NA: Supporting Care for Dysphagia

presented by Wanda Goldschmidt, RN, BSN, MA

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Financial— Wanda Goldschmidt receives compensation from MedBridge for the production of this course. There are no other relevant financial relationships. Nonfinancial— No relevant nonfinancial relationship exists.

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Video Runtime: 28 Minutes

Dysphagia, or difficulty swallowing, results from damage to the brain that interferes with control of the muscles in the mouth and throat. This condition occurs more frequently in older adults, and presents a major challenge for staff working in long-term care. It is estimated that 40% of long-term care residents suffer from dysphagia. The risks associated with dysphagia are high. The person with difficulty swallowing will have difficulty eating. If a person cannot eat well, inadequate nutrition and hydration can easily result. Poor nutrition and hydration can lead to other problems that threaten one's health. Difficulty eating also increases the risk of choking, which increases the risk of aspiration pneumonia, which can be deadly--especially in an older person. A primary responsibility of the nursing assistant in long-term care is to assist residents with meals. Since dysphagia affects eating, the nursing assistant must be armed with knowledge and skills to provide supportive interventions at mealtimes, and carefully observe, respond, and report any problems or complications. This course will explain dysphagia and provide guidance to the nursing assistant on how to support the resident during meals to minimize risks and prevent complications.

Meet Your Instructor

Wanda Goldschmidt, RN, BSN, MA

Wanda Murray-Goldschmidt, a life-long resident of Baltimore, Maryland, found her passion for working with older adults while working as a nursing assistant in a nursing home shortly after completing high school. That passion sparked her pursuit of nursing as a career. She first completed a hospital-based program of study to become a licensed practical nurse…

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1. Dysphagia: What Are We Going to Learn?

This introductory chapter provides an overview of what the nursing assistant will learn in this course about dysphagia in the long-term care environment. A case scenario is presented to introduce the nursing assistant to a sampling of residents who are experiencing dysphagia, and is used to highlight why the nursing assistant should be motivated to learn about this topic. Specific learning objectives are identified that reflect what the nursing assistant will be able to do upon completion of this course.

2. Dysphagia: A Major Care Challenge in Long-Term Care

This chapter lays the foundation for understanding dysphagia and why dysphagia presents a major care challenge for the nursing assistant in long-term care. Dysphagia will be defined and explained to provide a basis of understanding of the condition and its causes. This chapter will also include a discussion of the impact that dysphagia has in long-term care, in terms of the number of residents affected, risks, and associated challenges of providing care. Using the case scenario as a point of reference, the nursing assistant is guided to reflect on how dysphagia impacts daily workflow and the ability to meet the needs of multiple residents.

3. Recognizing Dysphagia

The nursing assistant provides observation of the resident and assistance with food and fluid intake. It is important to know what to look for during food and fluid intake so that signs of dysphagia can be detected and reported. The case scenario is used to engage the nursing assistant in identifying signs and symptoms. The nurse must be aware of possible symptoms of dysphagia in order to facilitate thorough assessment and treatment. This chapter will highlight key observations that should be reported to the nurse.

4. Supportive Care for Dysphagia

A resident with dysphagia must still maintain adequate nutrition and hydration, but special care is needed when providing food and fluid to minimize the risk of choking and aspiration. This chapter outlines the supportive measures that are necessary to avoid the complications of dysphagia. It introduces all the members of the interdisciplinary team and their respective roles in dysphagia care. Supportive care techniques that promote safety and minimize mealtime risks are reviewed, including modified diets, thickened liquids, positioning, and other feeding techniques. Skill demonstrations are included.

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