Swallowing disorders and maintaining nutrition Flashcards
Why is swallowing important?
(McBean and Wijck, 2012).
- allows us to eat and drink safely
- nutrition
- hydration
- social- many social activities revolve around eatings and drinking, therefore impaired social contact
What is dysphagia and how is it caused?
(McBean and Wijck, 2012).
eating, drinking, and swallowing problems
often caused as a conseqeuce of neurological diseases e.g. stroke, demenita, Parkinson’s, motor neurone disease, MS. Stroke is the biggest cause (90%)
damage to the strctures of mouth and pharynx, sensory and motor nerves supplying these areas and associated muscles or control centers in brain
What are some problems associated with dysphagia?
(McBean and Wijck, 2012).
- poor QoL
- choking
- aspiration
- drooling
- chest infections- due to aspiration
- delayed recovery due to malnutrition and dehydration
- breakdown of skin- due to drooling
What are the structures of the mouth and oral cavity?
(McBean and Wijck, 2012).
- lips
- teeth
- tongue
- hard and soft palate
- pharynx
- larynx
- oesophagus
Describe the oral phase of swallowing.
(McBean and Wijck, 2012).
- food enters the mouth and is broken down by chewing, mixing it with saliva and is held forward by the tongue
- the food travels back along the tongue, being squeezed and rolled, passing into the pharynx
- this is a voluntary phase requiring muscle tone and control. without this spillage and choking may occur
Describe the pharyngeal phase of swallowing.
(McBean and Wijck, 2012).
- reflex controlled movements that direct the food into the oesophagus, protecting the airways
- sensory stimulation of tonsillar pillars excite sensory nerves feeding back to swallowing centers in the brain.
- this then excites motor nerves, controlling muscles associated with the pharynx and larynx, initating the swallowing reflex
Describe swallowing difficulties with age.
(McBean and Wijck, 2012).
- if there is a delay or failure in reflex movement food can enter the airways or escape from the mouth
- it takes longer to swallow as we age due to slower triggering
- this isnt normally an issue but if there is addional neurological damage e.g. stroke, dementia, the food may be aspirated leading to choking and infection
Describe the role of a speech and language therapist (SLT)?
(Martin et al, 2014).
- assess ability of pateints to swallow
- may suggest exercises to improve swallowing
- may make it easier to feed by modifying texture of the food, usually thickening it
- if these options dont work then they may implement an NG or PEG tube
- NG and PEG tube solves the issue of nutrition but mouth care must be carried out and hydrated to protect the airways
How does malnutrituon impact the elderly?
(Amarya, 2015)
- poor apetite, feelings of unwantedness, sense of neglect, and lack of physical activity are all common issues in the elderly, leading to decreased interest in eating, contributing to malnutrition.
- malnutrition is both a cause and consequence of ill health
- due to malnutrition there is increased risk of muscle weakness leading to falls and frality, infections, poor wound healing and a weakened immune system in the elderly.
How does demenita and the swallowing difficulties associated with it affect patients?
(Martin et al, 2014).
- certain types of dementia can cause taste and smell impairments, putting people off food
- dementia decreases interest and motivation in eating also temporal confusion can cause people to be confused on whether theyve eaten or not
- muscle weakness, tremor, reduced coordination and slowness make preparing, cooking, and eating food difficult.
- in later stages difficulties with feeding, chewing, and swallowing are often seen which may impact nutruional status.
What is a MUST assessment?
(Martin et al, 2014).
- Malnutrition Universal Screening Tool
- 5 step scale, used by health professionals
- first three steps evaluate BMI, whether there has been involuntary weight loss during last 3-6 months, and detecting if there has been inadequate food intake in the past 5 or more days due to acute illness.
- step 4 classes the person as low, mid, or high risk of malnutrition
- the fifth step consists of management guidelines for setting an appropriate care plan
- after a MUST assessment is carried out an in-depth evaluation should be carried out investigating nutritional habits, physical activity, and body function.
How does diet affect cognitive functioning?
(Martin et al, 2014).
- many studies show that adherance to diets based on healthy policy guidelines might be associated with improved cognitive functioning
- mediterannian diet has the largest body of evidence support it in the reduction of cognitive decline and is assocoaited with. reduced risk of Alzheimer’s disease.
What is the WHO model of ICF (International Classification of Functioning, Disability, and Health)?
(WHO, 2002).
A framework, integrating both medical and social models of disability. it consisits of two main components:
functioning and disability:
- body functions and structures, activities they perform, and participation in society
- recognises health and disability arent just determined by medical conditions but also by environmental and personal factors.
contextual Factors:
- considers environmental and personal factors that can influence an individual’s functioning and disability.
List some references for swallowing and swallowing disorders.
- (McBean and Wijck, 2012)
- (Martin et al, 2014).
- (Amarya, 2015)
- (WHO, 2002) ICF model
