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Mythbusters : We should not be the SLPs we were 10 years ago!!

Mythbusters : We should not be the SLPs we were 10 years ago!!. Jamie L Johnson, MA L/CCC-SLP, BCS-S KSHA 2019 Thursday Sept, 25, 2019. How do we start?. EVALUTIONS OF DYSPHAGIA Clinical Swallow Evaluation Videoswallow Evaluation Fiberoptic Endoscopic Evaluation of Swallow or FEES.

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Mythbusters : We should not be the SLPs we were 10 years ago!!

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  1. Mythbusters: We should not be the SLPs we were 10 years ago!! Jamie L Johnson, MA L/CCC-SLP, BCS-S KSHA 2019 Thursday Sept, 25, 2019

  2. How do we start? • EVALUTIONS OF DYSPHAGIA • Clinical Swallow Evaluation • Videoswallow Evaluation • Fiberoptic Endoscopic Evaluation of Swallow or FEES

  3. SIGNS AND SYMPTOMSOF DYSPHAGIA

  4. CLINICAL SWALLOW EVALUATION • What do you use to complete a clinical swallow evaluation?

  5. Symptoms we listen for and watch for when we evaluate……..

  6. The Cough

  7. Recommendations

  8. MODIFIED DIET • LIQUIDS • SOLIDS

  9. Let’s talk WATER!

  10. Swallowing Strategies: • Chin Tuck • Straws

  11. Oral Care

  12. Off to Radiology with you!

  13. or a FEES….!

  14. ASPIRATION!

  15. PENETRATION!

  16. THE RECOMMENDATIONS

  17. THE TREATMENT PLAN

  18. FEEDING TUBES • You can eat • You can aspirate

  19. Shame on us!!

  20. The Literature • We should be on top of our game-the latest research • If we don’t our patients will!!

  21. Modifying more than diets: Rethinking a common practice • Ed Bice, M.Ed, CCC-SLP • Co-Author Angela Van-Sickle • The Current State of Practice

  22. The supposedly unsolvable sliding tile puzzle of dysphagia managementDysphagia CaféPamela Smith PhD CCC-SLP

  23. Literature Review • Evidence Based Practice

  24. References: Andersen, U., Beck, A., Kjaersgaard, A., Hansen. (2013). Systematic review and evidence based recommendations on texture modified foods and thickened fluids for adults (>18 years) with oropharyngeal dysphagia. European Society for Clinical Nutrition and Metabolism, 8(4), e127-e134. Ashford, J. R. (2005, March). Pneumonia: Factors Beyond Aspiration. Perspectives in Swallowing and Swallowing Disorders (Dysphagia), 14, 10-16. Beck, A. M., Kjaersgaard, A., Hansen, T., & Poulsen, I. (2018). Systematic review and evidence based recommendations on texture modified foods and thickened liquids for adults (above 17 years) with oropharyngeal dysphagia – An updated clinical guideline. ClinNutr, 37(6 Pt A), 1980-1991. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28939270. doi:10.1016/j.clnu.2017.09.002 Bennett, J. A. (2000). Dehydration: hazards and benefits. GeriatrNurs, 21(2), 84-88. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10769332. doi:10.1067/mgn.2000.107135

  25. Castellanos, V. H., Butler, E., Gluch, L., & Burke, B. (2004). Use of thickened liquids in skilled nursing facilities. J Am Diet Assoc, 104(8), 1222-1226. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15281038. doi:10.1016/j.jada.2004.05.203 Cichero, J. A. (2013). Thickening agents used for dysphagia management: effect on bioavailability of water, medication and feelings of satiety. Nutr J, 12, 54. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23634758. doi:10.1186/1475-2891-12-54. Crary, M. A., Carnaby, G. D., LaGorio, L. A., & Carvajal, P. J. (2012). Functional and physiological outcomes from an exercise-based dysphagia therapy: a pilot investigation of the McNeill Dysphagia Therapy Program. Archives of physical medicine and rehabilitation, 93(7), 1173-1178. Feinberg, M. J., Knebl, J., Tully, J., & Segall, L. (1990). Aspiration and the elderly. Dysphagia, 5(2), 61-71. Feinberg, M. J., Knebl, J., & Tully, J. (1996). Prandial aspiration and pneumonia in an elderly population followed over 3 years. Dysphagia, 11(2), 104-109. Garcia, J. M., Chambers, E., & Molander, M. (2005). Thickened liquids: practice patterns of speech-language pathologists. Am J Speech Lang Pathol, 14(1), 4-13. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15962843. Gosa, M., Schooling, T., Coleman, J. (2011). Thickened Liquids as a Treatment for Children With Dysphagia and Associated Adverse Effects A Systematic Review. Infant, Child, & Adult Nutrition, 3(6), 344-350.

