Overview of Dysphagia and the role of Speech Pathologists in assessment and management of swallowing problems; particularly as seen in aged care populations.

1. What is Dysphagia?
LOQUI Speech
Pathology
Speak | Swallow | Communicate

2. Dysphagia is a
swallowing disorder.
People with dysphagia
have an impairment to the
function and safety of
their swallowing.
Dysphagia: Definition
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3. Dysphagia: Causes
Causes may be…
• Neurological: Stroke; Head injury; Progressive
neurological disorders (Parkinson’s Disease,
MND, Dementia, MS)
• Surgical: Affecting Head/neck or oesophageal
regions
• Metabolic: Diabetes, thyroid dysfunction
• Other: Radiation therapy, Age related factors,
Reflux (GORD) or Respiratory (COPD)
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4. Dysphagia: Statistics
50% of older people in
Nursing Home (or
Residential Aged Care
Facility) have dysphagia
(Park et al 2013)
84% of people with
Parkinson’s Disease
have dysphagia (Kalf et al
2012)
50-78% of people
who have had a
stroke have
dysphagia (Kalf et al
2012)
3x greater chance of
malnutrition in older
adults with dysphagia
than in those without
(Serra-Prat et al, 2012)

5. Dysphagia
• Swallowing is important
for:
– Maintaining life
– Nourishing body
– Swallow 100 times per day!!!
(Dodd, 1989)
Improved safety
Lesson the symptoms
Improve weight
Improve safety
Change the fluid
consistencies and
food textures
=
• Swallowing difficulties lead
to:
– Aspiration Pneumonia
– Respiratory Distress
– Malnutrition / Dehydration

6. Dysphagia: Assessment
• Speech pathologists assess and treat
dysphagia.
• To assess dysphagia, a speech pathologist will
complete a full swallowing assessment:
– Check that the muscles of the head and neck are
working properly (oromotor exam)
– Observe a patient eating and drinking food and
drinks.
– ‘Feel the swallow’ by placing their hand under
the patient’s chin
– Trial some strategies, if needed, to see what
helps the patient to swallow
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7. Dysphagia: Treatment
To help improve swallow safety –
a speech therapy might include:
• Recommend changes to diet
texture or fluid consistencies
• Suggest swallowing strategies (i.e.
chin tuck, effortful swallow, etc.)
• Prescribe exercises to support
swallow (i.e. base of tongue or
pharyngeal wall exercises, etc.)
Pictures from ‘Australian Standards for Texture Modified
Foods and Fluids’ poster. (Dietitians Association of
Australia & Speech Pathology Australia joint initiative).

8. More Information
• American Speech Language and Hearing Association:
http://www.asha.org/public/speech/swallowing/Swallowing-Disorders-in-
Adults/
• Speech Pathology Australia FACTSHEET:
http://www.speechpathologyaustralia.org.au/library/2013Factsheets/Fact
sheet_Communication_Difficulties_Following_Stroke.pdf
• Australian Standardised Terminology and Definitions for Modified Texture
Foods and Fluids:
http://www.hnehealth.nsw.gov.au/__data/assets/pdf_file/0004/87916/23
344_D5_RH.pdf

9. More support
If dysphagia has affected you, or someone you know, please
contact a speech pathologist to receive support specific for the
person’s individual needs.
You can use the ‘Find a Speech Pathologist’ function on the
Speech Pathology Australia website, to find a
Speech Pathologist in your area.