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Hospital mealtime volunteers workshop

Hospital mealtime volunteers workshop . Julie Quinn Speech and Language Therapist (x2712) 21/12/12. By the end of the training you will have a better understanding of the:. Prerequisites for safe eating and drinking Process of normal swallowing

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Hospital mealtime volunteers workshop

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  1. Hospital mealtime volunteers workshop Julie Quinn Speech and Language Therapist (x2712) 21/12/12

  2. 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

  3. What do you need to do in order to eat and drink safely?

  4. The stages of the normal swallow

  5. 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

  6. 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?

  7. Stages of normal swallowingStage 1: Anticipatory phase • Environment • Sight, smell, touch • Hand to mouth • Saliva • Access • Health

  8. 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

  9. 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)

  10. 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

  11. The normal swallow animation http://www.linkstudio.info/images/portfolio/medani/Swallow.swf

  12. What can go wrong when eating and drinking?

  13. 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

  14. 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

  15. What are the main causes of swallowing problems (dysphagia)?

  16. 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

  17. 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

  18. What do you do if you think that someone has a swallowing problem? Stop! Report to the nurse immediately

  19. Vulnerable patients – Issues for discussion Involving mealtime volunteers with patients who:- • have swallowing problems??? • are challenging because of their behaviour?? • Need to be fed??

  20. Thank you for listening Any comments, questions?

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