Exam 1 Flashcards
Text Prefers: (Def)
[An] impairment of emotional, cognitive, sensory, and/or motor acts involved with transferring a substance from the mouth to the stomach, resulting in failure to maintain hydration, nutrition and postinga risk of chocking and aspiration.
What is Dysphagia?
- A symptom, not a disease, with clinical signs.
- Definition of Dysphagia: Simplest and most frequently used definition: Difficulty moving food from the mouth to the stomach
Feeding Disorder vs. Swallowing Disorder vs. Eating Disorder
Logemann’s definition:
Feeding: placement of food in the mouth, manipulation of food in the oral cavity prior to the initiation of the swallow including mastication of food and the oral state of the swallow when the bolus is propelled backward by the tongue. Oral prep and oral stages of the swallow
Feeding Disorder vs. Swallowing Disorder vs. Eating Disorder (Cont)
Swallowing: techniques for reducing delay in triggering the pharyngeal swallow, improving pharyngeal transit time and the individual neuromotor actions comprising the pharyngeal stage of the swallow and well as all of the techniques to improve the oral prop and oral stages of the swallow –the entire act of deglutition from placement in the mouth until material enters the stomach.
Textbook on Difference…
Swallowing Disorder
Swallowing disorder: the act of swallowing
Textbook on Difference… (CONT)
Feeding Disorder
Feeding disorder: result of weakness or incoordination I the hand or arm used to move the food from the plate to the mouth
Textbook on Difference… (CONT)
Eating Disorder
Eating disorder: anorexia or bulimia nervosa: poor appetite, changes in dietary selections, problems with oral preparation of the bolus, may have swallowing difficulties
Who Manages Dysphagia?
Dysphagia Team Members
Speech Language Pathologist- often the team leader/coordinator (additional role of the SLP) Otolaryngologist Gastroenterologist Radiologist Neurologist Dentist Nurse Dietician Occupational Therapist Respiratory Therapist Physical Therapist Neonatal Development Specialist
History of SLPs and Dysphagia
- History of dysphagia study: Late 1970s and early 1980s
- Logemann’s “purple book” 1983.
ASHA:
First practice guide 1987
- Most recent - 2002; many other documents developed to help the SLP
- Special interest division formed in 1992 Swallowing and Swallowing Disorders - Division 13.
- Specialization now available: Board-Recognized Specialist in Swallowing and Swallowing Disorders (BRS-S)
Today
- Swallowing is one of the 9 major areas of required knowledge now.
Means……Jobs for SLPS!!
ASHA 2002 Omnibus Survey:
90% of SLPs in residential health care work with dysphagia
84% in hospitals
50% in non-residential health care,
11% in schools.
Recent Health Care survey (2002) SLPs in adult health care settings spend 31% of their time in services related to dysphagia
Incidence and Prevalence
Definitions:
Incidence: Reported frequency of new occurrences over a period of time (e.g. a year) related to a population
Prevalence: Number of cases in a population during a shorter period, often a specific setting
Prevalence and incidence help medical personnel who screen, hospital administrators, third-party payors, groups like ASHA.
Prevalence of dysphagia is highest among those with neurologic disease
Prevalence
ASHA: about 300,000 to 600,000 new cases are identified annually.
Cherney (2001)
Acute care= 1/3 of all patients are dysphagic
Acute Rehab. = 42%
Chronic Care = 60%
Prevalence By Setting
General Community: Among older persons, dysphagia at 16-22%
Acute care intensive care units and skilled nursing facilities– highest risk for dysphagia,
Varied reports: as high as 87% nursing home residents at risk.
Acute General Hospitals:
Groher & Bukatman = 13%
Acute Rehab. Hospitals: About 1/3
Levels of Care
- Acute Care Setting
- Subacute Care Setting
- Rehabilitation Setting
- Skilled Nursing Facility - SNF Unit
- Home Health
