Instrumental swallowing assessment in adults in residential aged care homes : Practice patterns and opportunities

Journal article


Birchall, Olga, Bennett, Michelle, Lawson, Nadine, Cotton, Susan M. and Vogel, Adam P.. (2023). Instrumental swallowing assessment in adults in residential aged care homes : Practice patterns and opportunities. Australasian Journal on Ageing. 42(1), pp. 108-117. https://doi.org/10.1111/ajag.13122
AuthorsBirchall, Olga, Bennett, Michelle, Lawson, Nadine, Cotton, Susan M. and Vogel, Adam P.
Abstract

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.

Keywordsdeglutition; delivery of health care; dementia; referral and consultation; residential facilities
Year2023
JournalAustralasian Journal on Ageing
Journal citation42 (1), pp. 108-117
PublisherJohn Wiley & Sons Australia, Ltd
ISSN1741-6612
Digital Object Identifier (DOI)https://doi.org/10.1111/ajag.13122
PubMed ID35938310
Scopus EID2-s2.0-85135512013
Open accessPublished as ‘gold’ (paid) open access
Page range108-117
FunderResearch Training Program Scholarship (RTP), Australian Government
National Health and Medical Research Council (NHMRC)
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online08 Aug 2022
Publication process dates
Accepted12 Jul 2022
Deposited10 Aug 2023
Grant ID1136344
1135683
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