Swallowing

Speech and language therapists play an important role in supporting adults who have eating, drinking and swallowing difficulties (dysphagia) to eat and drink safely.  They do this by working directly with individuals or indirectly by training others, including families and the wide health and care workforce, to identify and manage problems.

Eating, drinking and swallowing difficulties have potentially life-threatening consequences.  They can result in choking, pneumonia, chest infections, dehydration, malnutrition and weight loss.  They can also make taking medication more difficult.

Swallowing difficullties

Dysphagia in adults is associated with a number of different conditions, including:

• Stroke
• Progressive neurological disorders, including dementia, Parkinson's disease, motor neurone disease, multiple sclerosis, and muscular dystrophy.
• Cancer, including head and neck, lung, and oesophageal
• Respiratory conditions, including chronic obstructive pulmonary disease, emphysema, and asthma
• Learning disability, developmental and acquired disorders
• Disorders of the immune system
• Traumatic brain injury

Acutely ill patients in critical care beds, including those with cervical spinal injuries and those with community-acquired pneumonia, Guillain-Barre and influenza can also have dysphagia.  Acid reflux can also result in swallowing difficulties.

How speech and language therapy can help

Speech and language therapists have a unique role in the assessment, diagnosis and management of swallowing difficulties.  They:

• Play a key role in the diagnosis of dysphagia
• Help people regain their swallowing through exercises, techniques and positioning
• Promote patient safety through modifying the texture of food and fluids, reducing the risk of malnutrition, dehydration and choking
• Promote quality of life, taking into account an individual's and their families' preferences and beliefs, and helping them adjust to living with swallowing difficulties
• Work with other healthcare staff, particularly dieticians, to optimise nutrition and hydration
• Educate and train others in identifying, assessing and managing dysphagia, including families and the wider health and care workforce

The impact of speech and language therapy

Early identification and management of dysphagia by speech and language therapists improves quality of life, and reduces the possibility of further medical complications and death.  Improved nutrition and hydration have an impact on physical and mental wellbeing.

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