Hospital mealtime volunteers workshop
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Transcript of Hospital mealtime volunteers workshop
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Hospital mealtime volunteers workshop
Julie Quinn Speech and Language Therapist (x2712)21/12/12
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By the end of the training you will have a better understanding of the:• Prerequisites for safe eating and drinking• Process of normal swallowing• Warning signs of a swallowing problem (dysphagia)• Types of patients who may experience a swallowing
problem• Practical strategies to support eating and drinking• Actions to take if there is a problem identified
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What do you need to do in order to eat and drink safely?
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The stages of the normal swallow
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Normal swallowing process
• Eating and drinking central to our life• Complex and rapid process involving more than 50
muscles• Voluntary and involuntary control• 4 stages of swallowing• Frequency 2x times per minute
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What do we do when we eat and drink?
• What position is your head in, in relation to your body?
• What do your lips do before and after each mouthful?
• What is your tongue doing?• Are you breathing? Do you stop at any point?• Are you able to talk? What happens to your voice
box?• How is drinking different from eating?
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Stages of normal swallowingStage 1: Anticipatory phase
• Environment• Sight, smell, touch• Hand to mouth• Saliva• Access • Health
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Stage 2 – Oral phase (mouth)• Putting food in mouth• Chewing• Mixing food with
saliva• Lips keep the food in
the mouth• Tongue moves the
food around
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Stage 3 – Pharyngeal phase (throat)
• Involuntary phase• Airway shuts to stop
food / drink going wrong way
• Muscles of throat push food down towards oesophagus (gullet)
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Stage 4 – Oesophageal phase (gullet)
• Top of oesophagus (gullet) opens
• Food pushed down by rhythmical movement
• Sphincter opens at bottom of oesophagus – food enters stomach
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The normal swallow animation
http://www.linkstudio.info/images/portfolio/medani/Swallow.swf
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What can go wrong when eating and drinking?
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Signs of a swallowing problem• Poor lip closure – food / liquid leaking out of
mouth, dribbling• Difficulty biting and chewing• Difficulty getting the food into a soft ball in the
mouth and moving it backwards• Food pocketing in mouth / sticking to teeth• Food / drink coming down nose
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Signs of a swallowing problem• Coughing or choking on food and drink• Wet gurgly voice• Increased breathing rate / shortness of breath• Slow to swallow / swallow not triggering • Avoiding certain food textures• Food sticking in the throat• Fear of eating• Recurrent chest infections
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What are the main causes of swallowing problems (dysphagia)?
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Potential Causes of swallowing problems
• Neurological changes - stroke, parkinson’s disease, MS, head injury
• Dementia (in end stages)• Structural changes – cancer of the mouth /
throat, surgery or trauma, laryngectomy• Severe confusion / deliruim• Reduced levels of consciousness
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Potential consequences of a swallowing problem
• Chest infection / pneumonia• Malnutrition / dehydration /
weight loss• Longer stays in hospital• Slower physical recovery• Anxiety / distress /
embarrassment• Reduced quality of life
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What do you do if you think that someone has a swallowing problem?
Stop! Report to the nurse immediately
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Vulnerable patients – Issues for discussion
Involving mealtime volunteers with patients who:-
• have swallowing problems??? • are challenging because of their behaviour??• Need to be fed??
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Thank you for listening
Any comments, questions?