Sandra Robinson HCPCReg, MRCSLT
Independent Speech and Language Therapist
Difficulty in swallowing is a widespread health problem. In fact, dysphagia affects 590 million worldwide.
The term dysphagia derives from the Greek; dys – meaning ‘difficult’ and phagia meaning ‘to eat’.
Dysphagia is a serious condition that can be experienced by people who’ve had a stroke; head and neck cancer, progressive neurodegenerative diseases such as Parkinson’s Disease, acute brain injury, dementia, cerebral palsy or adult learning disabilities amongst others.
More than 50% of aged and frail nursing home residents may have dysphagia. It can occur at any time of life from premature babies to centenarians. Even animals can experience the condition.
Devoted to helping
Speech and Language Therapist, Sandra Robinson, based in Worcestershire, has devoted her career to helping dysphagia patients throughout the UK.
She explains: “Dysphagia is a difficulty or inability to move food, drink or tablets effectively and safely from the mouth, through the oesophagus to the stomach and, some say, involves the whole digestive tract.
Then there’s the social-psychological impact of not being able to eat and drink normally. Dysphagia can really affect the person’s quality of life.
Assessment and treatment
“It’s a condition that occurs due to other illnesses. Proper assessment of patients is essential before implementing the next steps.”
Speech therapists assess patients in a bedside evaluation and also via instrumental assessments, which reveal the nature of the swallowing difficulty.
The Royal College of Speech and Language Therapists (RCSLT) and the Health and Care Professions Council (HCPC) ensure that speech therapists are adequately trained and competent to work with children or adults with dysphagia.
They provide a variety of options including exercises, sensory work, manoeuvres, strategies and protocols to improve function.
“For example, in the case of stroke patients, treatments aim to achieve neuroplasticity (rewiring parts of the brain that manage swallowing),” she explains.
Making drinks thicker
There are a number of options which can be used to assist patients swallowing, one of these is adding thickeners to food and drinks.
Sandra says: “Thickeners are a useful tool as part of rehabilitation. They can improve swallow safety for people with dysphagia enabling them to enjoy tea, coffee or squash rather than being ‘nil by mouth’. Thickeners are no longer just starch based. Advancements to the more recent gum-based thickeners ensures the same level of consistency in the cup as well as the mouth. Gum-based thickeners are also clear and tasteless.”
IDDSI stands for International Dysphagia Diet Standardisation Initiative. All over the world, people with dysphagia are recommended modified food and drink using IDDSI.
“Speech therapists are supported by thickener manufacturers to provide nurses and carers with excellent training in the correct use of thickening products” she says.
The condition can cause long term ill-health
From her years of experience working for the NHS in acute and community settings and then in private practice, Sandra knows that treating dysphagia is vitally important because left untreated the condition can be fatal.
“The consequences of untreated or inadequately treated dysphagia can lead to significant ill health and complications as well as death through choking, aspiration pneumonia, chest infections, malnutrition and dehydration.”
Improving quality of life
“Then there’s the social-psychological impact of not being able to eat and drink normally. Dysphagia can really affect the person’s quality of life.
“In hospitals and nursing homes, giving food and drink to a relative is often the one caring act left for family members to show their love. It’s important we make this possible in every way we can.”