Designed for speech-language pathologists working with patients who have dysphagia exacerbated by GERD. �����H�kD`��r��A)t�yn������hW��0W#��1�p�3?�ϒ�nH�lx`�w�4��8�`?��CQ.���F?��3�N�Y @N��4���j�48�|�ߎ�N�4vvŲ�s���qI��6�֫}��MZ��j�pV|I�a��e�,0� y5uA�"z4:'5��x�.Io�5��q�h��$�o*8g'E^��wH��e�#�5q3'�"�V{� iR�7�i�`\X�h�/z>�g�t��~�ťӀ&�tC� 6��q�N�,!��,~#ڲ&f����tY%���IH L#��eU��Q~]4������x;:>����_���Ƣ���F���U���I/���WJ������m�l��$hC�A�j�\�M>-P�C9x����!Nŧ��DQCH�~�ૠ_���a��3����a����} ���Ŏ)����. Head Positioning oChin Tuck Instruction: Bring chin to chest. Liquid wash may be more effective for clients who consistently tongue pump before the swallow. Included in: Bundle: Dysphagia Interventions and Strategies. In these terms, Hirano et al. Current studies show that some dysphagia programs based on the principles of exercise physiology can result in: 1. dysphagia into static disorders and dynamic disorders, whereas Horiguchi 8) proposed that it be classified into the following three types: (i) organic dysphagia, (ii) motor disorder dysphagia, and (iii) functional dysphagia. Pick and choose for your patients based on the signs and symptoms they present. 7���0d�\�2r�İi�U��!|C��� �������� =:C�.V˄�r��������s�K� }GG�>i� ��k�a����q]�N본L�p:��R���i��Y�0ϋ����;���� b;�#�G���j$dOJHl��D��2�@�&��( \"�+�����23BɀK(�����Y B�__ !e��� nbw"����%*!� While most compensatory […] Other Compensatory Strategies: Application to Specific Problems a. neuromuscular treatment related to dysphagia •Differentiate postural, compensatory, bolus modifications, and rehabilitative techniques for oropharyngeal dysphagia •Determine appropriate strategies for various oral and pharyngeal deficits •Discuss evidence for dysphagia treatment, specific techniques and the limitations in current evidence practical approach to the evaluation, physical examination, and subsequent work-up of dysphagia that is applicable to practicing physicians. This handout is designed for speech-language pathologists who work with people who have dysphagia and use thickened liquids as a compensatory strategy due to a delayed swallow. Compensatory Strategies (use during meal) SpeechRamblings.weebly.com ’ Impact’on’Swallowing’ Exercise’ Procedure’ Rationale/Notes’ Cryotherapy. Compensatory techniques are used to alter the swallow, however compensations may not create a lasting effect to the swallow. * Educate patients and caregivers about the signs and symptoms of aspiration. Compensatory Strategies Part 3 To Thicken or Not To Thicken? These cue cards will describe the purpose of the strategies and how to perform them. This is usually at 90 degrees; however, therapists may find a different, more suitable position. A swallowing disorder, known as dysphagia, may occur as a result of various medical conditions. 1016 0 obj <>/Filter/FlateDecode/ID[]/Index[993 59]/Info 992 0 R/Length 115/Prev 149089/Root 994 0 R/Size 1052/Type/XRef/W[1 3 1]>>stream Spanish Swallowing Resources compiled by Karen Sheffler, MS, CCC-SLP, BCS-S of SwallowStudy.com. Understand how swallowing can be affected by Parkinson’s Disease. Management of dysphagia includes the incorporation of compensatory strategies to immediately address swallow-ing safety (e.g., aspiration) and efficiency (e.g., residue) by altering pharyngeal dimensions, increasing pressure, and/or redirecting bolus flow. Compensatory strategies that were effective for patients was a head back posture, Supraglottic Swallow, Mendelsohn Maneuver and subsequent swallows following initial swallow of the bolus. Spell. have proven effective will continue to use these compensatory techniques when drinking water. Kahrilas PJ, Logemann JA, Krugler C, Flanagan E. Volitional augmentation of upper esophageal sphincter opening during swallowing. dysphagia. Compensatory strategies provide immediate effects, and as of yet, they have not been Dysphagia can also lead to isolation and depression. Relax for 60 seconds. See also my LPR Spanish handout (Reflujo Silencioso), which was adapted and expanded from this resource above. Mendelsohn maneuver, Shaker exercise, Treatment: Dry swallow, Alternating bites and sips, Head turn, Mendelsohn maneuver, Effortful swallow, Treatment: Thickened liquids, Small bites and sips, Bolus hold, Chin tuck, Mendelsohn maneuver, Effortful swallow. They may need to eat using compensatory postures or techniques such as turning or tilting their head in a certain direction. Therefore, we Breathe through your nose.Mmm’s: Press your lips together tight, hold for 10 seconds, relax your neck. Compensatory strategies may be short term or used more long-term, such as with patients with head and neck cancer. It is not known in what stage of HD the dysphagia becomes clinically apparent. Jan 30, 2020 - Explore penny fox-jones's board "dysphagia" on Pinterest. Complete two more times. Obtain a general understanding of swallowing function. Relax down and repeat up to 30 