If you know of someone who has had a brain or neck injury, has Parkinson’s disease, has had a stroke, is a child or adult with a developmental condition, has motor neurone dieases or is in an aged care centres, the chances are very high that you will personally know someone who has some level of swallowing difficulty.
When you stop to think about it, swallowing is something we do a lot each day, whether it be with food or drink or just saliva, we do it and not even think about it.
It is actually an amazing process where the food enters the mouth and is then broken up into pieces which allow it to go down the oesophagus using the teeth and saliva, then the food has to be moved to the back of the mouth and the flap moved to prevent that food from going down into the lungs and causing choking, then it has to be pushed down toward the stomach.
Apparently the process using 32 paired muscles, and both sensory and motor nerves. It is really incredible that more of us do not experience that dreadful choking when we try to swallow.
Some foods and size of food s are more of an issue than others when it comes to swallowing difficulties. Alcohol and some medications can also contribute to issues with the swallowing process.
Food is such an important part of out lives, none more so that during our annual festivals, like Christmas. Special foods are often a key part of these festivals, for example plum pudding at Christmas, or Hot Cross Buns at Easter.
The experience of those with swallowing difficulties at these times is even more than during the rest of the year and these difficulties are often even more obvious to those surrounding them during these times. This cause much embarrassment and can become a reason for these people to start isolating themselves from social contact.
So what is the solution to enable these people with Dysphagia to be able to enjoy the foods we all do and not miss out on the joy of those special foods?
Texture modification will not give these people the experience of the crunch of hot chips as an example, but it will enable them to enjoy the flavour of all foods.
As of 01 May 2019, there will be a worldwide standard in place for texture modification of both foods and drinks. It uses a eight level system starting with the thinnest drink at a Level 0 through to a level 4 which is the thickest drink and food and ending with a level 7 with regular food.
It is designed to be used for both adults and children and will be in use in aged care centres, child care centres, hospitals and respite centres across Australia by the end of April.
The process starts with a Speech Pathologist assessing a person’s ability to swallow and recommending a suitable level from the new IDDSI Framework. The centre providing the food then ensures that that recommendation is recorded in the person’s file. The kitchen at that business then ensures that food of that level is available and then it is served to that person. For these people, there is an absolute requirement for continuous monitoring by those serving the food, as the level required may change without any warning.