Dysphagia Essay

Swallowing is a complex action involving the muscles and nerves within the pharynx and esophagus, a swallowing center in the brain, and nerves that connect the pharynx and esophagus to the swallowing center (medicine net). But what would happen if it became difficult to swallow, or even worse, you lost the ability to swallow? What are the causes of this and what treatments are available? There are many specific causes that include physical obstruction of the pharynx or esophagus, diseases of the brain, diseases of the smooth muscle of the esophagus, diseases of skeletal muscle of the pharynx, and miscellaneous diseases (e.g., Parkinson’s disease and dementia) (Dysphagia, n.d.). Intervention for patients with dysphagia is diet modification of solid foods and/or liquids.

“It is estimated that up to 45% of patients institutionalized with dementia have some degree of swallowing difficulty. Dysphagia affects up to 68% of elderly nursing home residents” (Sura, Madhavan, Carnaby & Crary, 2012.) My grandfather suffered from Alzheimer’s and spent the last few years of his life in a nursing home. Toward the end of his life, actually, two weeks before he passed away, he could no longer remember how to swallow and developed pneumonia. “Common complications of dysphagia in dementia patients include malnutrition and pneumonia” (Sura, Mahajan, Carnaby & Crary, 2012.) My grandmother was given several options such as inserting a feeding tube, which she knew my grandfather would not have wanted. She chose diet modification of thickened liquids. The nurses and staff who managed him faced difficult challenges when working with him. When a small amount of food was placed in his mouth, the nurse would take her hand and move his cheeks arou...

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...er and apple juice do. Orange juice contains acid and pulp, resulting in a slightly thicker drink. You do not want to have a fluid that is either too thin or too thick. This could mean putting a dysphagia patient at a higher risk of complications such as aspiration pneumonia. “Aspiration of an overly thickened fluid can increase the risk of pneumonia, as it is difficult to clear the airway” (Garcia & Chambers, 2010). “One primary concern of over-using thickened liquids is the risk of dehydration” (Sura, Madhavan, Carnaby & Crary, 2012.) Compliance of patients with thickened liquids is often reduced. Sura, Madhavan, Carnaby & Crary (20102) state, that “a recent survey of SLPs suggested that honey like liquids were strongly disliked and nectar thick liquids were poorly accepted.” This could lead to reduced fluid intake and can increase the risk of dehydration.