1. Identify the 3 phases of swallowing (oral, pharyngeal, esophageal) and conditions causing potential dysphagia
2. LIst 5 factors (clues) that a patient may be at risk for aspiration
3. List treatment options for aspiration (swallowing exercises, position changes, dietary modification)
This exercise is designed to cover the practical aspects of swallowing and dysphagia. It's goal is to help learners identify risk factors for aspiration in older adults and to be able to then implement an initial assessment plan to evaluate the condition further. Trial of the liquids is done to increase empathy and understanding of the risks and benefits of modifying liquid consistence for patients and the challenges of postural and behavioral modifications as well. The teacher/facilitator does not need to be an expert in swallowing and dysphagia. The materials provided are an initial point for teaching and the Frequently Asked Questions/References (Ask the Speech Therapist Sheet) is designed to supplement the session and to provide a starting place for further study.
While the session is most easily taught as a small group session (6-8 learners), it was taught at the American Geriatrics Society Clinical Skills session to approximately 60 learners. The small group portions were completed by having learners work with one or two persons next to them to complete the Dysphagia Etiologies Chart, and liquids were passed on trays.
Materials needed for the session:
1. Session Agenda - facilitator (one)
2. Session Agenda - Participants (one for each participant)
3. PowerPoint presentation with included 5 video clips
4. Dysphagia Etiologies sheets - blank (one for each participant or for each small group)
5. Dysphagia Etiologies sheet - answer key (one for the facilitator)
6. Nectar and honey consistency thickened liquids. These may be made with a starch/thickener product such as "Thickit" (mix the starch with water according to ratios in the product directions - be aware that the liquids thicken further upon standing, so you may need to thin the liquid out with more water), or by purchasing pre-thickened liquids in the two consistencies ( a more expensive, but easier approach). It is a time-saver and stress-reducer to have the liquids prepared in the small cups prior to the session. They may be place on the table or passed around via a tray. It is important to identify which liquid (nectar or honey thickened) is in which cup. This may be done with a marker "N" or "H" on the cups, or by simply using two different style/color of cups.
7. Small, disposable cups (2 per learner)
8. Spoons and napkins, tray (optional)
9. Frequently Asked Questions/Reference Sheet