Griffin, Hannah ORCID: https://orcid.org/0000-0001-6874-9825, Wilson, Jennie, Tingle, Alison, Görzig, Anke ORCID: https://orcid.org/0000-0002-7623-0836, Harrison, Kirsty, Harding, Celia ORCID: https://orcid.org/0000-0002-5192-2027, Aujla, Sukhpreet, Barley, Elizabeth and Loveday, Heather (2024) Supporting safe swallowing of care home residents with dysphagia: How does the care delivered compare with guidance from speech and language therapists? International Journal of Language and Communication Disorders. ISSN 1368-2822 (Print), 1460-6984 (Online) (doi:10.1111/1460-6984.13015)

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Abstract

Introduction
Dysphagia affects up to 70% of care home residents, increasing morbidity and hospital admissions. Speech and language therapists make recommendations to support safe nutrition but have limited capacity to offer ongoing guidance. This study aimed to understand if recommendations made to support safe and effective care are implemented and how these relate to the actual care delivered.
Methods
Eleven mealtimes with residents with dysphagia were observed during 2020 using a tool capturing 12 elements of expected practice. Staff actions during mealtimes were compared with adherence to residents’ care plans and speech and language therapist recommendations.
Results
Written recommendations predominantly focused on food and fluid modification. Observations (n = 66) revealed food texture, posture, and alertness were adhered to on 90% of occasions, but alternating food and drink, prompting and ensuring swallow completed adherence was less than 60%. Thickened fluids frequently did not align with required International Dysphagia Diet Standardisation Initiative levels. Nutrition care provided in the dining room was less safe due to a lack of designated supervision.
Conclusion
Care homes need to be supported to establish a safe swallowing culture to improve residents’ safety and care experience.

Item Type:	Article
Uncontrolled Keywords:	dysphagia; speech and language therapy; care homes; safety and care
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM)
Last Modified:	29 Jan 2024 10:33
URI:	http://gala.gre.ac.uk/id/eprint/45493

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