Speech Pathology Articles

Downgrading a resident’s diet can actually make swallowing more difficult

A common response to a resident having a swallowing difficulty is for facility staff to downgrade their diet. There is a misperception that downgrading the diet will improve the situation, and that it’s only upgrading a diet that comes with risk.   Unfortunately this is not the case – it depends on the type of dysphagia. Depending on the cause and the stage of swallowing affected, changes to a texture modified diet or fluids (e.g. downgrading it) can actually exacerbate certain symptoms of dysphagia and swallowing difficulties. If changes are made that aren’t correct, then:

  •      Swallowing can actually be made more difficult if the downgrade is “too low” (e.g. if oesophageal dysphagia)
  •      The resident can still be at risk of aspiration and/or choking if the downgrade is “not low enough”

A review of evidence states that it is important that formal dysphagia screening protocols are in place and that nurses are trained to use them. Imagine the risk if a person who hasn’t had specific training in the management of dysphagia made a change and an incident occurred…

The bottom line?

Changes to texture modified diet and fluids should be made by specialists in dysphagia risk-management who work to reduce unnecessary modified diet & thickener use to maintain residents’ quality of life. Click here if your site isn’t receiving this type of service (or you’d like more information about training in this area).