Dysphagia. It’s a growing problem in skilled nursing care, and an urgent one, as the condition, in which a person has deep difficulty swallowing, can lead to serious complications including malnutrition, dehydration or even death.
As of 2020, studies showed global rates of dysphagia among nursing home residents as high as 70%. These swallowing problems often arise in older adults following a stroke, Dementia, Alzheimer’s or Parkinson’s disease, or from injuries to the head or neck after a fall.
Diagnosing swallowing problems and applying therapy can be complicated, but eased with the use of evaluation tools, such as those provided by Powerback Rehabilitation through its program Swallow Solutions. Usually SNF operators call speech-language pathologists (SLPs) to address swallowing problems. In many cases, SLP-led therapy can successfully teach patients to train the muscles in the throat and mouth to enable them to swallow without issues.
But the right tools can make the difference.
Swallow Solutions has proven effective in allowing SLPs to examine patients using endoscopes — a small tube with an attached camera inserted through the patient’s nose. This process, called flexible endoscopic evaluation of swallowing (FEES), allows the SLP to peek inside the upper respiratory tract for a correct diagnostic and a therapy plan.
Powerback, one of the largest rehabilitation services providers in the nation, uses endoscopes developed by PatCom Medical Inc. The company has seen success with Swallow Solutions in the pilot stage, introducing FEES as a demonstration project in Albuquerque, NM. In the first 235 procedures under this pilot program, 66% of exams resulted in patients receiving immediate changes in diet recommendation, and 94% resulted in identification for further skilled intervention through accurate and thorough diagnostics from the FEES procedure.
Today, the Swallow Solutions’ FEES service has expanded to many of Powerback’s contract locations across 17 states, helping more than 30 Powerback speech-language pathologists to be trained in this procedure and receive the necessary state-of-the-art devices.
“The aspect I love most is seeing how empowered our own SLPs feel having this clinical tool as part of their practice,” says David Gerst, Senior Clinical Director and FEES lead at Powerback. “It is uplifting to hear the amazing stories they share of the impact they are making with their patients.”
What SNFs need with regards to speech therapy
Because dysphagia can impact health outcomes and patient care in the skilled nursing setting if left untreated, diagnostic and therapy tools such as those provided by Powerback are essential, especially in the post-pandemic era.
“One large lesson the pandemic taught us was the need to enhance access to patient care,” Gerst says. “When we review the literature, the need for instrumental assessment is paramount to treating patients with dysphagia in any environment. Powerback Rehabilitation recognizes the need and the positive impacts of this procedure — key reasons why our in-house FEES program was created.”
How Swallow Solutions helps
During a FEES examination, a trained SLP will assess swallow physiology and function for residents who experience swallowing difficulties. The painless imaging procedure is completed in the safety and comfort of the patient’s own living environment and does not require anesthesia, allowing the patient to be awake and alert while consuming various liquid and food consistencies and interacting with the SLP.
The SLP will also use the test to identify possible ways to help the individual swallow safely and with less difficulty as part of a speech therapy care plan. This examination can be readministered as needed to determine if there have been any improvements or declines in swallowing over time. Powerback reports approximately 1,400 contracts nationwide for its FEES clinical tool, and plans to further expand the service across its portfolio of therapy services.
“As a leading provider of a wide variety of rehabilitation services, we are well poised to successfully partner with skilled nursing centers, assisted living facilities, independent living facilities, hospitals, home health companies, adult day care programs and outpatient clinics to provide comprehensive therapy services, including solutions for dysphagia,” Gerst says.
This article is sponsored by Powerback Rehabilitation, which focuses on patient-centered care that provides a sustainable way of feeling, moving, breathing and living better, all designed to get patients back home or to their prior level of functioning as quickly as possible. For more information, visit http://www.powerbackrehab.com.
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