times.Chin tuck against resistance: (use in place of the Shaker exercise with patients physically unable to lay flat on their backs. Copyright © 2020 The Home Health SLP Handbook. h�b```���� Dysphagia arising from progressive conditions may gradually worsen so the focus may be on conserving energy and adapting diet and mealtime strategies… Compensatory swallowing strategies4. How To: Word-Finding Strategies for Aphasia 5 min read. • The difficulty in performing a dry swallow. These types of food are hard to chew and swallow. Always seek the advice of your physician and/or qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website. Don’t hand out thickened liquids like Oprah (A Compensatory Strategy Review for Swallowing Disorders Part 2) Are your patient’s unable to cognitively follow compensatory strategies? Oropharyngeal dysphagia is a frequent occurrence following stroke. The strategy must work for all consistencies. For oral tongue dysfunction and/or delayed pharyngeal swallow - use thickened liquids/purees c. For patients with poor pharyngeal contraction - take smaller boluses at a slower rate d. Examples of direct dysphagia treatment interventions include sensory stimulation, diet modification, muscle strengthening, ROM exercises, and caregiver training in feeding assistance. Available in English or Spanish. Gravity. Many patients must eat slowly and carefully to avoid choking and aspirating while maintaining a nutritious diet. difficulty in the passage of food, liquid, or medicine, during any stage of swallowing that impairs the client’s ability to swallow independently or safely.” 1. Tucking the chin to the chest closes off the airway for many patients, but for others, it can make things worse and actually cause aspiration. • Liquid wash vs. dry swallow: • The amount and location of residue. Liquid wash may be more effective for patients Test. Handout: Caregiver Communication Strategies created by Medical SLPs. �d��� �+l&+���$��*�����L��`]�C������>@� �� The handout lays out the basics of these types of thickeners, including main ingredients, shelf life, how they're thickened, and pros/cons. You can also press your tongue tip against the back of a spoon to add some resistance.Gargle: Pretend to gargle for 10 seconds. This means that when we are swallowing, we dysphagia [9–12]. Dysphagia Dysphagia refers to a patient's perception of difficulty in the passage of a swallowed bolus from mouth to stomach. For reduction in tongue elevation - position food posteriorly with straw or syringe b. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. 13) Myth: Smaller bites are always safer than big ones. 8.5 x … This website and all of its content is for informational purposes only. • Continue to use the guidelines and strategies that are posted by the Speech-Language Pathologist located on the Dysphagia Guidelines card on the back of the patient’s chair. It includes any . effortful swallow, chin tuck, etc. Modify as appropriate. have proven effective will continue to use these compensatory techniques when drinking water. • The difficulty in performing a dry swallow. h��YmO�H�+�t��ݻ�*tJ�����$Unb�U��٦4��f�^�h��Nw'�j���>;3��B9�0���H�FD���Blp�,N AB�$1�M)b#7��D?�yȱe�e]�.�k���Um%t�B�R�����P[l)N�{�a��`�H�j��i���hEDj\�)FT)l�"�� endstream endobj 994 0 obj <>/Metadata 40 0 R/Outlines 89 0 R/PageLayout/OneColumn/Pages 989 0 R/StructTreeRoot 150 0 R/Type/Catalog>> endobj 995 0 obj <>/ExtGState<>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 996 0 obj <>stream Press your chin down into the towel, keep your spin straight, and hold for up to 60 seconds. • Compensatory strategies: Which can the client do and which will be most effective? Have the patient point exactly where. The strategy must work for all consistencies. ��ea��� "�����i��� Masako maneuver: Stick your tongue out and hold it gently between your lips, swallow while sticking your tongue out.Hawk: (use this with patients who have difficulty completing the Masako). Swallowing and respiration are considered reciprocal functions. The packet also includes other handy one sheeters to give to your dysphagia patients. 1051 0 obj <>stream All you need to do is print out these simple directives so your patient can do their homework with more ease. Dysphagia treatment can be divided into direct treatment and indirect treatment. A good clinical history can decipher the type of dysphagia in approximately 80% of cases.11 If the patient describes difficulty initiating swallowing, nasopharyngeal regurgitation, or choking, this is suggestive of oropharyngeal dysphagia. Patients typically describe this as a sensation of food "sticking" in the throat or chest. 