Causes of Death Determined in Medicolegal Investigations in Residents of Nursing Homes: A Systematic Review

Kennedy, Briohny; Ibrahim, Joseph E.; Bugeja, Lyndal; Ranson, David

doi:10.1111/jgs.12929

Cited by 23 publications

(23 citation statements)

References 24 publications

(164 reference statements)

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“…The committee developed detailed definitions for each level of the draft Framework, based on (a) the measurement activities conducted at the 2015 face-to-face meeting; (b) drawing from descriptors in all available national standards documents; and (c) the literature describing properties that increase risk for choking [35–44]. The draft definitions included a warning after Level 6 to clarify that the physiological skills of being able to both bite and chew food were required to safely transition to Level 7 Regular foods.…”

Section: Resultsmentioning

confidence: 99%

“…Children younger than three years of age, adults over 65 years of age, individuals with poor dentition, and those with neurological conditions are at high risk of death from asphyxiation on food [35, 60]. In healthy people, regardless of the initial state of the food, after oral processing and at the point of swallow initiation, the bolus is a cohesive mass.…”

Section: Discussionmentioning

confidence: 99%

“…This practice is consistent with evidence in the literature specific to choking and asphyxiation risk, which reveals that food textures that pose the most risk are categorized according to texture, shape, and size. Specifically, foods that are described as hard or dry; chewy or sticky; crunch or crumbly; floppy; fibrous or ‘tough’; have husks; are stringy; round or long in dimension or consist of multiple or ‘dual’ textures are high choking risks [35–44]. Additional discussion regarding choking risk can be found in the IDDSI Foundation manuscript [26].…”

Section: Discussionmentioning

confidence: 99%

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Development of International Terminology and Definitions for Texture-Modified Foods and Thickened Fluids Used in Dysphagia Management: The IDDSI Framework

et al. 2016

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Dysphagia is estimated to affect ~8% of the world’s population (~590 million people). Texture-modified foods and thickened drinks are commonly used to reduce the risks of choking and aspiration. The International Dysphagia Diet Standardisation Initiative (IDDSI) was founded with the goal of developing globally standardized terminology and definitions for texture-modified foods and liquids applicable to individuals with dysphagia of all ages, in all care settings, and all cultures. A multi-professional volunteer committee developed a dysphagia diet framework through systematic review and stakeholder consultation. First, a survey of existing national terminologies and current practice was conducted, receiving 2050 responses from 33 countries. Respondents included individuals with dysphagia; their caregivers; organizations supporting individuals with dysphagia; healthcare professionals; food service providers; researchers; and industry. The results revealed common use of 3–4 levels of food texture (54 different names) and ≥3 levels of liquid thickness (27 different names). Substantial support was expressed for international standardization. Next, a systematic review regarding the impact of food texture and liquid consistency on swallowing was completed. A meeting was then convened to review data from previous phases, and develop a draft framework. A further international stakeholder survey sought feedback to guide framework refinement; 3190 responses were received from 57 countries. The IDDSI Framework (released in November, 2015) involves a continuum of 8 levels (0–7) identified by numbers, text labels, color codes, definitions, and measurement methods. The IDDSI Framework is recommended for implementation throughout the world.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Development of International Terminology and Definitions for Texture-Modified Foods and Thickened Fluids Used in Dysphagia Management: The IDDSI Framework

et al. 2016

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“…; Kennedy et al . ). While more people choke in the community or at home, choking still occurs in hospital settings (69% and 9.5–27%, respectively) (Berzlanovich et al .…”

Section: Changes To the Integrity Of The Chewing And Swallowing Mechamentioning

confidence: 97%

Adjustment of Food Textural Properties for Elderly Patients

Cichero

2016

Journal of Texture Studies

110

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Over the next twenty years the number of people over 60 years will exceed one billion. Changes associated with ageing have an impact on food texture choices for healthy elders and those used therapeutically for people with swallowing difficulties (dysphagia). The ideal “swallow‐safe” bolus is moist, cohesive and slippery. A general reduction in muscle strength is seen throughout the ageing oropharyngeal musculature, resulting in a reduced ability to safely and efficiently manage hard or fibrous textured foods. Reduced masticatory ability combined with dental loss further compounds the issue. Dry mouth is commonly associated with old age, making it difficult to propel dry or sticky textures through the pharynx, and increases the likelihood of pharyngeal residue. An age related reduction in laryngopharyngeal sensitivity dampens the ability to detect residue, increasing choking risk. Reduced tongue pressure, increases in pharyngeal transit time, valleculae residue, number of clearing swallows and slower and less efficient oesophageal transit occur with aged swallowing. Food textures that are sticky and adhesive will require increased lingual effort to propel them into and through the pharynx. Taken in combination these factors mean that food textures prescribed to the elderly need to be soft and moist and for fibers to be easily broken. To improve moisture content, additional nutrient dense products (e.g., milk, cream or butter) may be required to artificially moisten the bolus. Careful, individualized attention to diet recommendations will result in a diet that is appealing and also provide a variety of textures that are swallow‐safe and nutrient dense. Practical Application Aged related changes in the oral cavity and the oral, pharyngeal and oesophageal phases of swallowing require special thought to the suitability of food textures for the elderly. Foods that are fibrous, hard or dry may be unsuitable due to difficulties with safe particle size reduction and bolus formation for swallowing. Foods that are sticky and adhesive are also problematic and increase risk for both choking and residue. Food texture properties that are ideally suited for the elderly include those that are soft, moist, and easily reduced with minimal chewing effort. Hard food textures that break down and dissolve easily with minimal chewing should be investigated. Increased aroma and flavor may improve appeal lost through reduced variety in food textures. Diet reviews need to consider both textures that can be safely managed and the nutrient density of those textures.

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“…The experience is NOT uniquely American, but as De Leo and Spathonis (2004) and Kennedy, Ibrahim, Bugeja and Ranson (2014) demonstrate the high suicide rate among elders is an international phenomenon. The critical question is, "What can practitioners do create or nurture an environment that reduces the likelihood that an elder would want to pursue that course of action?"…”

Section: Introductionmentioning

confidence: 99%

The Measurement of Suicide Assessment and the Development of a Treatment Strategy for Elders: Durkheim an Approach

Marson¹,

Hong²,

Bullard³

2017

JSSW

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Causes of Death Determined in Medicolegal Investigations in Residents of Nursing Homes: A Systematic Review

Abstract: This systematic review informs researchers, clinicians and policy-makers about how to reduce external causes of death in nursing homes.

Cited by 23 publications

References 24 publications

Development of International Terminology and Definitions for Texture-Modified Foods and Thickened Fluids Used in Dysphagia Management: The IDDSI Framework

Development of International Terminology and Definitions for Texture-Modified Foods and Thickened Fluids Used in Dysphagia Management: The IDDSI Framework

Adjustment of Food Textural Properties for Elderly Patients

The Measurement of Suicide Assessment and the Development of a Treatment Strategy for Elders: Durkheim an Approach

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