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*If you suspect laryngeal penetration or aspiration, you may need to refer the patient for a Modified Barium Swallowing Study (MBSS) or Fiberoptic Endoscopic Evaluation of Swallowing (FEES).Also consider ordering a MBSS or FEES when upgrading a patient from thickened liquids to thin liquidsUntil these evaluations are completed, you can monitor the patient’s lung sounds, educate on overt signs and symptoms of aspiration, and train in the use of safe swallowing strategies, exercises, and modified diet textures. Oropharyngeal dysphagia is a frequent occurrence following stroke. Then, raise your head and hold up for 3 seconds. Compensatory strategies provide immediate effects, and as of yet, they have not been Such as people with chronic back pain). * Educate patients and caregivers about the signs and symptoms of aspiration. Breathe through your nose.Mmm’s: Press your lips together tight, hold for 10 seconds, relax your neck. Hint: motility problems in the esophagus tend to cause dysphagia to liquids and solids, whereas as an obstructive/mucosal issue (i.e., stricture) tends to cause dysphagia … Compensatory strategies used by our participants are consistent with clinical recommendations for patients who are experiencing dysphagia or increased residue in the valleculae and pharynx. Previous studies into dysphagia in HD investigated dysphagic features in the different phases of ingestion [13–17]. ��ea��� "�����i��� Relax for 60 seconds. Modify as appropriate. 0
1. Created by. The strategy must work for all consistencies. Swallowing Take small mouthfuls / sips Alternate mouthfuls of food and drink Allow ____ swallows per mouthful Use teaspoon / dessertspoon Use a cup with a spout / straw for drinking Listen to the voice – if it sounds “wet”, cough and clear the throat then swallow again Thehomehealthslphandbook.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. Compensatory strategies that were effective for patients was a head back posture, Supraglottic Swallow, Mendelsohn Maneuver and subsequent swallows following initial swallow of the bolus. These cue cards will describe the purpose of the strategies and how to perform them. Patients typically describe this as a sensation of food "sticking" in the throat or chest. The handout lays out the basics of these types of thickeners, including main ingredients, shelf life, how they're thickened, and pros/cons. Add to cart . In these terms, Hirano et al. Other Compensatory Strategies: Application to Specific Problems a. Jun 27, 2018 - Handout featuring explanation of aspiration pneumonia as related to GERD as well as 8 specific strategies for reducing the symptoms of GERD and related risk of aspiration pneumonia. dysphagia [9–12]. Safe Swallowing Tips – Spanish; Silent Reflux: Laryngopharyngeal Reflux Disease. 8.5 x … In direct treatment, the clinician works directly with the resident, teaching him or her compensatory strategies. 1016 0 obj
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���Ŏ)����. • Liquid wash vs. dry swallow: • The amount and location of residue. Also, avoid foods that fall apart in your mouth, such as seeds, muffins, and nuts. Safe/functional swallow pattern leading to a decrease in infection 2. Relax for 60 seconds. 's category of static disorders corresponds to organic Management of dysphagia includes the incorporation of compensatory strategies to immediately address swallow-ing safety (e.g., aspiration) and efficiency (e.g., residue) by altering pharyngeal dimensions, increasing pressure, and/or redirecting bolus flow. Your physician or speech-language pathologist will select which exercises are useful to improving your swallowing function. While seated, place a rolled-up hand towel under your chin, pressed lightly against your neck. 3. PLAY. Without the use of unnatural postures and compensatory strategies HANDOUT-ABLE: Articulation Strategies for improving Dysarthria There are many benefits that can be obtained if compensatory strategies are utilized when dysarthria/slurred speech is present. Masako maneuver: Stick your tongue out and hold it gently between your lips, swallow while sticking your tongue out.Hawk: (use this with patients who have difficulty completing the Masako). • Compensatory strategies: Which can the client do and which will be most effective? This means that when we are swallowing, we Head Positioning oChin Tuck Instruction: Bring chin to chest. �d��� �+l&+���$��*�����L��`]�C������>@� ��
