Nursing Assistant Resources On The Web

Nursing Home Magazine does it again: AN excellent article about dysphagia and swallowing problems, some of which is aimed at CNA’s:

Dysphagia is not unusual among older adults living in long-term care facilities. One study recorded the presence of mealtime difficulties in nursing home residents and found that nearly 90% had impairments that included dysphagia, poor oral intake, positioning problems, or challenging behaviors. Furthermore, 68% of the residents experienced dysphagia, compromising their ability to enjoy meals, let alone consume the necessary calories to meet nutritional requirements. Dysphagia can lead to aspiration, choking, dehydration, malnutrition, and pneumonia. In fact, aspiration pneumonia is the fifth leading cause of death in people over 60 years of age and the third leading cause of death in people over 80. Clearly, food intake is crucial to many residents’ health and quality of life.

Residents with dysphagia often require modified diet consistencies, such as thickened liquids or pureed foods. In addition, nursing assistants must often comply with specialized feeding techniques, such as placing food in the non-impaired side of the mouth, limiting the use of straws, or facilitating the use of adaptive feeding equipment. In the dining room, nursing assistants who provide help to, monitor, or feed residents must follow the techniques for the residents’ safety and nutritional health. Failure to successfully comply with swallowing and feeding recommendations can cause inadequate hydration and nutrition and unsafe feeding.

More:

Through therapy, a speech-language pathologist can help many residents with dysphagia learn compensatory swallowing techniques. Researchers have found that poor staff training and a lack of understanding about feeding recommendations can cause malnutrition and dehydration in long-term care. McGillivray and Marland conducted a review of the literature on assisting people with dementia during meals. Their review found that mealtime assistance is often stressful for residents and staff because feeding becomes task centered and staff have not been sufficiently educated or trained.

I think ALL staff could use more training.

Did you know?

Signs and Symptoms of Dysphagia
Some signs and symptoms of dysphagia are not commonly known. For example, did you know that a persistent low-grade fever might be a sign of dysphagia? Did you know that if a resident is spitting food at meals, he or she might have oral phase dysphagia and might be unable to chew properly? Review the list below with your staff. Residents displaying the following signs and symptoms of dysphagia should be seen by a speech-language pathologist:

* Having trouble recognizing food
* Difficulty placing food in mouth
* Drooling or spitting
* Food falling out of mouth
* Pocketing of food in mouth
* Rocking tongue back and forth while chewing
* Food left in mouth after the swallow
* Chewing for a long time
* Coughing before, during, or after the swallow
* Delayed or absent rise of the larynx during the swallow
* Requiring 3–4 swallows after each bite
* Continuous throat clearing during or after the meal
* Wet or hoarse voice
* Complaining of something caught in throat
* Refusing to eat or very slow eater
* Lasting low-grade fever
* Unplanned weight loss or unexplained loss of appetite
* Pneumonia
* Malnutrition or dehydration

This article provides an excellent review of swallowing problems for nursing home residents and would be a timely and good resource for an in service.