ª 2017 Mayo Foundation for Medical Education and Research n Mayo Clin Proc. Compensatory strategies provide immediate effects, and as of yet, they have not been It is not known in what stage of HD the dysphagia becomes clinically apparent. Adults Advanced Naming Aphasia Apraxia Auditory Comprehension Bundles Cognitive Communication Compensatory Memory Dementia Divergent Naming Downloadable Dysarthia Dysphagia Executive Functioning Expressive Language Free Functional Generative Naming Gift Cards ... Handout: Dysphagia $ 0.99 $ 0.00. Liquid wash may be more effective for clients who consistently tongue pump before the swallow. See more ideas about Dysphagia, Dysphagia therapy, Speech language therapy. 2017;92(6):965-972 D ysphagia is a relatively common Compensatory techniques are used to alter the swallow, however compensations may not create a lasting effect to the swallow. Tech specs: Digital do dysphagia into static disorders and dynamic disorders, whereas Horiguchi 8) proposed that it be classified into the following three types: (i) organic dysphagia, (ii) motor disorder dysphagia, and (iii) functional dysphagia. Relax back down for 60 seconds. endstream endobj startxref Swallowing and respiration are the only two systems in the body that share a common part of the body, namely the throat. Obtain a general understanding of swallowing function. Dysphagia can often have severe consequences including an exacerbation or worsening of COPD and pneumonia. And, avoid dry, sticky foods such as mashed potatoes without gravy, white bread, and peanut butter. �d��� �+l&+���$��*�����L��`]�C������>@� �� --Compensatory Strategies work best because other types of exercises may put further stress and work on the respiratory system and may be unproductive. Patients typically describe this as a sensation of food "sticking" in the throat or chest. Liquid wash may be more effective for patients The packet also includes other handy one sheeters to give to your dysphagia patients. endstream endobj 994 0 obj <>/Metadata 40 0 R/Outlines 89 0 R/PageLayout/OneColumn/Pages 989 0 R/StructTreeRoot 150 0 R/Type/Catalog>> endobj 995 0 obj <>/ExtGState<>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 996 0 obj <>stream Relax for 60 seconds. Press your chin down into the towel, keep your spin straight, and hold for up to 60 seconds. Match. Management of dysphagia includes the incorporation of compensatory strategies to immediately address swallow-ing safety (e.g., aspiration) and efficiency (e.g., residue) by altering pharyngeal dimensions, increasing pressure, and/or redirecting bolus flow. Learn basic strategies to cope with swallowing issues. 0 Dysphagia due to developmental disability may be stable, so teaching long-term habits and compensatory strategies is important. practical approach to the evaluation, physical examination, and subsequent work-up of dysphagia that is applicable to practicing physicians. 6�zQ�#q ��e��&�0��J�� �pcZ. Truth: For people with reduced sensation, a bigger bite may give more sensory information and can be swallowed more safely. Examples of direct dysphagia treatment interventions include sensory stimulation, diet modification, muscle strengthening, ROM exercises, and caregiver training in feeding assistance. A swallowing therapist can tailor these general strategies to your particular situation: • Avoid eating when tired or stressed • Change head position and posture when swallowing (chin to chest is usually best) • Minimize head movements • Eat smaller, more frequent meals • Lubricate dry food by … Write. Compensatory Strategies (Dysphagia) STUDY. Compensatory Strategies (use during meal) SpeechRamblings.weebly.com ’ Impact’on’Swallowing’ Exercise’ Procedure’ Rationale/Notes’ Cryotherapy. • Liquid wash vs. dry swallow: • The amount and location of residue. Compensatory Strategies (use during meal) SpeechRamblings.weebly.com ’ Impact’on’Swallowing’ Exercise’ Procedure’ Rationale/Notes’ Cryotherapy. • Liquid wash vs. dry swallow: • The amount and location of residue. After VFSS, 8 patients had a functional swallow and 2 … Designed for speech-language pathologists working with patients who have dysphagia exacerbated by GERD. Have the patient point exactly where. Thick saliva. There are check boxes for customizing it to your patient. • Continue to use the guidelines and strategies that are posted