Dysphagia: decisions, decisions, decisions Sean White Home Enteral Feed Dietitian Sheffield Teaching Hospitals NHS Foundation Trust
Alali et al 2018
Lets get inside the mind of a person with dysphagia: Consider the impact of having significant dysphagia on your life…
Of those reporting dysphagia: • 60% reported swallowing is a major distraction in their lives and a difficult problem to deal with • 50% frustrated, depressed, discouraged, annoyed by swallowing problems • 50% afraid of choking or aspirating • 45% have reduced enjoyment of food and difficulty choosing foods • 33% take longer to finish meals • 25% concerns about socialising and going out for food
Ask the experts
300 calories 600 calories
Optimising intake…
Always potentially at a cliff edge
Mean: 18.4 years Range 1-51 years (SD 9.3)
54% 46% (N=28) (N=25)
When is the best time?
Plan ahead… IT IS ALSO FOR NEUROLOGY TEAMS AND PATIENTS WITH LONG TERM NEUROLOGICAL CONDITIONS
Expanded disability Status Scale (EDSS scale) Median = 8.5 ‘Essentially restricted to bed much of day. Has some effective use of arms retains some self-care functions’
Shared decision making in action Make it clear patient has a choice Holistic assessment Clarify values Weigh up risks and benefits Decision time….
Survival
…AND HEF TEAMS… Plan ahead… IT IS ALSO FOR NEUROLOGY TEAMS AND PATIENTS WITH LONG TERM NEUROLOGICAL CONDITIONS
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