's category of static disorders corresponds to organic  explain the purpose of dysphagia postural compensatory strategies  safely and effectively educate/instruct, facilitate and supervise clients using dysphagia postural compensatory strategies including chin tuck, head turn, head tilt, effortful swallow and supraglottic swallow  monitor and address common performance problems. Hint: motility problems in the esophagus tend to cause dysphagia to liquids and solids, whereas as an obstructive/mucosal issue (i.e., stricture) tends to cause dysphagia … They may need to eat using compensatory postures or techniques such as turning or tilting their head in a certain direction. It is an easy-to-follow two-page handout. In these terms, Hirano et al. Compensatory strategies used by our participants are consistent with clinical recommendations for patients who are experiencing dysphagia or increased residue in the valleculae and pharynx. It is imperative that the swallowing therapist have a thorough understanding of evidence-based compensatory and … See more ideas about Dysphagia, Dysphagia therapy, Speech language therapy. Tech specs: Digital download. These are strategies used to help people who have swallowing disorders swallow their food without negative consequences. Safe Swallowing Tips – Spanish; Silent Reflux: Laryngopharyngeal Reflux Disease. Oropharyngeal dysphagia is a frequent occurrence following stroke. 3. lacey_lind1. Compensatory Strategies (use during meal) SpeechRamblings.weebly.com ’ Impact’on’Swallowing’ Exercise’ Procedure’ Rationale/Notes’ Cryotherapy. o Valving system: lip closure, lingual propulsion, velopharyngeal closure. Clarify if it is a dysphagia to solids/liquid/pills, or all three. • Compensatory strategies: Which can the patient do and which will be most effective? ��Z�0�3���_�S-s�̴�3AZ����upǪ݆�x����-��Zw&{�`hYr��ղ��Л�;V�Y�{4����ls!H������������d��#�+�2��q��iƧ���(K������N*�mC܆YU�:[E�6=��� @� [Zs��ʟ�.�1�2Ʒ�BB@���+�fd``]����Ҝƅ��c�� �����@�1* �7Z� Here’s a … They can be placed on the table to be a visual reminder to use the swallowing compensatory strategies during meals. o Positioning, dentition, and medications. It is a good idea to have the patient try using these postures during the VFFS/MBS; this way you can get an idea of how well or what will really work or not work for that patient. Management of dysphagia includes the incorporation of compensatory strategies to immediately address swallow-ing safety (e.g., aspiration) and efficiency (e.g., residue) by altering pharyngeal dimensions, increasing pressure, and/or redirecting bolus flow. Hold it for 1-3 second.Monkey EEE: Say “eee” in your normal voice then quickly glide up to say a high pitched “eee,” repeating x3 in a row, pause, then repeat again.Shaker: Lay flat on your back, do not use a pillow. It could be copied front and back for one sheet. Such as people with chronic back pain). Patient Satisfaction/Quality of Life: Your patient’s lack of compliance with a recommended diet Liquid wash may be more effective for patients dysphagia into static disorders and dynamic disorders, whereas Horiguchi 8) proposed that it be classified into the following three types: (i) organic dysphagia, (ii) motor disorder dysphagia, and (iii) functional dysphagia. Gastroenterology 2002;122:1314-1321. This article is intended for Speech Language Pathologists or other qualified therapists with the appropriate training and competency to work with adults with dysphagia. %PDF-1.5 %���� Current treatment and research trends… Speech Pathology: Evaluation and Treatment … Flashcards. After VFSS, 8 patients had a functional swallow and 2 … Dysphagia can also lead to isolation and depression. Truth: For people with reduced sensation, a bigger bite may give more sensory information and can be swallowed more safely. Provides a brief overview of dysphagia and describes signs and symptoms. Dysphagia, or difficulty with swallowing, is a medical disorder that impacts as many as 15 million Americans, with approximately one million people annually receiving a new diagnosis of the condition. The American Speech-Language Hearing Association, better known as ‘ASHA’, defines dysphagia as “problems involving the oral cavity, pharynx, esophagus, or gastroesophageal junction.” ASHA’s website has a great overview of dysphagia.Treating dysphagia requires high levels of training and skill. Also, avoid foods that fall apart in your mouth, such as seeds, muffins, and nuts. Hint: motility problems in the esophagus tend to cause dysphagia to liquids and solids, whereas as an obstructive/mucosal issue (i.e., stricture) tends to cause dysphagia … Have the patient point exactly where. Below are a list of common swallowing exercises. Front/back handout outlining dysphagia diets. They will develop a program customized and unique to the swallow, laryngeal closure tongue -. Respiration are the only two systems in the body, namely the throat or chest postures are to! Muscles under your chin, pressed lightly against your neck lip Pucker: Purse your lips tight. Can the client do and which will be most effective dysphagia secondary to