Body Positioning – Please make sure your loved one is sitting in the most optimal position. Specific postures are used to compensate for particular types of dysphagia by changing the way that the food moves through the pharynx. * It’s important to educate EVERY dysphagia patient and their caregivers about the risk of aspiration. It is an easy-to-follow two-page handout. According to Dysphagia Following Stroke (Daniels & Huckabee, 2014), a few key points to consider when deciding to recommend thickened liquids include: 1. • Continue to use the guidelines and strategies that are posted by the Speech-Language Pathologist located on the Dysphagia Guidelines card on the back of the patient’s chair. Introduce task and seek consent The AHA introduces him/herself to the client. The strategy must work for all consistencies. • Liquid wash vs. dry swallow: • The amount and location of residue. For oral tongue dysfunction and/or delayed pharyngeal swallow - use thickened liquids/purees c. For patients with poor pharyngeal contraction - take smaller boluses at a slower rate d. Dysphagia due to developmental disability may be stable, so teaching long-term habits and compensatory strategies is important. In these terms, Hirano et al. Available in English or Spanish. Management of dysphagia includes the incorporation of compensatory strategies to immediately address swallow-ing safety (e.g., aspiration) and efficiency (e.g., residue) by altering pharyngeal dimensions, increasing pressure, and/or redirecting bolus flow. Chin Tuck: Take a sip of your drink, immediately look down at your lap, then swallow.After each bite of food, take a sip of your drink.Take small bites, one at a time.After each bite, set your fork down and eat slowly.Effortful swallow: Every time you swallow, swallow HARD like you’re trying to swallow a whole grape.Swallow each bite and sip TWICE before taking another bite or sip.Bolus hold: Hold each bite and sip in your mouth for 3 seconds, then swallow.After each bite and sip, turn your head and then swallow.Super supraglottic: Hold your breath and bear down, take a small sip and swallow, pause and then cough.Sit bolt upright whenever you eat or drink something.Sit upright for at least 30 minutes after eating.After each swallow, clear your throat hard and swallow again.Use your tongue to clear out any leftovers in your mouth.Avoid straws and drink straight from the cup.Use a straw to avoid tilting your head back when you drink from a cup.Place your medications in a carrier, such as apple sauce, yogurt, or pudding.Cut your pills in half.Crush up your pills and place them in a carrier, such as apple sauce, yogurt, or pudding.Avoiding speaking while there’s food in your mouth.Eat only when you feel awake and alert.Reduce distractions while you’re eating, do not watch TV or read a book while eating. Terms in this set (31) Whole Body Positioning. Flashcards. h��YmO�H�+�t��ݻ�*tJ�����$Unb�U��٦4��f�^�h��Nw'�j���>;3��B9�0���H�FD���Blp�,N AB�$1�M)b#7��D?�yȱe�e]�.�k���Um%t�B�R�����P[l)N�{�a��`�H�j��i���hEDj\�)FT)l�"�� Effortful swallow: Swallow your saliva HARD, pretend that you’re swallowing a whole grape, and repeat 10 times.Mendelsohn maneuver: Swallow your saliva and feel your Adam’s apple move up and down. Common signs of dysphagia and how to treat them2. Patient Satisfaction/Quality of Life: Your patient’s lack of compliance with a recommended diet Compensatory Strategies …. Client handout and any required feeding equipment . 1051 0 obj
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A swallowing therapist can tailor these general strategies to your particular situation: • Avoid eating when tired or stressed • Change head position and posture when swallowing (chin to chest is usually best) • Minimize head movements • Eat smaller, more frequent meals • Lubricate dry food by … Press your lips against the back of a spoon to add some resistance.Pucker side-to-side: Purse your lips then stretch your lips over to the right, hold for 5 seconds, and then stretch your lips over to the left, hold for 5 seconds.Smile: Showing your upper and lower teeth and gums, clench your teeth gently, avoid squinting your eyes or tensing your neck, hold for 5 seconds.Pucker/Smile: Purses your lips like you’re about to whistle, hold for 5 seconds, then smile wide for 5 seconds. Handout: Caregiver Communication Strategies created by Medical SLPs. dysphagia compensatory strategies whilst eating the client should remain in sitting for a minimum of 20 minutes after the task. This is usually at 90 degrees; however, therapists may find a different, more suitable position. Designed for speech-language pathologists to give to patients, nurses, dieticians, kitchen staff, etc. Press your chin down into the towel and hold for 3 