Swallowing Difficulties and Eye Impairments

dysphagia

difficulty swallowing. muscles and nerves that help move food through the throat and esophagus are not working properly. happens in people with Alzheimer’s, CP, MS, MD, Parkinson’s, cancer, and people who have had a stroke

signs of dysphagia

• Coughing or gagging when attempting to swallow

• Gurgling sound when talking

• Holding food in mouth

• Feeling like food is stuck in throat

aspiration pneumonia

food and drink particles end up in the lungs causing difficulty breathing or infection

dysphasia

difficulty speaking

barium swallow

fluoroscopy after drinking barium to see where it goes and how the muscles are working. used to diagnose dysphagia

fluoroscopy 

x ray movie

nectar

mildly thick

honey

moderately thick

pudding

extremely thick (need a spoon)

what needs to be thickened

• Water, milk, tea, coffee, nutrition supplements, juice & soup

• Ice cream, ice cubes, sherbet, Jello and popsicles melt at room temperature. Use specialized ice creams & sherbet (MAGIC CUP)

how do thickened liquids work

the muscles to swallow are still working, just slowly. thickened liquids move slower, giving the body enough time to reach. the thicker the liquid, the slower it moves

food

most people on thickened liquids need different food. food can either be pureed or mechanically chopped

pureed foods

• Is usually eaten with a spoon

• Holds its shape with a spoon

• Flows very slowly

• Is not sticky

• Falls off the spoon when tilted in a single spoonful

• Does not separate into liquid and solid

• Cannot be sucked through a straw

etiquette when working with a client with dysphagia

• Be mindful of your nonverbal behaviors (facial expression of disgust)

• Avoid making negative remarks about the modified drinks or food

• Validate when the client expresses displeasure

• Educate the client about the importance of the modification

• Right to refuse - Consult with nurse, physician or dietician & follow their recommendations

• Attend trainings before preparing thickened beverages or feeding clients (done at agency)

functional independence

an individual’s ability to perform activities of daily living (ADLs)

cataracts

clouding of the lens (can be in one or both eyes). causes blurred and hazy vision. some are small and don’t impact eyesight but others are large and reduce vision. colors can often become duller (beige tint)

cataract surgery

natural lens is replaced with an artificial one

age-related macular degeneration (AMD)

affects central vision (macula) which you need for reading, driving, and telling time. results in scotoma, blurry vision, and sensitivity to glare

scotoma

dark spot in middle of vision

glaucoma

damage to the optic nerve and eye builds up with pressure which can lead to blindness if left untreated. results in darkness in peripheral vision and can be treated with lifelong eye drops