Mid-term stay: 3–5 weeks
Smaller institutions may not employ a speech therapist and the detection of swallowing problems may fall to hospital staff at the point of patient admission.
The physiotherapist, dietician, auxiliary or nurse may all be exposed to the issue and have to assess the risk.
Nutrisens has devised a kit, the DSA Pack to help staff treat patients safely and teach staff how to react if something goes down the wrong way. We provided the kit, conducted a training session on its use and invited participants to follow a webinar on the subject.
The test was carried out on patients aged 70–80 with age-related neurological problems and prescribed by a doctor or recommended by carers suspecting swallowing problems. In 90% of cases, the test resulted in a change in the texture of the recommended diet, from grade 3–4 to 1–2.
Staff feedback on the use of the DSA pack
After a period of familiarisation with the practice and protocol, hospital staff found the kit easy to use and were able to assess the correct texture and grade to be administered.
However, they found the number of spoonfuls to be given between each stage too restrictive.
Patient feedback on the use of the DSA pack
Generally appreciated as long as the aim and the outcome of the test are explained. The change in texture is welcomed as it stimulates taste buds and increases hydration.
Follow-up is difficult as it is not part of normal practice but staff hope to introduce it so as to improve rehabilitation with suitably textured food and drink.
Ideas for tools were put forward: a measuring jug with graduations permitting to check fluid intake at a glance and a hydration monitor sheet to check the amount of thickened water given and consumed during the day.
Staff also expressed the wish to recommend thickened water to patients returning home to help them stay sufficiently hydrated on a long-term basis.