Management Approaches Flashcards

0
Q

What does modifying the food involve?

A

Looking at:

Viscosity

Volume

Temperature

Lubricity

Aesthetics

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1
Q

What are the behavioural approaches to management?

A

Modifying:

The food

The feeding activity

The patient

The mechanism

The swallow

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2
Q

What does modifying the feeding activity involve?

A

Thinking about:

Timing of meals - such as not eating when fatigued after physiotherapy

Lubricating the oropharynx with a sip of drink before eating

Supplying equipment such as non slip mats and adapted utensils to facilitate independent feeding

Oral hygiene after meals

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3
Q

What does modifying the clients behaviour involve?

A

Prompting them to slow down their rate of self feeding

Using a chin down position when swallowing

Remaining upright for 30 minutes after a meal to prevent reflux

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4
Q

What is direct therapy?

A

Logemann (1999): working directly on swallowing

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5
Q

What direct therapy techniques are there?

A

Head turn

Supraglottic swallow

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6
Q

What is indirect therapy?

A

Exercises to improve motor control without swallowing food or drink

May involve practising swallowing saliva

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7
Q

When is indirect therapy commonly used?

A

When patients aspirate on all food and drink and are therefore unsafe for all oral intake

Logemann (1998) advises that it is not helpful to place a patient in a situation where he/she is aspirating with no hope of getting rid of material

Clients with a chest infection as it is harder to coordinate respiration and swallowing in these times

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8
Q

What is an alternative to indirect therapy?

A

Advice to clients and carers only (Kennedy 1992)

Offered advice regarding positioning, modification of dietary consistencies and strategies to optimise the environment to facilitate safer eating and drinking

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9
Q

When does Kennedy (1992) suggest advice is generally given?

A

When an active and aggressive approach is inappropriate:

Those in end stages of terminal or progressive illness

Those with significant cognitive deficits

Very frail elderly

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10
Q

What are the management approaches available to SLTs?

A

1) compensatory approach: to reduce aspiration and residue to improve oral transit of for and fluid
Diet and fluid modification
Swallow postures and manoeuvres

2) rehabilitative approach: to improve motor skills to change swallow physiology
Facilitation techniques - e.g. therapy exercises, improving range and strength of movement

3) combination of approaches

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11
Q

What options are there regarding medication in patients with dysphagia?

A

Syrup
Soluble
Crushed - but we need to be aware of the possible change in efficacy and the fact that this can produce a powder which may be inhaled by therapist
IV

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