seconds, relax and repeat up to 30 times. Jan 30, 2020 - Explore penny fox-jones's board "dysphagia" on Pinterest. neuromuscular treatment related to dysphagia •Differentiate postural, compensatory, bolus modifications, and rehabilitative techniques for oropharyngeal dysphagia •Determine appropriate strategies for various oral and pharyngeal deficits •Discuss evidence for dysphagia treatment, specific techniques and the limitations in current evidence The frequency of this incapacitating sign is not known. This website and all of its content is for informational purposes only. For oral tongue dysfunction and/or delayed pharyngeal swallow - use thickened liquids/purees c. For patients with poor pharyngeal contraction - take smaller boluses at a slower rate d. Compensatory strategies may be short term or used more long-term, such as with patients with head and neck cancer. This handout is designed for speech-language pathologists who work with people who have dysphagia and use thickened liquids as a compensatory strategy due to a delayed swallow. Therefore, we Thick saliva. Don’t hand out thickened liquids like Oprah (A Compensatory Strategy Review for Swallowing Disorders Part 2) Are your patient’s unable to cognitively follow compensatory strategies? Lip Pucker: Purse your lips like you’re about to whistle and hold for 5 seconds. 993 0 obj
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They will develop a program customized and unique to the needs of each patient. Dysphagia is “dysfunction in any stage or process of eating. All you need to do is print out these simple directives so your patient can do their homework with more ease. Dysphagia treatment can be divided into direct treatment and indirect treatment. Signs and symptoms of aspiration (FREE patient handout), Treatment: Thickened liquids, Labial exercises, Treatment: Modified diet textures, Lingual exercises, Treatment: Alternating bites and sips, Lingual exercises, Treatment: Thickened liquids, Small bites and sips, Bolus hold, Chin tuck, Lingual exercises, Treatment: Small bites and sips, Thinner consistencies, Masako maneuver, Mendelsohn maneuver, Shaker exercise, Treatment: Mendelsohn maneuver, Effortful swallow, Treatment: Dry swallow, Alternating bites and sips, Chin tuck, Effortful swallow, Mendelsohn maneuver, Lingual exercises, Masako maneuver, Treatment: Head turn. Compensatory Strategies (Dysphagia) STUDY. Do not tense your neck muscles.Cheek puffs: Puff out your cheeks like a blow fish and hold for 5 seconds. Provide a list of the exercises you recommend. Current treatment and research trends… Speech Pathology: Evaluation and Treatment … Copyright © 2020 The Home Health SLP Handbook. Below are a list of common swallowing exercises. Spell. Learn basic strategies to cope with swallowing issues. 's category of static disorders corresponds to organic Dysphagia affects quality of life in at-risk pediatric populations, 2. rehabilitation populations, 3 These types of food are hard to chew and swallow. Press your chin down into the towel, keep your spin straight, and hold for up to 60 seconds. Other Compensatory Strategies: Application to Specific Problems a. Learn. These are strategies used to help people who have swallowing disorders swallow their food without negative consequences. This handout is designed for speech-language pathologists working with patients who have dysphagia and are using thickened liquids as a compensatory strategy. ---Compensatory changes usually do not increase muscular effort or the duration of airflow closure, which tends to be a problem with patients who have a respiratory disease. Common compensatory strategies are explained including diet modifications and swallowing maneuvers (i.e. This link below is to an information sheet on swallowing problems (in English and Spanish). They may need to eat using compensatory postures or techniques such as turning or tilting their head in a certain direction. Tucking the chin to the chest closes off the airway for many patients, but for others, it can make things worse and actually cause aspiration. h�b```���� Match. Handout: Caregiver Communication Strategies created by Medical SLPs. 2. Mendelsohn maneuver, Shaker exercise, Treatment: Dry swallow, Alternating bites and sips, Head turn, Mendelsohn maneuver, Effortful swallow, Treatment: Thickened liquids, Small bites and sips, Bolus hold, Chin tuck, Mendelsohn maneuver, Effortful swallow. Compensatory strategies provide immediate effects, and as of yet, they have not been Relax down and repeat up to 30 times.Chin tuck against resistance: (use in place of the Shaker exercise with patients physically unable to lay flat on their backs. endstream
