Management of Dysphagia: Building Consistency Across the Continuum of Care (Recorded Webinar)

1. If You’ve Seen One Swallow, You’ve Seen One Swallow

We can’t expect to identify abnormalities in swallowing until we understand what normal swallowing looks like. This chapter will review the evidence describing normal swallow variability and the impact of normal aging on swallow function.

2. Aspiration Pneumonia Isn’t Just About Aspiration

Every aspiration event does not inevitably lead to aspiration pneumonia, so who does get sick? This chapter will discuss risk factors for pneumonia in a variety of patient populations to allow the clinician to evaluate aspiration in the context of each patient’s health, respiratory, nutritional, and hydration status.

3. Assessment of Aspiration and Aspiration Pneumonia

Now that we have identified risk factors for aspiration pneumonia, how can we incorporate that knowledge into our assessment process? This chapter will discuss the assessment process, with a focus on putting the aspiration in the context of everything that is known about our client.

4. NPO: Friend or Foe?

NPO, or nil per os, is an all too frequent recommendation for clients at risk of aspiration. This chapter will discuss rationales for an NPO recommendation as well as the risks inherent in restricting oral intake.

5. Texture Modification: More Than Meets the Eye

Dysphagia clinicians often reduce the texture of foods to compensate for oral motor dysfunction and reduce choking risk. These modifications are not without risk, however. This chapter will discuss the impact of texture modification on oral intake and nutrition.

6. To Thicken or Not to Thicken?

Thickened liquids are often the first line of defense in dysphagia intervention. This chapter will evaluate the benefits and risks of thickening and will provide strategies to mitigate those risks.

7. Therapy Only Works If You Do It

Clinicians are often frustrated by clients who can’t or won’t adhere to their exercise program or use their strategies. This chapter will provide strategies for assessment of health literacy and potential for adherence in dysphagic clients.

8. When It Comes to Therapy, Sometimes Less Is More

Dysphagia clinicians often take a “more is better” approach to therapy, providing clients with long lists of strategies and interventions. This chapter will train clinicians to choose compensations and sensory interventions that are based on specific underlying impairments.

9. Making Exercise Work

Exercise should be prescribed—specific to the individual client and to the specific underlying impairment. This chapter will assist clinicians in improving outcomes by matching exercise to impairment.

10. Question and Answer Session

This section is a viewer-submitted question and answer session facilitated by Angela Mansolillo.