Home Health Blogger

A Patient with Swallowing Difficulties? Clinicians should know...

Posted by Joy Joan E. De Castro, RN, MSN on Aug 21, 2023

Dysphagia is among the most common conditions in home health patients and poses a great risk for re-hospitalization. Teaching and guidance on the National Dysphagia Diet (NDD) Dysphagia Diet for patients with swallowing, feeding and eating difficulties should be included in your HHA's home health clinical policy and procedure manual.

The easiest way to describe dysphagia is difficulty in swallowing.

Unmanaged swallowing issues predispose the patient to aspiration pneumonia, choking, malnutrition and dehydration.

What are the signs to watch out for when diagnosing dysphagia?Download the  Swallowing Exercises Teaching Sheet

Medical News Today links the following symptoms to dysphagia:

•    Choking when eating.
•    Coughing or gagging when swallowing.
•    Drooling.
•    Food or stomach acid backing up into the throat.
•    Recurrent heartburn.
•    Hoarseness.
•    Sensation of food getting stuck in the throat or chest, or behind the breastbone.
•    Unexplained weight loss.
•    Bringing food back up (regurgitation).
•    Difficulty controlling food in the mouth.
•    Difficulty starting the swallowing process.
•    Recurrent pneumonia.
•    Inability to control saliva in the mouth.
•    Patients may feel like "the food has got stuck."

img-Dysphagia-Diet.pngWhat conditions predispose a patient to dysphagia?

Dysphagia is usually caused by another health condition, such as:

•    stroke
•    nervous system disorders, such as Parkinson's disease and Cerebral Palsy
•    problems with esophagus, like gastroesophageal reflux disease (GERD)
•    head or spinal cord injury
•    cancer of the head, neck, or esophagus

How is dysphagia treated?Download the  Guidelines for National Dysphagia Diet

It is not always possible to totally resolve dysphagia but treatments may include:

•    therapy with focus on swallowing techniques
•    modifying the types of food based on the dysphagia severity level (a diet guide by American Dietetic Association is available for free download with this article)
•    alternative feeding through gastric tube feeding or parenteral nutrition
•    surgery to correct structures that causes impaired swallowing

References: https://www.medicalnewstoday.com/articles/177473.php

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