Interprofessional Collaborative Practice in Long-Term Care: Swallow Training

Abstract

Oropharyngeal dysphagia is common in elders living in long-term care facilities. Nasogastric tubes are used in place of normal eating when severe swallowing disorders affect oral intake. Swallowing training is usually delivered by a speech therapist who uses different food textures for training at different stages, depending on the severity and progression of the disorder. The amount and texture of foods are adjusted by the dietitian based on an elder's ability to eat. The current care model allows the specific preferences and experiences of the implementing specialist to guide delivery of swallowing training and thus lacks comprehensive discussion and planning, which may result in interventions failing to achieve their expected effect. In this study, we discuss how to implement the professional integration of dietitians and speech therapists, set goals for nutrition improvement and safe oral eating for the elderly with swallowing disorders in long-term care facilities. Swallowing training protocols and diet for each stage, texture adjustment, design, and caregiver guidance to prepare quantitative diets are provided to enhance the effectiveness of swallowing training. It is expected that implementation of the holistic care model presented in this study will improve quality of life in patients with oropharyngeal dysphagia, meet the expectations of both patients and family members, and help realize the professional core value of "case-centered".