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Here’s a … Tech specs: Digital do • The difficulty in performing a dry swallow. Liquid wash may be more effective for clients who consistently tongue pump before the swallow. dysphagia into static disorders and dynamic disorders, whereas Horiguchi 8) proposed that it be classified into the following three types: (i) organic dysphagia, (ii) motor disorder dysphagia, and (iii) functional dysphagia. Press your chin down into the towel and hold for 3 seconds, relax and repeat up to 30 times.Super spraglottic swallow: Take a deep breath and hold it tight, take a bite or a sip, swallow hard, cough, then breathe. 1. --Compensatory Strategies work best because other types of exercises may put further stress and work on the respiratory system and may be unproductive. For reduction in tongue elevation - position food posteriorly with straw or syringe b. Clarify if it is a dysphagia to solids/liquid/pills, or all three. effortful swallow, chin tuck, etc. After VFSS, 8 patients had a functional swallow and 2 … Many patients must eat slowly and carefully to avoid choking and aspirating while maintaining a nutritious diet. o Positioning, dentition, and medications. Kahrilas PJ, Logemann JA, Krugler C, Flanagan E. Volitional augmentation of upper esophageal sphincter opening during swallowing. The Dysphagia Patient Handout Package includes easy to read Dysphagia Exercises for the patient to easily understand and easily follow. Say the word “hawk,” emphasizing the “k” sound.Superior lingual press: Tough your tongue tip to the roof of your mouth, where it feels softer, then press and hold for 20 seconds.Lateral lingual press: Push your tongue inside your cheek and hold for 10 seconds, switch sides and hold for 10 seconds. Complete two more times. ��Z�0�3���_�S-s�̴�3AZ����upǪ݆�x����-��Zw&{�`hYr��ղ��Л�;V�Y�{4����ls!H������������d��#�+�2��q��iƧ���(K������N*�mC܆YU�:[E�6=��� @� [Zs��ʟ�.�1�2Ʒ�BB@���+�fd``]����Ҝƅ��c�� �����@�1* �7Z�
It is not intended to be a substitute for professional medical advice, diagnosis or treatment. There are check boxes for customizing it to your patient. Press your chin down into the towel, keep your spin straight, and hold for up to 60 seconds. Dysphagia arising from progressive conditions may gradually worsen so the focus may be on conserving energy and adapting diet and mealtime strategies… Included in: Bundle: Dysphagia Interventions and Strategies. In direct treatment, the clinician works directly with the resident, teaching him or he r compensatory strategies. Adults Advanced Naming Aphasia Apraxia Auditory Comprehension Bundles Cognitive Communication Compensatory Memory Dementia Divergent Naming Downloadable Dysarthia Dysphagia Executive Functioning Expressive Language Free Functional Generative Naming Gift Cards ... Handout: Dysphagia $ 0.99 $ 0.00. difficulty in the passage of food, liquid, or medicine, during any stage of swallowing that impairs the client’s ability to swallow independently or safely.” 1. A swallowing disorder, known as dysphagia, may occur as a result of various medical conditions. This pamphlet is specifically for patient/caregiver education on Dysphagia Management. It is not known in what stage of HD the dysphagia becomes clinically apparent. Avoid foods that are hard or have tough skins, such as raw apples. Have the patient point exactly where. The packet also includes other handy one sheeters to give to your dysphagia patients. (Hyper).. Compensatory techniques are used to alter the swallow, however compensations may not create a lasting effect to the swallow. • Compensatory strategies: Which can the patient do and which will be most effective? Oropharyngeal dysphagia is a frequent occurrence following stroke. Dysphagia can also lead to isolation and depression. You can also press your fingers against your cheek to add some resistance.Anterior lingual press: Stick out your tongue tip as far out as it can go, hold for 10 seconds, relax and repeat. Jul 3, 2020 - There are many swallowing compensatory strategies speech pathologists may recommend to patients. How to Write an Evaluation Report – with Examples! Many patients must eat slowly and carefully to avoid choking and aspirating while maintaining a nutritious diet. 2017;92(6):965-972 D ysphagia is a relatively common Swallowing and respiration are the only two systems in the body that share a common part of the body, namely the throat. Skip to ... Dysphagia Bundle. Model each, then have the patient demonstrate it back to you. Swallow your saliva again, but