Thickener and beyond: an individualised approach to dysphagia management

Abstract

Use of thickener is a widely-known intervention in the management of oropharyngeal dysphagia, aiming to reduce the incidence of aspiration pneumonia. Thickener can benefit some patients with dysphagia, but does not reduce aspiration pneumonia in all patients and can pose other risks for physical health and psychological well-being. This article draws together current research to explore the benefits and risks of thickener and a range of less well-known interventions, many of which are delivered by nurses. It highlights an individualised approach to dysphagia management and case studies provide a context for management decisions. It concludes that thickener is one of a range of interventions carefully assessed by a speech and language therapist on an individual basis. Nursing observations and interventions are also essential in dysphagia management, with joint working recommended, especially for oral hygiene, fluid intake monitoring and support with feeding. All interventions recommended by speech and language therapists that are delivered by nurses are equally important in providing holistic, individualised treatment for patients with dysphagia.