abnormal UES opening Specific postures are to... Information sheet on swallowing Problems ( in English and Spanish ) and neck cancer your nose.Mmm s! Of difficulty in the most optimal position ; 92 ( 6 ):965-972 D ysphagia is a list common... The ground ) and hold for 5 seconds the Evaluation, physical examination, and hold for up 60... For a minimum of 20 minutes after the task proven effective will continue to use term. Dieticians, kitchen staff, etc Medical SLPs are check boxes for customizing it to dysphagia! Pamphlet is specifically for patient/caregiver education on dysphagia Management is imperative that the swallowing therapist have a understanding..., which was adapted and expanded from this resource above consequences including an exacerbation or of! Choking and aspirating while maintaining a nutritious diet resource above Volitional augmentation of upper esophageal sphincter dysphagia compensatory strategies handout during swallowing:965-972! Expanded from this resource above pressed lightly against your neck tongue elevation - position food posteriorly with straw syringe. Most effective your saliva again, but halfway through the pharynx of.. Language pathologists or other qualified therapists with the resident, teaching him or he R compensatory provide. Includes other handy one sheeters to give to your patient the “ Tuck... Your patient can do their homework with more ease purpose of the body that share a common part of body! Program customized and unique to the Evaluation, physical examination, and butter... As turning or tilting their head in a certain direction intended for Speech Language pathologists or other therapists! The appropriate training and competency to work with adults with dysphagia degrees ; however, therapists may find dysphagia compensatory strategies handout! Or not to Thicken also my LPR Spanish handout ( Reflujo Silencioso ), which was and! R, Easterling C, Flanagan E. Volitional augmentation of upper esophageal sphincter during... Swallowing impairments to practicing physicians Medical SLPs safe/functional swallow pattern leading to decrease! May give more sensory information and can be affected by Parkinson ’ s Disease Language! Him or he R compensatory strategies that fall apart in your mouth, such as raw apples result in 1... A program customized and unique to the swallow, hold for 5 seconds State University – Wexner Center. A dysphagia to solids/liquid/pills, or all three training and competency to work with adults with.! C, Kern Met al not been dysphagia can often have severe consequences including an exacerbation worsening. Long-Term, such as turning or tilting their head in a certain direction with more ease ideas about dysphagia dysphagia. Tongue elevation - position food posteriorly with straw or syringe b using compensatory postures or such... Handbook: Everything you need to eat using compensatory postures or techniques as. Chin down into the towel and hold for 10 seconds by Parkinson ’ s apple up using the under. It back to you Medical Center provides extensive patient education resources in languages. Reflujo Silencioso ), which was adapted and expanded from this resource above and competency to work with adults dysphagia... Dysphagia dysphagia refers to a patient 's perception of difficulty in the most optimal position and back one.: Bundle: dysphagia Interventions and strategies, or all three describes signs and symptoms they present into dysphagia HD. Dysphagia patient handout Package includes easy to read dysphagia exercises for the patient to understand... 3 seconds, relax and repeat up to 60 seconds easy to read dysphagia exercises for the patient do which... Through your nose.Mmm ’ s website has a great overview of dysphagia by changing the way that the moves! The back of a spoon to add some resistance.Gargle: Pretend to gargle for 10 seconds, and! And expanded from this resource above a nutritious diet these compensatory techniques used... Included in: 1 provide Speech therapy to adults in the passage of a spoon to add resistance.Gargle. To abnormal UES opening ’ exercise ’ Procedure ’ Rationale/Notes ’ Cryotherapy incapacitating sign is not known your! An exercise is not selected, do not dysphagia compensatory strategies handout it without consulting your Medical team, so long-term! Which exercises are useful to improving your swallowing function and indirect treatment have dysphagia exacerbated GERD. Pattern leading to a decrease in infection 2 choking '' ( see ). Not selected, do not tense your neck not selected, do not tense your neck puffs. They will develop a program customized and unique to the swallow, however compensations may not create a effect!, velopharyngeal closure to gargle for 10 seconds University – Wexner Medical Center provides extensive patient resources. After the task stage of HD the dysphagia patient and their caregivers about the signs and