halfway through the swallow, hold your Adam’s apple up using the muscles under your chin. dysphagia into static disorders and dynamic disorders, whereas Horiguchi 8) proposed that it be classified into the following three types: (i) organic dysphagia, (ii) motor disorder dysphagia, and (iii) functional dysphagia. Pick and choose for your patients based on the signs and symptoms they present. The Home Health SLP Handbook: Everything you need to provide speech therapy to adults in the home health setting. It is a good idea to have the patient try using these postures during the VFFS/MBS; this way you can get an idea of how well or what will really work or not work for that patient. Obtain a general understanding of swallowing function. They may also use the term "choking" (see below) to describe the same feeling. Pre/post and 30 day post measurements: – Functional Oral Intake Scale – SWAL-QOL – MD Anderson Dysphagia Inventory – Dysphagia Severity Scale RESULTS: – All groups found signifncant therapy effects on the dysphagia severity scale – SWAL-QOL and MDADI. explain the purpose of dysphagia postural compensatory strategies safely and effectively educate/instruct, facilitate and supervise clients using dysphagia postural compensatory strategies including chin tuck, head turn, head tilt, effortful swallow and supraglottic swallow monitor and address common performance problems. Liquid wash may be more effective for patients oropharyngeal and esophageal dysphagia. See more ideas about Dysphagia, Dysphagia therapy, Speech language therapy. Compensatory Strategies (use during meal) SpeechRamblings.weebly.com ’ Impact’on’Swallowing’ Exercise’ Procedure’ Rationale/Notes’ Cryotherapy. Write. No well-proven strategies to prevent dysphagia are available. The length of acute care hospitalization, however, has decreased over time with many individuals weak and frail upon admission for rehabilitation and possibly with continued dysphagia upon discharge. Swallowing and respiration are considered reciprocal functions. Dysphagia Dysphagia refers to a patient's perception of difficulty in the passage of a swallowed bolus from mouth to stomach. Clarify if it is a dysphagia to solids/liquid/pills, or all three. Relax back down for 60 seconds. The American Speech-Language Hearing Association, better known as ‘ASHA’, defines dysphagia as “problems involving the oral cavity, pharynx, esophagus, or gastroesophageal junction.” ASHA’s website has a great overview of dysphagia.Treating dysphagia requires high levels of training and skill. Current studies show that some dysphagia programs based on the principles of exercise physiology can result in: 1. endstream
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b;�#�G���j$dOJHl��D��2�@�&��( \"�+�����23BɀK(�����Y B�__ !e��� nbw"����%*!� How To: Word-Finding Strategies for Aphasia 5 min read. Compensatory Strategies Part 3 To Thicken or Not To Thicken? And, avoid dry, sticky foods such as mashed potatoes without gravy, white bread, and peanut butter. Spanish swallowing resources and links: The Ohio State University – Wexner Medical Center provides extensive patient education resources in many languages. 13) Myth: Smaller bites are always safer than big ones. This means that when we are swallowing, we The outcome of using such strategies provides you the best chance to improve intelligibility Dysphagia can often have severe consequences including an exacerbation or worsening of COPD and pneumonia. The length of acute care hospitalization, however, has decreased over time with many individuals weak and frail upon admission for rehabilitation and possibly with continued dysphagia upon discharge. Therapy Insights provides fresh materials and continuing education for rehabilitation therapists (SLP, OT, and PT) designed to help clinicians save time and change lives. This article is intended for Speech Language Pathologists or other qualified therapists with the appropriate training and competency to work with adults with dysphagia. A good clinical history can decipher the type of dysphagia in approximately 80% of cases.11 If the patient describes difficulty initiating swallowing, nasopharyngeal regurgitation, or choking, this is suggestive of oropharyngeal dysphagia. Twice a day severe consequences including an exacerbation or worsening of COPD pneumonia... Practical approach to the swallow, laryngeal closure including diet modifications and swallowing maneuvers ( i.e of with. Tuck ” is a popular compensatory strategy for swallowing impairments compensatory strategies: which can the demonstrate. 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