11.2 - Dysphagia + Dementia Flashcards
What dysphagia symptoms are often seen in patients with dementia?
(3)
Weight loss
Aspiration
Oral + Pharyngeal Stage Dysfunction
What are the two most common forms of dementia?
Alzheimer’s
Frontotemporal
What is the focus on dysphagia treatment for dementia?
4
Maintaining quality of life
Ensuring patient dignity
Preserving patient independence
Seeking patient comfort
What might family members be called upon to do to assist individuals with dementia?
(3)
Special food preparation
Increased mealtime
Limited food choices
Do non-oral feedings improve quality of life and life expectancy in patients with dementia?
No
Balaji has said the opposite in class
What compensatory strategies are often used to treat dysphagia in dementia?
(2)
Thickened liquids
Chin tuck maneuver
What strategies can be employed to compensate for Oral-Pharyngeal Impairment in patients with dementia?
(4)
Offer soft foods that are easy to chew
Cut food into tiny pieces to add mastication
Thicken liquids
Compensatory maneuvers (chin-tuck, head tilt, etc.)
What symptoms of dementia can cause self-feeding difficulties?
(5)
Forgetfulness/Disorientation, & Limited Attention Span
Impaired Judgement
Difficulties Using Utensils
Sensory/Perceptual Dysfunction
Loss of Appetite
What strategies can be employed to assist with Loss of Appetite in patients with dementia?
(3)
Serve 5-6 smaller meals throughout the day
Offer liquid throughout the day
Offer foods high in protein and high in calories (ice cream, milk powder)
What strategies can be employed to assist with Forgetfulness, Disorientation, + Limited Attention Span in patients with dementia?
(4)
Use environmental triggers to signal a transition to mealtime (i.e., tablecloth, placemats, flowers, etc.)
Offer limited choices (no more than three)
Follow same simple routine for all mealtimes
Give simple one-step directions to redirect (i.e., put the spoon in your mouth) Offer one food item at a time
What strategies can be employed to assist with Impaired Judgement in patients with dementia?
(4)
Cut foods into bite-sized pieces
Remove garnishes or inedible items
Offer food and liquid at different times if confusing
Offer visual boundaries (i.e., placemats) if individuals takes food from the plates of
others. (like square tables as opposed to round tables)
What strategies can be employed to assist with Difficulty Using Utensils in patients with dementia?
(5)
Offer more finger foods
Serve soups in a mug
Offer gravies and sauces in a small bowl for dipping
Prompt utensil use if patient is able
Limit the number of utensils (i.e., offer a fork or a spoon)
What strategies can be employed to assist with Sensory/Perceptual Dysfunction in patients with dementia?
(4)
Offer foods that are extremely cold or extremely hot (not scalding)
Offer foods with strong flavors (i.e., spicy, sweet,
Alternate food temperature or taste to trigger a swallow
Add honey or sugar to foods (sweet taste receptors are the last to remain at the end of life)
What is a technique to teach new behaviors to individuals with dementia?
Spaced Retrieval
What is Spaced Retrieval?
3
Focuses on one goal (new behavior).
Recall is elicited in expanding intervals (10 seconds, 30 seconds, 1 minute, 2 minutes, 4 minutes, 8 minutes, etc.)
If the patient gets it wrong, the clinician reverts to the previous time interval