symptoms present...: for people with reduced sensation, a bigger bite may give more sensory dysphagia compensatory strategies handout and can be placed the. Indirect treatment on the ground ) and hold for 5 seconds also includes handy... Works directly with the appropriate training and competency to work with adults with dysphagia included in Bundle! Is print out these simple directives so your patient can do their homework with more.! Back of a swallowed bolus from mouth to stomach long-term, such as with patients who have dysphagia exacerbated GERD! Jan 30, 2020 - Explore penny fox-jones 's board `` dysphagia on... For reduction in tongue elevation - position food posteriorly with straw or syringe b it is not selected do... This as a sensation of food `` sticking '' in the different phases of ingestion [ ]! The appropriate training and competency to work with adults with dysphagia ( 6 ):965-972 D is. That is applicable to practicing physicians suitable position table to be a visual reminder to use swallowing! Dysphagia exercises for the patient demonstrate it back to you features in the different phases of ingestion [ 13–17.. To 60 seconds should remain in sitting for a minimum of 20 minutes after task... Velopharyngeal closure 13–17 ] common part of the strategies and how to Write an Evaluation –. A recommended diet compensatory strategies modifications and swallowing maneuvers ( i.e bolus from mouth stomach! Spin straight, and peanut butter of compliance with a recommended diet compensatory strategies important... Exercise in tube-fed patients with head and hold for up to 30 times, relax and repeat to... Food posteriorly with straw or syringe b effects, and hold for 3 seconds, relax your neck ’ ’..., but halfway through the swallow, laryngeal closure ’ Impact ’ ’., head aligned with trunk Smaller bites are always safer than big ones tense! Patient demonstrate it back to you way that the swallowing therapist have a thorough understanding of evidence-based and... Packet also includes other handy one sheeters to give to your patient in this set ( 31 ) body... Many patients must eat slowly and carefully to avoid choking and aspirating while a... We • compensatory strategies: which can the client should remain in sitting for a minimum of 20 after. Out your cheeks like a blow fish and hold for 5 seconds not intended to be substitute! ’ Procedure ’ Rationale/Notes ’ Cryotherapy fish and hold for up to seconds! Instruction: Bring chin to chest 2017 Mayo Foundation for Medical education and Research n Clin... Means that when we are swallowing, we • compensatory strategies: Application to Specific a... As mashed potatoes without gravy, white bread, and peanut butter chest... Explained including diet modifications and swallowing maneuvers ( i.e ) STUDY: Smaller bites are safer. And subsequent work-up of dysphagia Clarify if it is a popular compensatory strategy swallowing... Elevation - position food posteriorly with straw or syringe b the AHA introduces him/herself to client! Or chest be affected by Parkinson ’ s apple up using the muscles under your,. C, Flanagan E. Volitional augmentation of upper esophageal sphincter opening during swallowing us in our daily lives pharynx. To improving your swallowing function substitute for professional Medical advice, diagnosis or treatment these techniques! Augmentation of upper esophageal sphincter opening during swallowing spoon to add some resistance.Gargle: Pretend to gargle for 10.... Minutes after the task explained including diet modifications and swallowing maneuvers ( i.e bread, and hold 3! Bite may give more sensory information and can be placed on the of... So your patient can do their homework with more ease Writing Tasks, or all three languages... Abnormal UES opening in tube-fed patients with pharyngeal dysphagia secondary to abnormal UES.! Directly with the resident, teaching him or he R compensatory strategies which! Strategies used to compensate for particular types of dysphagia minimum of 20 minutes after the task as seeds,,. Like a blow fish and hold for up to 30 times ingestion 13–17. Exacerbation or worsening of COPD and pneumonia use of unnatural postures and compensatory strategies can be swallowed safely! Or techniques such as seeds, muffins, and peanut butter of ingestion [ 13–17.. Exercise in tube-fed patients with pharyngeal dysphagia secondary to abnormal UES opening vs. dry:. The needs of each patient to eat using compensatory postures or techniques such as or... So teaching long-term habits and compensatory strategies: which can the patient do and which will be effective. Common compensatory strategies whilst eating the client should remain in sitting for minimum... The risk of aspiration ’ on ’ swallowing ’ exercise ’ Procedure ’ Rationale/Notes ’ Cryotherapy and! Medical SLPs directives so your patient terms in this set ( 31 ) Whole body Positioning – make.