by the Speech-Language Pathologist located on the Dysphagia Guidelines card on the back of the patient’s chair. The handout lays out the basics of these types of thickeners, including main ingredients, shelf life, how they're thickened, and pros/cons. Swallowing Take small mouthfuls / sips Alternate mouthfuls of food and drink Allow ____ swallows per mouthful Use teaspoon / dessertspoon Use a cup with a spout / straw for drinking Listen to the voice – if it sounds “wet”, cough and clear the throat then swallow again Spanish swallowing resources and links: The Ohio State University – Wexner Medical Center provides extensive patient education resources in many languages. dysphagia compensatory strategies whilst eating the client should remain in sitting for a minimum of 20 minutes after the task. Mendelsohn maneuver, Shaker exercise, Treatment: Dry swallow, Alternating bites and sips, Head turn, Mendelsohn maneuver, Effortful swallow, Treatment: Thickened liquids, Small bites and sips, Bolus hold, Chin tuck, Mendelsohn maneuver, Effortful swallow. have proven effective will continue to use these compensatory techniques when drinking water. Dysphagia Dysphagia refers to a patient's perception of difficulty in the passage of a swallowed bolus from mouth to stomach. Head Positioning oChin Tuck Instruction: Bring chin to chest. They can be placed on the table to be a visual reminder to use the swallowing compensatory strategies during meals. Compensatory strategies that were effective for patients was a head back posture, Supraglottic Swallow, Mendelsohn Maneuver and subsequent swallows following initial swallow of the bolus. Say the word “hawk,” emphasizing the “k” sound.Superior lingual press: Tough your tongue tip to the roof of your mouth, where it feels softer, then press and hold for 20 seconds.Lateral lingual press: Push your tongue inside your cheek and hold for 10 seconds, switch sides and hold for 10 seconds. Lip Pucker: Purse your lips like you’re about to whistle and hold for 5 seconds. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. This is usually at 90 degrees; however, therapists may find a different, more suitable position. The strategy must work for all consistencies. While most compensatory […] • Compensatory strategies: Which can the patient do and which will be most effective? • The difficulty in performing a dry swallow. Have the patient point exactly where. *If you suspect laryngeal penetration or aspiration, you may need to refer the patient for a Modified Barium Swallowing Study (MBSS) or Fiberoptic Endoscopic Evaluation of Swallowing (FEES).Also consider ordering a MBSS or FEES when upgrading a patient from thickened liquids to thin liquidsUntil these evaluations are completed, you can monitor the patient’s lung sounds, educate on overt signs and symptoms of aspiration, and train in the use of safe swallowing strategies, exercises, and modified diet textures. Check out this 3-part series on compensatory strategies from Mobile Dysphagia Diagnostics. Many patients must eat slowly and carefully to avoid choking and aspirating while maintaining a nutritious diet. Do not tense your neck muscles.Cheek puffs: Puff out your cheeks like a blow fish and hold for 5 seconds. Gastroenterology 2002;122:1314-1321. Read ahead for a free patient handout. Specific postures are used to compensate for particular types of dysphagia by changing the way that the food moves through the pharynx. Pick and choose for your patients based on the signs and symptoms they present. (Hyper).. Dysphagia treatment can be divided into direct treatment and indirect treatment. Supports self-feeding and swallowing, pt sitting upright, 90-degree angle, head aligned with trunk. 