An Overview of the Dysphagia Diet Essay Example

An Overview of the Dysphagia Diet Essay Example An Overview of the Dysphagia Diet Paper An Overview of the Dysphagia Diet Paper The Dysphagia Diet is a specialized diet developed for people suffering from dysphagia. Dysphagia is a medical condition in which swallowing food becomes difficult and poses a danger to the patient. Dysphagia can be a result of trauma or injury such as stroke and thus predisposes the client to malnutrition. The dysphagia diet was developed to address this condition and consists of five levels (levels I-V), with each level designed to cater to a patient’s specific situation and/or condition. An Overview of the Dysphagia Diet There is no question that food, plays a very important role in mankind’s health and being. After all it is one of man’s most basic needs and people require sustenance to live and function. Food plays a central role in everybody’s lives. It dictates livelihoods, it represents culture and most importantly it affects health. Diet is generally defined as the food intake habits/practice of individuals in order to gain nutrition. In healthcare, diet may be used as a preventive, therapeutic or rehabilitative tool. One such kind of diet that has a rehabilitative/supportive purpose is what is known as Dysphagia diet. Dysphagia diet in the simplest terms is a specialized form of food preparation for individuals suffering from dysphagia. Dysphagia is a medical condition wherein it becomes difficult to chew or swallow food or liquids. This condition is a result of a blockage or malfunction in the system that controls the swallowing mechanism (Jackson-Seigelbaum, 2008). This interruption may occur in any of the three phases of the swallowing process and can be dangerous to the patient as this predisposes the patient to asphyxiation, aspiration and complications such as pneumonia (Lippincott, Williams Wilkins, 2007). There are two types of dysphagia. First is esophageal dysphagia which â€Å"occurs when food/liquid stops in the esophagus. This happens most often because of consistent stomach acid refluxing (backing up) into the esophagus† and the second is termed as oropharyngeal dysphagia which â€Å"involves difficulty moving food to the back of the mouth and starting the swallowing process† (Jackson-Seigelbaum, 2008). Since these individuals have difficulty taking in food, they become prone to malnutrition. It then becomes an important part of the treatment to provide the patient with adequate nutrition while at the same time safeguarding against possible complications of the condition such as asphyxiation, aspiration and pneumonia. Thus the situation requires a specialized diet: the dysphagia diet. According to the National Dysphagia Diet (NDD) published by the American Dietetic Association, â€Å"there are five different diet levels from pureed (level 1) up through modified regular food (level 5). The diets vary in texture and consistency, and are chosen depending on which would be most effective for a specific patient† (Jackson-Seigelbaum, 2008). There are four frequently used terms in describing the consistency of liquid viscosity to be used in preparing foods for the dysphagia diet: thin, nectar-like, honey-like and spoon-thick. However there are â€Å"texture modifications for dysphagia management†¦one that is open to wide variation across clinicians and the facilities Previous research has demonstrated that clinicians, including speech-language pathologists (SLPs), show significant variation in the amount of thickening powder they feel is necessary to mix a liquid to nectar-thick or honey-thick consistency† (McCullough, Pelletier Steele, 2003, p. 16,27). Level I of the dysphagia diet includes pureed foods pureed to a smooth consistency similar to mashed potatoes. This level is reserved for individuals that cannot tolerate solid foods at all. Level II involves mincing or chopping food into small pieces (1/8 inch) about the size of a sesame seed. This level is reserved for those who can slightly tolerate whole food. Foods in the level III group are ground/diced into 1/4-inch pieces similar in size to rice. On the other hand Level IV includes food chopped into ? inch sizes – about the size of an elbow macaroni or croutons. Lastly, Level V includes soft, moist, regularly textured foods (Jackson-Seigelbaum, 2008). These diets are chosen depending on the current status of the patient and according to the tolerability of the diet. Ideally, as a patient is treated for dysphagia, the diet provided is started with the one that is most tolerated and as the patient improves the diet level is also adjusted until the patient resumes normal function. Foods in the dysphagia diet are thinned or thickened depending on the necessity. Thinning agents include hot or cold milk (depending on the food being thinned), broth, gravy and other sauces. Thickening agents include commercially available agents including unflavored gelatin, baby rice and potato flakes. Gravy and other thick sauces may also be used (Jackson-Seigelbaum, 2008). Patients on dysphagia diet must be monitored closely especially in the early phases of the treatment and diet initiation. Nursing considerations that must be taken into account include the following: Consult the speech therapist to assess the patient for aspiration risk and swallowing exercises that can help decrease the risk; coordinate with the dietician about the foods with distinct textures and temperatures apt for the client; before beginning the meal, â€Å"stimulate salivation by talking with the patient about food, adding a lemon slice or dill pickle to his tray, and providing mouth care before and after meals†; and lastly, when feeding, place the patient in upright position with his neck slightly flexed forward keeping his chin at midline (Lippincott, Williams Wilkins, 2007). Additionally, compensatory techniques may be taught in order to reduce aspiration risks and improve pharyngeal clearance. Examples of such compensatory techniques include the chin-tuck position which â€Å"decreases the space between the base of the tongue and the posterior pharyngeal wall, creating increased phar yngeal pressure to move the bolus through the pharyngeal region† (Paik, 2008). Other techniques involve any of the following: head rotation to the affected side, tilting the head towards the strong side and lying on the side or back when swallowing. Maneuvers are also available to protect the airway and safeguard against aspiration. These maneuvers are the supraglottic swallow, extended supraglottic swallow, supersupraglottic swallow, effortful swallow, the Mendelson maneuver, the Shaker exercise and the well known Heimlich maneuver (Paik, 2008). Lastly, upon discharge of the patient, the client must be taught and made sure to understand the following: which foods and textures to avoid, be taught measures to reduce the risk of aspiration and choking hazards and make sure that the client has full understanding of the diagnosis and treatment plan developed by the healthcare team (Lippincott, Williams Wilkins, 2007) References Jackson-Seigelbaum. (2008). Dysphagia Diet: 5 levels for difficulty in swallowing diet. Retrieved 11 February 2009 from gicare. com/Diets/Dysphagia. aspx Lippincott, Williams Wilkins. (2007) Nursing: interpreting signs and symptoms. Retrieved on 11 February 2009 from wrongdiagnosis. com/symptoms/throat_symp-toms/book-causes-16a. htm McCullough, Gary; Pelletier, Cathy, Steele, Catriona. (2003, Nov. 4). National dysphagia diet: what to swallow? The ASHA Leader, pp. 16, 27. Paik, N. (2008, June 25). Dysphagia. eMedicine. com. Retrieved 11 February 2009 from http://emedicine. medscape. com/article/324096-overview