TY - JOUR
T1 - Instrumental swallowing assessment in adults in residential aged care homes
T2 - Practice patterns and opportunities
AU - Birchall, Olga
AU - Bennett, Michelle
AU - Lawson, Nadine
AU - Cotton, Susan M.
AU - Vogel, Adam P.
N1 - Publisher Copyright:
© 2022 The Authors. Australasian Journal on Ageing published by John Wiley & Sons Australia, Ltd on behalf of AJA Inc’.
PY - 2023/3
Y1 - 2023/3
N2 - Objective: To describe practice patterns in the use of instrumental swallowing assessment (ISA) for older adults in residential aged care homes (RACHs). Methods: A retrospective audit of medical records of residents living in RACHs in Melbourne, Australia to extract data on speech-language pathologist (SLP) involvement, indications for ISA and ISA practice patterns. Results: Medical files of 323 residents across four Melbourne facilities were reviewed. 36% (n = 115) of residents were referred to SLP for swallowing assessment. Referral to SLP was related to length of stay (U = 7393.00, p < 0.001), dementia status (χ2[1] = 7.06, p = 0.008), texture modification (χ2[1] = 93.34, p < 0.001) and an existing dysphagia diagnosis (χ2[1] = 112.89, p < 0.001). There were no referrals for ISA and no instances of ISA being used. Among 115 residents who were referred to SLP for swallowing assessment, there were 33 instances where ISA might be clinically relevant according to ISA indicators. Conclusions: Instrumental swallowing assessment is not being used for the management of swallowing in RACHs in Australia despite a clinical need for ISA and a potential role for ISA to improve swallowing care quality. Lack of timely ISA may fail to meet the complex health-care needs of older adults living with dysphagia in RACHs, increasing their vulnerability to complications of dysphagia and its management.
AB - Objective: To describe practice patterns in the use of instrumental swallowing assessment (ISA) for older adults in residential aged care homes (RACHs). Methods: A retrospective audit of medical records of residents living in RACHs in Melbourne, Australia to extract data on speech-language pathologist (SLP) involvement, indications for ISA and ISA practice patterns. Results: Medical files of 323 residents across four Melbourne facilities were reviewed. 36% (n = 115) of residents were referred to SLP for swallowing assessment. Referral to SLP was related to length of stay (U = 7393.00, p < 0.001), dementia status (χ2[1] = 7.06, p = 0.008), texture modification (χ2[1] = 93.34, p < 0.001) and an existing dysphagia diagnosis (χ2[1] = 112.89, p < 0.001). There were no referrals for ISA and no instances of ISA being used. Among 115 residents who were referred to SLP for swallowing assessment, there were 33 instances where ISA might be clinically relevant according to ISA indicators. Conclusions: Instrumental swallowing assessment is not being used for the management of swallowing in RACHs in Australia despite a clinical need for ISA and a potential role for ISA to improve swallowing care quality. Lack of timely ISA may fail to meet the complex health-care needs of older adults living with dysphagia in RACHs, increasing their vulnerability to complications of dysphagia and its management.
KW - deglutition
KW - delivery of health care
KW - dementia
KW - referral and consultation
KW - residential facilities
UR - https://www.scopus.com/pages/publications/85135512013
U2 - 10.1111/ajag.13122
DO - 10.1111/ajag.13122
M3 - Article
C2 - 35938310
AN - SCOPUS:85135512013
SN - 1440-6381
VL - 42
SP - 108
EP - 117
JO - Australasian Journal on Ageing
JF - Australasian Journal on Ageing
IS - 1
ER -