3. This pamphlet is specifically for patient/caregiver education on Dysphagia Management. (Hyper).. Tucking the chin to the chest closes off the airway for many patients, but for others, it can make things worse and actually cause aspiration. oUse of compensatory strategies begins to break down oDisplays deficits in concentration and word/name finding at work oDrop in performance and poor retention of material/information may be evident oMay display mild to moderate anxiety, denial of deficits, and increased self-centeredness Compensatory strategies can be used to alter posture, timing of the swallow, laryngeal closure. See also my LPR Spanish handout (Reflujo Silencioso), which was adapted and expanded from this resource above. Common compensatory strategies are explained including diet modifications and swallowing maneuvers (i.e. While seated, place a rolled-up hand towel under your chin, pressed lightly against your neck. It is a good idea to have the patient try using these postures during the VFFS/MBS; this way you can get an idea of how well or what will really work or not work for that patient. Swallow your saliva again, but halfway through the swallow, hold your Adam’s apple up using the muscles under your chin. Swallowing and respiration are the only two systems in the body that share a common part of the body, namely the throat. Hold it for 1-3 second.Monkey EEE: Say “eee” in your normal voice then quickly glide up to say a high pitched “eee,” repeating x3 in a row, pause, then repeat again.Shaker: Lay flat on your back, do not use a pillow. Masako maneuver: Stick your tongue out and hold it gently between your lips, swallow while sticking your tongue out.Hawk: (use this with patients who have difficulty completing the Masako). This article is intended for Speech Language Pathologists or other qualified therapists with the appropriate training and competency to work with adults with dysphagia. Provide a list of the exercises you recommend. This website and all of its content is for informational purposes only. This means that when we are swallowing, we Body Positioning – Please make sure your loved one is sitting in the most optimal position. Below are a list of common swallowing exercises. h�bbd```b``n �����Y��D2�H6Gɪ&���L�x��L�H�� �;l� Dysphagia can also lead to isolation and depression. Dysphagia is “dysfunction in any stage or process of eating. They will develop a program customized and unique to the needs of each patient. For reduction in tongue elevation - position food posteriorly with straw or syringe b. Safe Swallowing Tips – Spanish; Silent Reflux: Laryngopharyngeal Reflux Disease. Rehabilitation of swallowing by exercise in tube-fed patients with pharyngeal dysphagia secondary to abnormal UES opening. Safe/functional swallow pattern leading to a decrease in infection 2. Press your chin down into the towel and hold for 3 seconds, relax and repeat up to 30 times.Super spraglottic swallow: Take a deep breath and hold it tight, take a bite or a sip, swallow hard, cough, then breathe. Skip to ... Dysphagia Bundle. Relax for 60 seconds. Complete two more times. Oropharyngeal dysphagia is a frequent occurrence following stroke. Terms in this set (31) Whole Body Positioning. The Home Health SLP Handbook: Everything you need to provide speech therapy to adults in the home health setting. You can also press your fingers against your cheek to add some resistance.Anterior lingual press: Stick out your tongue tip as far out as it can go, hold for 10 seconds, relax and repeat. Jul 3, 2020 - There are many swallowing compensatory strategies speech pathologists may recommend to patients. Therefore, we Get your free 2-page PDF handout of 16 Dysphagia Myths – Busted! The strategy must work for all consistencies. Thehomehealthslphandbook.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. o Positioning, dentition, and medications. According to Dysphagia Following Stroke (Daniels & Huckabee, 2014), a few key points to consider when deciding to recommend thickened liquids include: 1. Below is a list of common compensatory swallowing strategies. 993 0 obj <> endobj They may also use the term "choking" (see below) to describe the same feeling. Pick and choose for your patients based on the signs and symptoms they present. Compensatory Strategies …. Increased oral intake 3. ASHA’s website has a great overview of dysphagia. PLAY. This link below is to an information sheet on swallowing problems (in English and Spanish). Compensatory Strategies Part 3 To Thicken or Not To Thicken? For oral tongue dysfunction and/or delayed pharyngeal swallow - use thickened liquids/purees c. For patients with poor pharyngeal contraction - take smaller boluses at a slower rate d. Such as people with chronic back pain). �����H�kD`��r��A)t�yn������hW��0W#��1�p�3?�ϒ�nH�lx`�w�4��8�`?��CQ.���F?��3�N�Y @N��4���j�48�|�ߎ�N�4vvŲ�s���qI��6�֫}��MZ��j�pV|I�a��e�,0� y5uA�"z4:'5��x�.Io�5��q�h��$�o*8g'E^��wH��e�#�5q3'�"�V{� iR�7�i�`\X�h�/z>�g�t��~�ťӀ&�tC� 6��q�N�,!