Delivering safe, effective nutrition and hydration care to residents with dysphagia
Introduction
Delivering safe, effective nutrition and hydration care to residents with dysphagia: a theory-based approach to developing a link dysphagia practitioner.
We aim to understand how people in nursing and residential care homes who have a problem with swallowing (dysphagia) can be cared for safely and effectively. The results of this study will be used to develop and test an intervention to improve this aspect of care and prevent harm to residents.
About the project
Swallowing difficulties are common in people who have had a stroke, have dementia, or other conditions such as Parkinson’s disease. A person who has difficulty swallowing may experience episodes of choking when food and fluid enters the lungs rather than the stomach. If this happens frequently people may develop pneumonia and are more likely to lose weight and be dehydrated.
Caring for residents with dysphagia requires some specialist knowledge and skills to ensure they have appropriately modified food and fluids and are correctly positioned to reduce the risk of choking and food or fluid entering their lungs. This advice is normally provided by speech and language therapist (SLT), but care homes have limited access to this advice.
Research suggests that healthcare staff lack the capability to position residents with dysphagia safely and assist them to eat and drink. Managing this aspect of care better, could improve residents’ quality of life, their food and fluid intake and reduce the incidence of pneumonia and admissions to hospital.
One way of supporting safe care may be a dysphagia link practitioner (DLP) who would be a link between the SLT and care home staff and would be trained to advise and support other care staff. We will speak to care home staff and link practitioners in other areas such as infection prevention and control to see if this might be useful.
What this study involves
- understanding the problems that care home staff encounter in assisting residents with dysphagia to eat and drink
- understanding the role of a link practitioner and what factors are important for the role to work effectively
- measuring how well the recommendations of the SLT are followed for residents with dysphagia
- measuring how often residents with dysphagia experience choking when eating or drinking or develop pneumonia
- identifying what needs to be done to improve how staff help residents to eat and drink safely
Interviews with care home staff and SLT will be help us to understand what helps and hinders safe care and develop an understanding of which element of care is the most amenable to change e.g. safe positioning, and what organisations need to do to support this. To do this we will apply behaviour change theory to our findings.
The information we collect will be used to design a future study, to test an intervention to improve the safety of eating and drinking for residents with dysphagia and reduce their risk of choking, dehydration, malnutrition and pneumonia.
Impact and research team
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Impact
Managing dysphagia care better, could improve residents’ quality of life, their food and fluid intake and reduce the incidence of pneumonia and admissions to hospital.
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Research team members
- Professor Heather Loveday - Director of Research (UWL)
- Professor Jennie Wilson - Professor of Healthcare Epidemiology (UWL)
- Dr Anke Görzig (University of Greenwich)
- Dr Celia Harding (City, University of London)
- Kirsty Harrison (University of East Anglia)
- Professor Elizabeth Barley (Surrey University)
- Sukhi Aujla (Central London Community Healthcare NHS Trust)
- Andrea Whitfield - Patient & Public Involvement
Additional information
- The research is funded by the National Institute of Health Research - Research for Patient Benefit Programme (NIHR RfPB). The NIHR RfPB programme funds and supports research that is concerned with the day-to-day practice of health and social care service staff and which has the potential to have an impact on the health or wellbeing of people using health/social care services.
- For further details please contact Alison Tingle: alison.tingle@uwl.ac.uk
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