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Innovation in Nutritional Treatment for Dysphagia

Innovation in Nutritional Treatment for Dysphagia. Thérèse Dufresne, RD. 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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  1. Innovation in NutritionalTreatment for Dysphagia Thérèse Dufresne, RD

  2. 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 2

  3. Our client Scientific Partner Research Partners Sainte.Anne’s Hospital McGill University Technology Partner 3

  4. 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

  5. Dysphagia dys = difficulty phagein = eat Oral Phase - Preparatory - Transport Pharyngial Phase Oesophagial Phase from: ME Groher, Dysphagia: Diagnosis and Management 5

  6. Over 50 nerves and arteries

  7. Over 45 muscles

  8. Etiology of Dysphagia • Neurogenic Dementia Multiple Sclerosis CVA - Strokes Muscular Dystrophy Parkinson’s Disease Alzheimer’s Disease Huntington’s Disease • Inadequate dentition • Psychiatric Depression • Iatrogenic Conditions Medication Induced Injury Chemotherapy Radiotherapy

  9. Sainte.Anne’s Dysphagic Population per Diagnostic April 2005 – March 2006

  10. from: ME Groher, Dysphagia: Diagnosis and Management Prevalence of Dysphagia • Acute Care Setting:  30 to 35% • Chronic Care:  35 to 75% • In Canada: 400,000 dysphagic persons 98,200 institutionalized dysphagic persons

  11. Traditional Modified Texture Diet • Unappealing • Diluted (↓nutrients, ↓taste) • Unrecognizable • No quantification nor standardization of texture • No demonstrated efficiency to treat dysphagia 11

  12. 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 12

  13. A Revolutionin the Nutritional Treatment of Dysphagia The Joy of Eating back on the menu! • 40 main entrees • Normal looking • Minced & Pureed • Meats, poultry & fish • Pasta 13

  14. Epikura’s Fresh Tasting Veggies • 10 Vegetables • Cooked & Raw • Puréed 14

  15. Epikura’s Sweetness • 9 Cakes • 6 Fruits • Puréed 15

  16. Tasting Break • Awareness of 3 phases of swallowing • Dysphagic swallow • Food Descriptors - Compaction vs aeration • Particle size • Cohesiveness • Adhesivene • Syneresis • Taste profile: intensity of flavours

  17. 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 17

  18. For the Joy of eating and a taste af life! After : 82 kg Before: 60 kg 18

  19. A Unique Technology which offers: • 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 19

  20. Implementation Support • Expert Team • Consulting and training 20

  21. 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 21

  22. Strategy, steps and calendar • Impact analysis • Identification of operational needs • equipements • procedures, recipes, menus, … • Communications • Operation team • Admin and multi team • Nursing team 22

  23. Now available for the Canadian Health Centres

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