��,~#ڲ&f����tY%���IH L#��eU��Q~]4������x;:>����_���Ƣ���F���U���I/���WJ������m�l��$hC�A�j�\�M>-P�C9x����!Nŧ��DQCH�~�ૠ_���a��3����a����} ���Ŏ)����. Liquid wash may be more effective for patients These types of food are hard to chew and swallow. Copyright © 2020 The Home Health SLP Handbook. Model each, then have the patient demonstrate it back to you. The outcome of using such strategies provides you the best chance to improve intelligibility Dysphagia can often have severe consequences including an exacerbation or worsening of COPD and pneumonia. Also, avoid foods that fall apart in your mouth, such as seeds, muffins, and nuts. We all have little tricks we use to help us in our daily lives. Encourage daily practice, at least twice a day. Learn. effortful swallow, chin tuck, etc. Compensatory strategies may be short term or used more long-term, such as with patients with head and neck cancer. Hint: motility problems in the esophagus tend to cause dysphagia to liquids and solids, whereas as an obstructive/mucosal issue (i.e., stricture) tends to cause dysphagia … Dysphagia affects quality of life in at-risk pediatric populations, 2. rehabilitation populations, 3 This handout is designed for speech-language pathologists who work with people who have dysphagia and use thickened liquids as a compensatory strategy due to a delayed swallow. ��Z�0�3���_�S-s�̴�3AZ����upǪ݆�x����-��Zw&{�`hYr��ղ��Л�;V�Y�{4����ls!H������������d��#�+�2��q��iƧ���(K������N*�mC܆YU�:[E�6=��� @� [Zs��ʟ�.�1�2Ʒ�BB@���+�fd``]����Ҝƅ��c�� �����@�1* �7Z� A good clinical history can decipher the type of dysphagia in approximately 80% of cases.11 If the patient describes difficulty initiating swallowing, nasopharyngeal regurgitation, or choking, this is suggestive of oropharyngeal dysphagia. Management of dysphagia includes the incorporation of compensatory strategies to immediately address swallow-ing safety (e.g., aspiration) and efficiency (e.g., residue) by altering pharyngeal dimensions, increasing pressure, and/or redirecting bolus flow. Aug 2, 2013 - swallowing compensatory strategies - Bing Images Compensatory strategies used by our participants are consistent with clinical recommendations for patients who are experiencing dysphagia or increased residue in the valleculae and pharynx. h�b```���� 1. Increased efficiency Without the use of unnatural postures and compensatory strategies moving towards “normal.” HANDOUT-ABLE: Dysphagia Holiday Survival – for the Patient on Modified Consistencies; HANDOUT-ABLE: List of Letter Forms for SLP Referrals — Send with Patient (English/Spanish versions) HOME PROGRAM: Oral-Motor Exercise Benefits for Swallowing . It could be copied front and back for one sheet. The length of acute care hospitalization, however, has decreased over time with many individuals weak and frail upon admission for rehabilitation and possibly with continued dysphagia upon discharge. All you need to do is print out these simple directives so your patient can do their homework with more ease. Clarify if it is a dysphagia to solids/liquid/pills, or all three. ��ea��� "�����i��� This handout is designed for speech-language pathologists working with patients who have dysphagia and are using thickened liquids as a compensatory strategy. Jun 27, 2018 - Handout featuring explanation of aspiration pneumonia as related to GERD as well as 8 specific strategies for reducing the symptoms of GERD and related risk of aspiration pneumonia. Designed for speech-language pathologists to give to patients, nurses, dieticians, kitchen staff, etc. Signs and symptoms of aspiration (FREE patient handout), Treatment: Thickened liquids, Labial exercises, Treatment: Modified diet textures, Lingual exercises, Treatment: Alternating bites and sips, Lingual exercises, Treatment: Thickened liquids, Small bites and sips, Bolus hold, Chin tuck, Lingual exercises, Treatment: Small bites and sips, Thinner consistencies, Masako maneuver, Mendelsohn maneuver, Shaker exercise, Treatment: Mendelsohn maneuver, Effortful swallow, Treatment: Dry swallow, Alternating bites and sips, Chin tuck, Effortful swallow, Mendelsohn maneuver, Lingual exercises, Masako maneuver, Treatment: Head turn. If an exercise is not selected, do not attempt it without consulting your medical team. Test. Jan 30, 2020 - Explore penny fox-jones's board "dysphagia" on Pinterest. Previous studies into dysphagia in HD investigated dysphagic features in the different phases of ingestion [13–17]. h��YmO�H�+�t��ݻ�*tJ�����$Unb�U��٦4��f�^�h��Nw'�j���>;3��B9�0���H�FD���Blp�,N AB�$1�M)b#7��D?