Dysphagia and 'dignity of risk'

23 July 2019
By Stephen Wiblin, Head of Clinical Strategy & Development


Dysphagia and 'dignity of risk'What is dysphagia?

Dysphagia is a medical term used to describe a difficulty with swallowing. The condition can be associated with an obstruction in the throat or oesophagus, or muscle problems with the face or neck.

While it can occur at any age, dysphagia is most common in people over 65. Some of the causes in elderly people include stroke, head and neck cancer, dementia or Parkinson’s disease.

How do you know if someone has dysphagia?

There are signs you can look and listen for that might lead you to believe someone has dysphagia; however, it should be diagnosed by a speech pathologist. Some signs to look for include:

Dignity of risk

The first principle in managing dysphagia for someone living in aged care is to balance risk management around meal planning with the resident’s right to choose their own food.

This concept is called ‘dignity of risk’ and is an important part of the new Aged Care Quality Standards, which came into effect on 1 July this year.

Dignity of risk is based on the belief that all adults have the right to make their own decisions about their health and care.

By the time someone enters an aged care home, they have led full lives. They have held careers, raised families, fought wars, and been stalwarts of the community.

The ageing process doesn’t change who they are, and we shouldn’t change the way we treat people as they grow older. In fact, the highest mark of respect we can give elderly Australians is to allow them the freedom to live their final years as they choose.

That doesn’t mean abandoning our duty of care for the people who live in our homes. To the contrary, it means carefully assessing the risks to a person’s safety and then agreeing the lifestyle choices that fit within that risk framework.

How to manage dysphagia and swallowing problems

Allity’s approach to maximising safety during meal times starts with prevention.

All our staff are trained to identify the signs and changes that are consistent with increased trouble swallowing and can refer a resident for further evaluation if needed.

When a resident comes to live with us, they are assessed for their nutritional requirements. Anyone who presents with swallowing difficulties is seen by a speech pathologist who, together with an accredited dietician, may offer some diet modifications around the texture of food or the thickness of fluids.

The goal is to promote safer swallowing, optimal nutrition and hydration, and making sure a resident is in control of their choices.

An effective management plan requires collaboration between the following team of people: speech pathologist, dietician, nursing staff and care staff, hospitality staff – and, of course, the resident.


Related articles

Health Times: Dietary management of dysphagia in aged care 

Australian Medical Association

Aged Care Quality Standards


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