagia and dehydration, clinical experience suggests one does exist. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. There is, though, also a chance they are silently inhaling fluid or food, a situation which could only be identified with special investigations such as a video fluoroscopy of the swallow action. Would you like to learn more about our services? Used correctly, thickeners have multiple benefits for dysphagic patients. One of the most common concerns with dysphagia is that food or fluids go down the wrong way, potentially entering the lungs rather than the stomach. Who doesn't love a fresh fruit smoothie? They may affect how medication works check with GP or pharmacist. This included changing the thickeners used and ensuring there was some consistency with regard to the terminology used related to food textures, as well as undertaking staff training. You can find a lot of thickeners on Amazon. The training sessions are viewed as essential for staff - although the numbers of residents using thickeners remains low, their safety and quality of life is paramount. less distractions), how others might be able to help at meal and drink times, Physiotherapists for advice about posture, positioning and chest care, Occupational therapists for advice about aids, adaptations and utensils at mealtimes, Dietitians for advice about nutritional intake, and. This will help us to influence the prescribing of gum rather than starch-based products. Your email address will not be published. If this occurs, the patient is often seen to cough and choke when eating or drinking. Sandra Robinson recommends thinking about the following values when considering the use of thickened fluids; firstly, the patients needs, wishes and preferences, and then how the patient will feel, function and survive if prescribed thickeners. Combine all the ingredients in your blender and process until smooth. Theres the trinity of industry, research and the profession on the ground as well, of course, as patient groups and patient feedback. The majority had been prescribed a starch-based product by their GP and had been using this for some time. Required fields are marked *, Research Outreach If information is presented to the patient in full, then they can judge the balance between risk and benefit of a modified diet for themselves. Directions This may be due to a refusal to drink adequate fluids or an inability to drink without assistance. Treatment may include: Other people who also provide help for people with dysphagia may include: It is important to always follow the advice given by clinicians for people with dysphagia. We recognised the importance of ensuring they can drink safely and that we needed to introduce staff training and education on the issue. It forms part of NICE Guideline NG128. Types of thickened beverages One of the treatments for this condition is drinking thickened liquids to prevent foods from slipping into the airway. She treats adult clients and provides dysphagia consultancy to business. Safety underpins their practice and they are dedicated to providing guidance, training and access to relevant services. Citation: Penney B (2014) Use of fluid thickener to reduce dysphagia risk. This is especially important when we think about the people who are administering thickener or blending a meal; it is often a busy carer or nurse who requires clear, specific guidance to prepare appropriate food and fluids. If the recipe makes too much for you to drink in one serving, you can refrigerate the remaining smoothie to enjoy later in the day. The aim is to reduce the risk of aspiration pneumonia by reducing the risk of fluid inhalation, thus making eating and drinking much safer for patients, as well as improving their quality of life. Research takes time and its companies like Nestl Health Science who can really help bring things along and say to the profession, Look, this is what we can deliver. Altman, K. W., Yu, G. P., & Schaefer, S. D. (2010). We have continued to provide staff training with the support of Nutricia, and held a one-day seminar for senior clinical and catering staff to improve communication with the company and to foster ongoing support for the training initiatives around the country. Suite 20 Westend Office Suites While this treatment is effective, some seniors dislike the texture of thickened beverages. There are many different thickeners available, including those produced by Nestl Health Science. Swallowing difficulties (dysphagia), can occur for a number of reasons, including damage to the nervous system, such as a stroke or head injury, or cancer, such as mouth cancer. The Francis Report highlighted the importance of giving people food and fluid in a form they can safely consume. Cooking a Low Sodium Oven Fried Chicken Recipe, Pureed Food For Adults With Dysphagia (Difficulty Swallowing), My Moms Death A Personal Account Of A Life Well Lived And Gently Died, How To Pack A Beach Bag For A Senior Citizen. This recipe is both sweet and energizing, so it's perfect for a morning snack. Therefore, multidisciplinary working between healthcare professionals is key to ensure that thickeners are used appropriately, especially where there may be a tendency to overthicken (Garcia and Chambers, 2019). Common symptoms of dysphagia can include dribbling, coughing or choking, pouching or storing food in the mouth, and avoiding mealtimes. You can read our affiliate policy here. Emotional impacts This is something weve developed.