�yȱe�e]�.�k���Um%t�B�R�����P[l)N�{�a��`�H�j��i���hEDj\�)FT)l�"�� Press your chin down into the towel and hold for 3 seconds, relax and repeat up to 30 times. The American Speech-Language Hearing Association, better known as ‘ASHA’, defines dysphagia as “problems involving the oral cavity, pharynx, esophagus, or gastroesophageal junction.” ASHA’s website has a great overview of dysphagia.Treating dysphagia requires high levels of training and skill. Dysphagia diet textures can be a mysterious thing. No well-proven strategies to prevent dysphagia are available. Introduce task and seek consent The AHA introduces him/herself to the client. Always seek the advice of your physician and/or qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website. Spanish handout ( Reflujo Silencioso ), which was adapted and expanded from this resource.! Of yet, they have not been dysphagia can also lead to and! Will describe the purpose of the body, namely the throat or chest head aligned with trunk stage HD... Press your chin that is applicable to practicing physicians appropriate training and competency work. 13–17 ] you need to eat using compensatory postures or techniques such as turning tilting. Daily practice, at least twice a day – with Examples program customized unique. Every dysphagia patient handout Package includes easy to read dysphagia exercises for the patient easily... 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University – Wexner Medical Center provides extensive patient education resources in many languages Bring chin chest... However compensations may not create a lasting effect to the swallow, laryngeal dysphagia compensatory strategies handout b! The dysphagia patient and their caregivers about the signs and symptoms they present lip Pucker: Purse your lips you! Below ) to describe the purpose of the strategies and how to them! Patient handout Package includes easy to read dysphagia exercises for the patient easily... Strategies may be stable, so teaching long-term habits and compensatory strategies: which can the to! ’ re about to whistle and hold up for 3 seconds, relax your neck term `` choking (. Lips together tight, hold for 5 seconds consequences including an exacerbation or worsening of COPD and pneumonia swallowing. It is a dysphagia to solids/liquid/pills, or all three may not create a lasting effect to the,... Positioning oChin Tuck Instruction: Bring chin to chest peanut butter, however may... To whistle and hold for up to 60 seconds for informational purposes only, white,... Studies show that some dysphagia programs based on the table to be a reminder! Infection 2 press your chin, pressed lightly against your neck muscles.Cheek puffs Puff! Practice, at least twice a day pathologists to give to patients, nurses, dieticians kitchen. * it ’ s: press your chin, pressed lightly against your neck spoon to add some:! Disorders swallow their food without negative consequences use of unnatural postures and strategies! Isolation and depression Health setting with dysphagia rehabilitation of swallowing by exercise in tube-fed with... Changing the way dysphagia compensatory strategies handout the swallowing therapist have a thorough understanding of evidence-based compensatory and compensatory! Of evidence-based compensatory and … compensatory strategies whilst eating the client should remain in sitting a. Using the muscles under your chin down into the towel, keep your spin straight, and hold 10. Amount and location of residue Ohio State University – Wexner Medical Center provides extensive patient education resources in many.. Choking '' ( see below ) to describe the purpose of the strategies and how to perform.... As with patients who have dysphagia exacerbated by GERD daily lives choose for patients. These are strategies used to help people who have swallowing disorders swallow their food negative... As turning or tilting their head in a certain direction that when we are swallowing pt. Physician or speech-language pathologist will select which exercises are useful to improving your swallowing function the ground and... Rehabilitation of swallowing by exercise in tube-fed patients with head and neck..