Understanding Dysphagia and the Role of IDDSI
Dysphagia, a disorder affecting swallowing, impacts approximately eight percent of the world’s population. This condition can manifest as difficulties in feeding, chewing, or swallowing, making certain foods and drinks a choking hazard or causing them to be aspirated into the airway. Dysphagia is prevalent across all age groups but is most commonly seen in infants and the elderly.
Causes and Consequences of Dysphagia
Swallowing difficulties can arise from various causes:
Cognitive Changes: Conditions such as dementia or brain injury.
Physical Changes: Issues like stroke or loss of muscle mass and strength due to aging.
Dysphagia is often linked to malnutrition, dehydration, and upper respiratory infections. Recognising the symptoms is crucial for early intervention. These symptoms include:
Drooling
Hoarse voice
Regurgitation
Unexpected weight loss
Heartburn
Coughing or choking when swallowing
Pain when swallowing
Difficulty chewing solid foods
Recurrent pneumonia
Importance of Dysphagia Diets and IDDSI
Many individuals with dysphagia require modified diets to ensure safety. The International Dysphagia Diet Standardisation Initiative (IDDSI), established in 2013 and implemented in the UK since April 2019, aims to standardise the terminology and definitions for texture-modified foods and thickened liquids. This standardisation enhances communication and minimises errors in food texture and liquid thickness, thereby reducing the risk of choking during patient transfers between care facilities.
For comprehensive information on IDDSI, visit www.iddsi.org. Updates are also available from the British Dietetic Association and The Royal College of Speech and Language Therapy.
Practical Tips for Managing Dysphagia
Proper positioning during meals is vital. Here are some guidelines:
Ensure the person is upright during eating and drinking.
Maintain this position for at least 30 minutes post-meal to prevent reflux.
Keep the head in a neutral position with the chin slightly down.
Recognising Adverse Signs During Mealtimes
Watch for these signs that may indicate dysphagia:
Coughing or clearing the throat during or after eating
Choking (inability to speak)
Food pocketing or residue in the mouth after swallowing
Dribbling or spilling food/drink from the mouth
Difficulty chewing or moving food in the mouth
Holding food in the mouth with difficulty initiating the swallow
Wet or bubbly-sounding voice during/after eating or drinking
Change in face colour or breathing pattern post-swallowing
Mealtime Matters Safety Pause
At Healthcare Ireland, we have implemented the "Mealtime Matters Safety Pause," an HSC regional framework to promote resident safety during meals. As part of this initiative, we ensure:
Care plans refer to IDDSI descriptors.
Staff understand and apply IDDSI descriptors for safe food and drink provision.
Staff can recognise and report signs of dysphagia.
Specialist advice from Speech and Language Teams (SALT) is sought when dysphagia risks are identified.
Consistency in care plans and risk assessments.
Mealtime Matters Safety Pause Regional Framework
By adhering to these guidelines and utilising the IDDSI framework, we aim to improve the safety and quality of life for those affected by dysphagia.
Dysphagia Awareness Training and Resources
For more information, the Northern Ireland Social Care Council (NISCC) have put together a comprehensive guide on Dysphagia awareness training and resources whire can he accessed here.