Last month, I wrote a post about Better Speech and Hearing Month. For some unknown reason, I lost it! May is the month that Speech Language Pathologists educate the public on speech and language disorders and audiologists educate on hearing disorders.
June is dysphagia awareness month. Did you know that dysphagia typically makes up the largest percentage of the medical Speech Language Pathologists caseload?
There was a recent study that was published looking at the burden of dysphagia.
What did they find? They found that:
- 3% of adult inpatients in the United States have a dysphagia diagnosis.
- The prevalence of dysphagia increased from 408,035 in 2009 to 656,655 in 2013.
- Length of stay with dysphagia 8.8 days, without dysphagia 5.0 days.
- The cost of patients increased $6, 243 when diagnosed with dysphagia.
- Patients with dysphagia were 2% more likely to be sent to a post-acute care facility.
- When diagnosed with dysphagia, patients were 1.7 times more like to die in the hospital.
Patel, D. A., Krishnaswami, S., Steger, E., Conover, E., Vaezi, M. F., Ciucci, M. R., & Francis, D. O. (2017). Economic and survival burden of dysphagia among inpatients in the United States. Diseases of the Esophagus.
Dysphagia can have a serious impact on patients. We typically associated dysphagia with aspiration pneumonia, however patients with dysphagia may have:
- poor healing
- pressure ulcers
- poor recovery from fractures or surgery
- increase in incidence of urinary tract infection
- changes in blood pressure
Identification is key in dysphagia. Diagnosis is typically achieved through use of instrumental assessment including a Videofluoroscopic Swallow Study (VFSS) or Flexible Endoscopic Evaluation of Swallowing (FEES). Either of these assessments allows you to visualize the oral and pharyngeal cavity as the person is preparing to and swallowing.
A screening or Clinical Swallowing Evaluation is typically performed at the patient’s beside, in the patient’s home or during an outpatient evaluation. This typically involves assessment of the cranial nerves, the patient chewing and swallowing a variety of consistencies and a series of questions to determine the nature of the patient’s swallowing difficulty.
It is important to realize that patients not only swallow food and drinks, but also medication and saliva. We typically can swallow anytime between 600 and 1200 times per day! That’s a lot of chances for anything to “go the wrong way.”
Often, we don’t realize the role that eating plays in our lives. Take a little while as you watch TV and count how many commercials are food-related. How many times do we socialize with friends and family and how often does that socialization involve food, drinks or eating?
It is important for the medical Speech Language Pathologist to recognize the impact that they make on a person’s life when they recommend a diet consistency (or altered diet consistency), recommend NPO (nothing by mouth) status or when they work with the patient to rehabilitate the swallow.
The Speech Language Pathologist plays a vital role, not only in assessing and diagnosing dysphagia but in the treatment and management of dysphagia.
It is important to learn as much as you can about dysphagia, if you plan to work in any type of medical setting and then realize that you will have to keep learning as we are continuously finding out more and more about dysphagia and how the brain controls the swallow.