common problems experienced by people with dysphagia or swallowing disorderas malnutrition, dehydration, choking, aspiration pneumonia and respiratory infections, could be improved and even avoided with an adequate speech therapy rehabilitation program adapted to the patient, as indicated by the Professional College of Speech Therapists of the Community of Madrid.
The dysphagia is a symptom of swallowing disorder or the ability to swallowing solid or liquid food, causing this swallowing to be performed without efficacy and safety. Depending on the swallowing area affected, there are two types of dysphagia: oropharyngeal and esophageal.
In the oropharyngeal dysphagia the problem is in the oral and pharyngeal regioncausing difficulty initiating swallowing and by propelling the food bolus from the mouth to the esophagus. This type of dysphagia diminishes the quality of life of the person who suffers it and causes malnutrition and dehydration problems. Likewise, it can also lead to choking and aspiration pneumonia,
In this sense, as explained marga duranvowel of Professional College of Speech Therapists of the Community of Madrid () and speech therapist at Hospital 12 de Octubre, “all these symptoms and consequences can be improved and avoided with a speech therapy rehabilitation program adapted to the circumstances and needs of each patient”.
The first step, points out this expert, is diagnose it correctly, another workhorse when it comes to dysphagia. And the experts say that mMore than 80% of patients with dysphagia nor do they have the appropriate treatment.
Experts say that more than 80% of patients with dysphagia are not diagnosed or have the appropriate treatment
This swallowing disorder is very common in older peopleespecially if they have frailty and cognitive deterioration and in patients with neurodegenerative diseases (Parkinson’s, Amyotrophic Lateral Sclerosis – ALS, Multiple Sclerosis…), as well as in patients with non-progressive neurological diseases (stroke or cranioencephalic trauma), and in cases of oncological diseases (head and neck tumors, radiotherapy sequelae…). However, from the CPLCM they warn that dysphagia can occur at all ages; in fact, there are also childhood dysphagias mainly in the oral phase.
For a correct intervention of swallowing disorders it is necessary that the speech therapist acts in the phases of prevention, detection, assessment and rehabilitation of the patient. Hence, the CPLCM considers speech therapists need to be part of multidisciplinary teams who care for patients with dysphagia.
Nevertheless, Currently, the presence of these professionals is conspicuous by their absence. In fact, of the 35 hospitals in the Community of Madrid, 11 lack speech therapist care, and in others autonomous, part-time speech therapists are hired, warns the Professional College of Speech Therapists of the Community of Madrid.
This College insist that dysphagia units are a resource that should be strengthened to give the best possible care to the citizen, to detect the greatest number of cases and to avoid serious complications inherent to this alteration. In this sense, Marga Durán affirms that it would be necessary to create dysphagia units in all hospitalssince in addition to being very beneficial for patients and their families, they would be a saving for the public health system.
Rehabilitation achieves effective and safe swallowing
The main objective of rehabilitation in cases of dysphagia is make swallowing effective and safe. To do this, in addition to learning a adequate postural control and the swallowing maneuver appropriate, patients work the muscles involved in swallowing (lips, tongue, palate, pharynx…) through exercises that increase strength, resistance, sensitivity and functionality.
With the rehabilitation program, a adequate hydration and nutritionand therefore a better patient health. Besides choking, drowning and respiratory infections are avoided. All of this results in a better quality of life for patients and peace of mind for the family members who care for them, highlights Marga Durán.
In addition, as explained by the member of the CPLCM, the involvement of the patient and family is essential for best results. To do this, they must follow the guidelines and exercises established by the speech therapist, and in case of any doubt, consult this specialist for advice and guidance.
Recommendations for people with dysphagia
Among the recommendations that professionals and family members should take into account for a correct and safe diet of people with dysphagia, Marga Durán highlights the following:
- See that the atmosphere is relaxedwithout distractions and without rush.
- Sit in front of the patient to help him eat.
- if you can remain seatedplace him with his back correctly aligned and resting on the back of the chair, and his head aligned with the trunk, to be able to perform the maneuver.
- not speak while eating. If possible, restrict visitors at mealtimes.
- facilitate that eat alone, by their own means. For this, it is advisable that there is an adaptation of cutlery, glasses, plates, etc. Do not use straws or syringes.
- While they eat, they should be accompanied.
- Do not give food or drink if the patient who is sleepy or agitated.
- Do not introduce food until it has been emptied the mouth.
- Do not mix textures food.
- not help yourself water to swallow.
- After eating, remain seated at least 30 minutes to avoid possible aspirations.
- If there is any choking, advise patient to coughNever hit the back.