Innovation in Nutritional Treatment for Dysphagia Thérèse Dufresne, RD.
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Transcript of Innovation in Nutritional Treatment for Dysphagia Thérèse Dufresne, RD.
Innovation in Nutritional Treatment for Dysphagia
Prophagia : a network of strategic alliances
– Synergy : together, we go faster & further
– Convergence of mission : quality of nutritional care for the Hospital client and LTC Resident
– Complementarity of compentencies
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Innovation in Nutritional Treatment for Dysphagia
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Our clientOur client
Technology Partner
Scientific PartnerResearch PartnersSainte.Anne’s HospitalMcGill University
Innovation in Nutritional Treatment for Dysphagia
Outline Overview of Dysphagia
– General Overview– Prevalence – Consequence
Epikura : a Novel Treatment for Dysphagia– Background– History– Results
Introduction to Food Rheology– Texture Parameters– Application to Nutritional Treatment of Dysphagia
Innovation in Nutritional Treatment for Dysphagia
Oral Phase - Preparatory - Transport
Pharyngial Phase
Oesophagial Phase
from: ME Groher, Dysphagia: Diagnosis and Management
Dysphagia dys = difficulty phagein = eat
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Innovation in Nutritional Treatment for Dysphagia
Etiology of Dysphagia
Dementia Multiple SclerosisCVA - Strokes Muscular DystrophyParkinson’s Disease Alzheimer’s DiseaseHuntington’s Disease
– Neurogenic
– PsychiatricDepression
– Iatrogenic ConditionsMedication Induced Injury Chemotherapy Radiotherapy
– Inadequate dentition
Innovation in Nutritional Treatment for Dysphagia
Cancer1%
Strokes12%
Parkinson's Disease
4%
Medication1%
Dentition35%
Dementia37%
Psychiatric Diseases
3%
Others5%Esophageal
Diseases1%
Sainte.Anne’s Dysphagic Population per DiagnosticApril 2005 – March 2006
Innovation in Nutritional Treatment for Dysphagia
Prevalence of Dysphagia
– Acute Care Setting: 30 to 35%
– Chronic Care: 35 to 75%
from: ME Groher, Dysphagia: Diagnosis and Management
– In Canada: 400,000 dysphagic persons
98,200 institutionalized dysphagic persons
Innovation in Nutritional Treatment for Dysphagia
Traditional Modified Texture Diet
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– Unappealing
– Diluted (↓nutrients, ↓taste)
– Unrecognizable
– No quantification nor standardization of texture
– No demonstrated efficiency to treat dysphagia
Innovation in Nutritional Treatment for Dysphagia
Consequences of dysphagia
– Dysphagia
– Slow eating – Choking– Fear to eat or drink
– Reduced food intake
– Undernutrition, frailness, decreased quality of life, decreased autonomy, increased infections, pneumopathies and cost of care
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Innovation in Nutritional Treatment for Dysphagia
A Revolution in the Nutritional Treatment of Dysphagia
– 40 main entrees– Normal looking– Minced & Pureed– Meats, poultry & fish– Pasta
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The Joy of Eating back on the menu!
Innovation in Nutritional Treatment for Dysphagia
Epikura’s Fresh Tasting Veggies
– 10 Vegetables– Cooked & Raw– Puréed
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Innovation in Nutritional Treatment for Dysphagia
– 9 Cakes– 6 Fruits– Puréed
Epikura’s Sweetness
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Innovation in Nutritional Treatment for Dysphagia
Tasting Break
1. Awareness of 3 phases of swallowing2. Dysphagic swallow3. Food Descriptors
- Compaction vs aeration
- Particle size
- Cohesiveness
- Adhesivene
- Syneresis4. Taste profile: intensity of flavours
Innovation in Nutritional Treatment for Dysphagia
Randomized Clinical Study 1999 (n=17)
A Demonstrated Efficacy (Germain et al, JADA, Oct. 2006)
The BMI of the Treated Subjects increases from 22 to 24 in 12 weeks while the BMI of Control Subjects remains low
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Innovation in Nutritional Treatment for Dysphagia
For the Joy of eating and a taste af life!
Before: 60 kg After : 82 kg
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Innovation in Nutritional Treatment for Dysphagia
– Something for every taste, every day– Offers the dysphagic clientèle a balanced
and varied diet– Competitive prices– Fresh food, pure ingredient– Handy frozen individual portions
A Unique Technology which offers:
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Innovation in Nutritional Treatment for Dysphagia
Implementation Support
– Expert Team
– Consulting and training
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Innovation in Nutritional Treatment for Dysphagia
Objectives and Indicators
– consumption of meals served (or food intake: protein, energy, …)
– variety of foods consumed
– weights (BMI) and nutritional status of residents – meal appreciation by patients
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Innovation in Nutritional Treatment for Dysphagia
Strategy, steps and calendar– Impact analysis
– Identification of operational needs – equipements– procedures, recipes, menus, …
– Communications– Operation team – Admin and multi team – Nursing team
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