Different patients will make different choices depending on their level of concern but for some patients, thickeners can empower them to manage their own health conditions. 2019). Stonehouse Although use of modified texture diets is not specified in this case, it is likely that many of those seen by a speech and language therapist were advised to thicken fluids, suggesting there is an economic benefit to intervention. As research has shown, there is a place for thickeners in dysphagia, but only if used correctly, monitored, reviewed and used in conjunction with other approaches such as swallowing rehabilitation and use of appropriate drinking vessels (Lippert et al, 2019). We also needed to engage our key stakeholders including GPs, local speech and language therapists, residents with dysphagia and their families. Thickeners, alongside other factors including positioning, use of different eating and drinking vessels, oral hygiene and the possible use of artificial hydration if clinically indicated can be a valuable tool in the treatment of dysphagia. While thickeners are widely used, best practice involves using fluids as close to normal as possible. If you are happy for us to contact you in this way, please tick below. A key element in reducing the risk of choking and aspiration when drinking is to modify the texture of the fluid consumed by people with dysphagia. A series of three-hour training sessions were attended by key staff from each home - these were mainly head chefs, senior nurses and care staff with a keen interest in nutritional issues. Just as weve noticed that industry has moved on, lets also move on. There are also different types of dysphagia, depending on which aspect of the swallowing process is affected, and this can result in a range of symptoms. Has a medicines review been carried out to make sure that medicines are necessary and can be taken safely? Each session was divided into an informative and lively overview of dysphagia, a comparison of starch-based and gum-based products with a practical demonstration, and tasting session. One approach often used by SLTs is the addition of thickening agents to normal fluids to make them more viscous, and therefore easier for patients to swallow. For example, patients with dysphagia have a 40% increase in length of hospital stay (Altman, Yu & Schaefer, 2010). Feel free to swap out strawberries for your favorite fruit. If thickeners are prescribed for individuals (rather than by bulk prescribing) are they only used for the people, they are prescribed for? Mocha Frappe Royal College of Speech and Language Therapists; British Association of Parenteral and Enteral Nutrition; Dysphagia puts people at risk of malnutrition, dehydration, choking and aspiration, The use of prescribed thickeners in food and fluid promotes safety and can enhance quality of life, Training for clinical and catering staff is key to understand modified diets and fluids, Communication between key staff is vital to make sure modified fluids and diet are appropriate and consistent, Involving all health professionals ensures a consistent approach to safety regarding people with dysphagia. I dont think we can get results without each other.
Julie Cichero, co-chair of the IDDSI framework, reports that in the UK, the annual cost of chest infections requiring hospital admission with routine care is around 1.8 times more expensive than chest infections requiring hospital admission with treatment from a speech and language therapist (Cichero, 2019). We found this one to be very easy to use. Thick It Instant Food and Beverage Thickener, 0.17 Ounce 200 per case. There is evidence to suggest that people with severe dysphagia who are worried about drinking thin fluids may appreciate the greater control over aspiration risk that thickened fluids allow (Schindler & Kelly, 2002). Its really important that were working ever more closely together. In contrast, gum-based thickeners have been shown to be more stable and maintain their thickness due to their amylase-resistant properties. It can be a comfort for some people who choke or have prolonged coughing bouts that are thoroughly distressing and uncomfortable, maybe even painful, on regular drinks. Early identification of dysphagia is key, and SLTs will use a variety of different techniques to assess swallowing impairment, including bedside screening tools, physical assessment and videofluoroscopy (Steele et al. Thick-It Clear Advantage Food & Beverage Thickener Powder Single Serve Packets (30/bx) (Nectar Consistency), ^Thick & Easy Packets 6.5 g packets, Honey Min.Order is 1 CS ( 100 Each / Case; ) by Diamond Crystal Brands, Thick & Easy Instant Food and Beverage Thickener, 8 Ounce, Hormel Thick & Easy Instant Food Thickener, Nectar Consistency, 0.16 Ounce (Pack of 100), Thick & Easy Honey Thickener, 6.5 Gram 100 Case, Hormel Thick & Easy Hydrolyte Nectar Consistency Thickened Water 4 Ounce (Pack of 24), Thick-It Aquacare H2O Nectar Consistency Thickened Water Beverage, 8 Ounce (Pack of 24), Thick & Easy Thickened Water with Natural Lemon Flavor, Nectar Consistency Sold by (6)-48oz Bottles, THICK & EASY Clear Thickened Iced Tea Nectar Consistency (Pack of 24), Thick & Easy Clear Thickened Cranberry Juice Cocktail, Nectar Consistency, 46 Ounce, Hormel Drink Thick & Easy Orange Juice (Nectar Consistency), 4-Ounce Portion Control Cups (Pack of 24), Thick & Easy Clear Hydrolyte Thickened Water, Honey Consistency, 46 Ounce (Pack of 6), Thick & Easy Clear Consistency Thickened Iced Tea, Honey, 4 Ounce, Hormel Thick & Easy Dairy Honey Consistency or IDDSI Level 3, 8 ounce Case of 27, Thick & Easy Clear Thickened Cranberry Juice Cocktail, Honey Consistency, 46 Ounce, Hormel Drink Thick & Easy Apple Juice (Honey Consistency), 4-Ounce Portion Control Cups (Pack of 24), Thick-It Aquacareh20 Thickened Decaffeinated Black Tea Beverage, Honey Consistency, 24 Count, Thick & Easy Clear Thickened Kiwi-Strawberry Drink, Nectar Consistency, 46 Ounce, Pureed Food For Adults With Dysphagia (Difficulty Swallowing) .
