The Role of Instrumental Swallowing Assessment in Adults in Residential Aged Care Homes: A National Modified Delphi Survey Examining Beliefs and Practices

Birchall, Olga; Bennett, Michelle; Lawson, Nadine; Cotton, Sue; Vogel, Adam P.

doi:10.1007/s00455-021-10296-2

Cited by 7 publications

(18 citation statements)

References 41 publications

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“…No residents were referred for ISA in this study, similar to earlier research indicating ISA is not commonly used in managing swallowing in Australian RACHs 8 . Based on ISA indicators, 6 we identified 33 potentially missed opportunities for ISA.…”

Section: Discussionmentioning

confidence: 54%

“…Others may not have documented this need due to perceived clinical contraindications (e.g. heightened agitation increasing the risk of endoscope intolerance) and/or access barriers 8 . In Australia, residents must travel off‐site to an outpatient clinical setting to access ISA.…”

Section: Discussionmentioning

confidence: 99%

“…In Australia, SLPs agree there is a clinical need for ISA in swallowing evaluation and management in RACHs. 8 However, barriers relating to governance, staff/consumer knowledge and collaboration may result in ISA being underutilised. 8 No residents were referred for ISA in this study, similar to earlier research indicating ISA is not commonly used in managing swallowing in Australian RACHs.…”

Section: Discussionmentioning

confidence: 99%

“…8 However, barriers relating to governance, staff/consumer knowledge and collaboration may result in ISA being underutilised. 8 No residents were referred for ISA in this study, similar to earlier research indicating ISA is not commonly used in managing swallowing in Australian RACHs. 8 Based on ISA indicators, 6 we identified 33 potentially missed opportunities for ISA.…”

Section: Discussionmentioning

confidence: 99%

“…Timely, personalised dysphagia assessment and management in older adults minimises dysphagia‐associated complications including choking, dehydration, malnutrition, sarcopenia, aspiration, psychosocial sequalae and death 3 . Instrumental swallowing assessments (ISA), including videofluoroscopic swallowing studies and flexible endoscopic evaluation of swallowing (FEES), are commonly used in community and hospital settings to obtain more information about swallow anatomy/physiology than is possible through a clinical swallowing evaluation alone 4–8 . Instrumental swallowing assessments may be performed when indications for ISA 6 (e.g.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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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 (χ 2 [1] = 7.06, p = 0.008), texture modification (χ 2 [1] = 93.34, p < 0.001) and an existing dysphagia diagnosis (χ 2 [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

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%