Supporting people who have eating and drinking difficulties

Porter, Karen; Burch, Nicola; Campbell, Claire; Danbury, Chris; Foster, Charles; Gabe, Simon; Goddard, Andrew; Harp, Katie; Holdoway, Anne; Hughes, Tom; Ball, Karen L.; Nightingale, Julie; Rochford, A.; Keene, Alex Ruck; Smith, Alison; Smith, Trevor; Silva, Aminda De

doi:10.7861/clinmed.2021-0161

Cited by 6 publications

(6 citation statements)

References 7 publications

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“…Testing in simulation established the Bed Band as being supportive and comfortable which can have a positive impact on health and well-being. Potential activities such as reading and gaming could be enabled while support for eating and drinking could help avoid weight loss, dehydration, aspiration and pulmonary infections 22…”

Section: Discussionmentioning

confidence: 99%

“…Potential activities such as reading and gaming could be enabled while support for eating and drinking could help avoid weight loss, dehydration, aspiration and pulmonary infections. 22 …”

Section: Discussionmentioning

confidence: 99%

“…Potential activities such as reading and gaming could be enabled while support for eating and drinking could help avoid weight loss, dehydration, aspiration and pulmonary infections. 22 All innovations for use in healthcare settings entail an inherent degree of risk that will persist despite mitigation efforts. 23 Risk-informed product development can improve the safety of innovations and increase their chance of success.…”

Section: Discussionmentioning

confidence: 99%

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Experience-based Modifications of the Bed Band ReAlised through Co-dEsign (EMBRACE)

Beattie,

Muirhead,

Gibb

et al. 2024

BMJ Open Qual

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BackgroundUpper body limitations are a common disability in neurological conditions including stroke and multiple sclerosis. Care of patients with upper body limitations while in bed involves positioning techniques to maximise comfort and independence. The Bed Band is a nurse-led innovation to support people with limited mobility to maintain a comfortable position in bed, thereby promoting comfort and independence with activities of daily living.AimTo co-design and implement adaptations to the Bed Band prototype with recommendations for user instructions towards enhanced product design and future development.MethodsA co-design approach involving collaboration between academic and industry partners. Expert stakeholders provided feedback on the Bed Band via an online focus group before healthy volunteers tested the product in a healthcare simulation suite. Data were thematically analysed and findings sense checked by expert stakeholders who then prioritised adaptations to the Bed Band using a modified Delphi technique.ResultsThree themes resulted from the analysis: (1) reaction to the Bed Band; (2) potential risks and mitigation; and (3) product adaptations. Simplicity was a strength of the innovation which easily enabled positional support. Adaptations to the Bed Band informed the development of an enhanced prototype for testing in future studies.ConclusionCo-design of the Bed Band prototype involving experts and healthy volunteers enabled early identification of potential risks with recommendations to mitigate them and priority adaptations. Further studies are required in hospital patients and community populations with upper mobility issues to determine the efficacy of the Bed Band and optimal duration of use.

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Section: Discussionmentioning

confidence: 99%

“…Potential activities such as reading and gaming could be enabled while support for eating and drinking could help avoid weight loss, dehydration, aspiration and pulmonary infections. 22 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Experience-based Modifications of the Bed Band ReAlised through Co-dEsign (EMBRACE)

Beattie,

Muirhead,

Gibb

et al. 2024

BMJ Open Qual

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“…Capacity assessment forms part of the decision-making process, and the patient is always involved if they are capable. The Royal College of Physicians (RCP) has also published guidance on supporting people with eating and drinking difficulties [5].…”

Section: Introductionmentioning

confidence: 99%

Decisions on eating and drinking in older adults admitted with pneumonia and referred for swallowing difficulties

Yoshimatsu,

Hansjee,

Markowski

et al. 2024

Eur Geriatr Med

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Purpose Older patients with pneumonia are commonly restricted from oral intake due to concerns towards aspiration. Eating and drinking with acknowledged risks (EDAR) is a shared decision-making process emphasising patient comfort. As part of our project to find the barriers and facilitators of EDAR, we aimed for this initial study to see how frequently EDAR was selected in practice. Methods We performed a retrospective cohort study at an acute hospital where EDAR was initially developed, of patients aged ≥ 75 years-old admitted with pneumonia and referred to speech and language therapy. Results Out of 216 patients, EDAR decisions were made in 14.4%. The EDAR group had a higher 1-year mortality than the modified/normal diet groups (p < 0.001). Pneumonia recurrence rate did not differ significantly between the groups (p = 0.070). Conclusion EDAR decisions were comparatively less common and most were associated with end-of-life care. Underlying reasons for the low EDAR application rate must be investigated to maximise patient autonomy and comfort as intended by EDAR while minimising staff burden.

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“…The ability to swallow is an essential aspect of human physiology and necessary for maintaining proper nutrition and hydration. 1 ) Dysphagia, or difficulty swallowing, is a common problem that can have serious consequences, including malnutrition, dehydration, pneumonia, and even death. 2 ) In addition to its negative health effects, dysphagia can affect the quality of life in older adults.…”

Section: Introductionmentioning

confidence: 99%

The Clinical Frailty Scale as a Risk Assessment Tool for Dysphagia in Older Inpatients: A Cross-Sectional Study

Kang¹,

Ji²,

Park³

et al. 2023

Ann Geriatr Med Res

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Background: Dysphagia is a common problem with potentially serious consequences including malnutrition, dehydration, pneumonia, and death. However, there are challenges in screening for dysphagia in older adults. We assessed the feasibility of using the Clinical Frailty Scale (CFS) as a risk assessment tool for dysphagia.Methods: This cross-sectional study was conducted at a tertiary teaching hospital from November 2021 to May 2022 and included 131 older patients (age ≥65 years) admitted to acute wards. We used the Eating Assessment Tool-10 (EAT-10), which is a simple measure for identifying individuals at risk of dysphagia, to assess the relationship between EAT-10 score and frailty status as measured using the CFS.Results: The mean age of the participants was 74.3±6.7 years, and 44.3% were male. Twenty-nine (22.1%) participants had an EAT-10 score ≥3. The CFS was significantly associated with an EAT-10 score ≥3 after adjusting for age and sex (odds ratio=1.48; 95% confidence interval [CI], 1.09–2.02). The CFS was able to classify the presence of an EAT-10 score ≥3 (area under the receiver operating characteristic [ROC] curve=0.650; 95% CI, 0. 544–0.756). The cutoff point for predicting an EAT-10 score ≥3 was a CFS of 5 according to the highest Youden index, with a sensitivity of 82.8% and a specificity of 46.1%. The positive and negative predictive values were 30.4% and 90.4%, respectively.Conclusion: The CFS can be used as a tool to screen for the risk of swallowing difficulty in older inpatients to determine clinical management encompassing drug administration routes, nutritional support, prevention of dehydration, and further evaluation of dysphagia.

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Supporting people who have eating and drinking difficulties

Cited by 6 publications

References 7 publications

Experience-based Modifications of the Bed Band ReAlised through Co-dEsign (EMBRACE)

Experience-based Modifications of the Bed Band ReAlised through Co-dEsign (EMBRACE)

Decisions on eating and drinking in older adults admitted with pneumonia and referred for swallowing difficulties

The Clinical Frailty Scale as a Risk Assessment Tool for Dysphagia in Older Inpatients: A Cross-Sectional Study

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