  26. Langmore, S. E., Terpenning, M. S., Schork, A., Chen, Y., Murray, J. T., Lopatin, D., & Loesche, W. J. (1998). Predictors of aspiration pneumonia: how important is dysphagia? Dysphagia, 13(2), 69-81. Leder, S. B., & Espinosa, J. F. (2002). Aspiration risk after acute stroke: comparison of clinical examination and fiberoptic endoscopic evaluation of swallowing. Dysphagia, 17(3), 214-218. Leslie, P. & Coyle, J (2020) Complex decisions involving gastrostomy feeding tubes: When you’re never right or wrong? Perspectives on Gerontology, December 2010, American Speech-Language Hearing Association; DOI: 10.1044/gero15.2.42. Lippert, W., Chadha, R., Sweigart. J. (2019). Things we do for no reason: The use of thickened liquids in treating hospitalized adult patients with dysphagia. Journal of Hospital Mediccine, 14(5), 315-317. Marik, PE., & Kaplan, D (2003) Aspiration pneumonia and dysphagia in the elderly. Chest 124:1, 328-336. McCurtin, A., Healy, C., Kelly, L., Murphy, F., Ryan, J., Walsh, J. (2018). Plugging the pateint evidence gap: what patients with swallowing disorders post-stroke say about thickened liquids. International Journal of Language & Communicaiton Disorders, 53(1), 30-39. Rowat, A., Graham, C., & Dennis, M. (2012). Dehydration in hospital-admitted stroke patients: detection, frequency, and association. Stroke, 43(3), 857-859. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22156691. doi:10.1161/STROKEAHA.111.640821

  27. Steele, C. M., Alsanei, W. A., Ayanikalath, S., Barbon, C. E., Chen, J., Cichero, J. A., Wang, H. (2015). The influence of food texture and liquid consistency modification on swallowing physiology and function: a systematic review. Dysphagia, 30(1), 2-26. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25343878. doi:10.1007/s00455-014-9578-x Sura, L., Madhavan, A., Carnaby, G., & Crary, M. A. (2012). Dysphagia in the elderly: management and nutritional considerations. ClinInterv Aging, 7, 287-298. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22956864. doi:10.2147/CIA.S23404 Swan, K., Speyer, R., Heijnen, B. J., Wagg, B., & Cordier, R. (2015). Living with oropharyngeal dysphagia: effects of bolus modification on health-related quality of life–a systematic review. Qual Life Res, 24(10), 2447-2456. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25869989. doi:10.1007/s11136-015-0990-y Vigano, C., Silva, P., Cremonezi, J., Vannucchi, P., Guilhereme, C. (2011). Variation in the energy and macronutrient contents of texture modified hospital diets. RevistaChilena de Nutricion, 38(4), 451-457. Wittbrodt, M. T., & Millard-Stafford, M. (2018). Dehydration Impairs Cognitive Performance: A Meta-analysis. Med Sci Sports Exerc, 50(11), 2360-2368. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29933347. doi:10.1249/MSS.0000000000001682 Wright, L., Cotter, D., Hickson, M., & Frost, G. (2005). Comparison of energy and protein intakes of older people consuming a texture modified diet with a normal hospital diet. J Hum Nutr Diet, 18(3), 213-219. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15882384. doi:10.1111/j.1365-277X.2005.00605.x

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