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Supporting Safe Swallowing of Care Home Residents with Dysphagia: How Does the Care Delivered Compare with Guidance from Speech and Language Therapists?

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Title: Supporting Safe Swallowing of Care Home Residents with Dysphagia: How Does the Care Delivered Compare with Guidance from Speech and Language Therapists?
Language: English
Authors: Hannah Griffin (ORCID 0000-0001-6874-9825), Jennie Wilson, Alison Tingle, Anke Görzig (ORCID 0000-0002-7623-0836), Kirsty Harrison, Celia Harding (ORCID 0000-0002-5192-2027), Sukhpreet Aujla, Elizabeth Barley, Heather Loveday
Source: International Journal of Language & Communication Disorders. 2024 59(4):1478-1488.
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 11
Publication Date: 2024
Document Type: Journal Articles
Reports - Research
Descriptors: Motor Reactions, Eating Disorders, Aphasia, Residential Care, Institutionalized Persons, Speech Language Pathology, Speech Therapy, Allied Health Personnel, Food, Safety, Foods Instruction
DOI: 10.1111/1460-6984.13015
ISSN: 1368-2822
1460-6984
Abstract: Introduction: Dysphagia affects up to 70% of care home residents, increasing morbidity and hospital admissions. Speech and language therapists make recommendations to support safe nutrition but have limited capacity to offer ongoing guidance. This study aimed to understand if recommendations made to support safe and effective care are implemented and how these relate to the actual care delivered. Methods: Eleven mealtimes with residents with dysphagia were observed during 2020 using a tool capturing 12 elements of expected practice. Staff actions during mealtimes were compared with adherence to residents' care plans and speech and language therapist recommendations. Results: Written recommendations predominantly focused on food and fluid modification. Observations (n = 66) revealed food texture, posture, and alertness were adhered to on 90% of occasions, but alternating food and drink, prompting and ensuring swallow completed adherence was less than 60%. Thickened fluids frequently did not align with required International Dysphagia Diet Standardisation Initiative levels. Nutrition care provided in the dining room was less safe due to a lack of designated supervision. Conclusion: Care homes need to be supported to establish a safe swallowing culture to improve residents' safety and care experience.
Abstractor: As Provided
Entry Date: 2024
Accession Number: EJ1431140
Database: ERIC
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  Data: Supporting Safe Swallowing of Care Home Residents with Dysphagia: How Does the Care Delivered Compare with Guidance from Speech and Language Therapists?
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  Data: <searchLink fieldCode="AR" term="%22Hannah+Griffin%22">Hannah Griffin</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-6874-9825">0000-0001-6874-9825</externalLink>)<br /><searchLink fieldCode="AR" term="%22Jennie+Wilson%22">Jennie Wilson</searchLink><br /><searchLink fieldCode="AR" term="%22Alison+Tingle%22">Alison Tingle</searchLink><br /><searchLink fieldCode="AR" term="%22Anke+Görzig%22">Anke Görzig</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-7623-0836">0000-0002-7623-0836</externalLink>)<br /><searchLink fieldCode="AR" term="%22Kirsty+Harrison%22">Kirsty Harrison</searchLink><br /><searchLink fieldCode="AR" term="%22Celia+Harding%22">Celia Harding</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-5192-2027">0000-0002-5192-2027</externalLink>)<br /><searchLink fieldCode="AR" term="%22Sukhpreet+Aujla%22">Sukhpreet Aujla</searchLink><br /><searchLink fieldCode="AR" term="%22Elizabeth+Barley%22">Elizabeth Barley</searchLink><br /><searchLink fieldCode="AR" term="%22Heather+Loveday%22">Heather Loveday</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22International+Journal+of+Language+%26+Communication+Disorders%22"><i>International Journal of Language & Communication Disorders</i></searchLink>. 2024 59(4):1478-1488.
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  Data: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
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  Data: 11
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  Data: Journal Articles<br />Reports - Research
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  Data: <searchLink fieldCode="DE" term="%22Motor+Reactions%22">Motor Reactions</searchLink><br /><searchLink fieldCode="DE" term="%22Eating+Disorders%22">Eating Disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Aphasia%22">Aphasia</searchLink><br /><searchLink fieldCode="DE" term="%22Residential+Care%22">Residential Care</searchLink><br /><searchLink fieldCode="DE" term="%22Institutionalized+Persons%22">Institutionalized Persons</searchLink><br /><searchLink fieldCode="DE" term="%22Speech+Language+Pathology%22">Speech Language Pathology</searchLink><br /><searchLink fieldCode="DE" term="%22Speech+Therapy%22">Speech Therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Allied+Health+Personnel%22">Allied Health Personnel</searchLink><br /><searchLink fieldCode="DE" term="%22Food%22">Food</searchLink><br /><searchLink fieldCode="DE" term="%22Safety%22">Safety</searchLink><br /><searchLink fieldCode="DE" term="%22Foods+Instruction%22">Foods Instruction</searchLink>
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  Data: 10.1111/1460-6984.13015
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  Data: 1368-2822<br />1460-6984
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Introduction: Dysphagia affects up to 70% of care home residents, increasing morbidity and hospital admissions. Speech and language therapists make recommendations to support safe nutrition but have limited capacity to offer ongoing guidance. This study aimed to understand if recommendations made to support safe and effective care are implemented and how these relate to the actual care delivered. Methods: Eleven mealtimes with residents with dysphagia were observed during 2020 using a tool capturing 12 elements of expected practice. Staff actions during mealtimes were compared with adherence to residents' care plans and speech and language therapist recommendations. Results: Written recommendations predominantly focused on food and fluid modification. Observations (n = 66) revealed food texture, posture, and alertness were adhered to on 90% of occasions, but alternating food and drink, prompting and ensuring swallow completed adherence was less than 60%. Thickened fluids frequently did not align with required International Dysphagia Diet Standardisation Initiative levels. Nutrition care provided in the dining room was less safe due to a lack of designated supervision. Conclusion: Care homes need to be supported to establish a safe swallowing culture to improve residents' safety and care experience.
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  Data: 2024
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  Data: EJ1431140
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      – SubjectFull: Eating Disorders
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      – SubjectFull: Aphasia
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