Management of Dysphagia: Building Consistency Across the
Continuum of Care (Recorded Webinar)
Presented by Angela Mansolillo
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Non-Financial: Angela Mansolillo has no competing non-financial interests or relationships with regard to the content presented in this course.
This course is a recording of a previously hosted live webinar event. Polling and question submission features are not available for this recording. Format and structure may differ from standard MedBridge courses.
Dysphagia clinicians are faced with a great deal of information, much of it conflicting, from a wide variety of sources and must differentiate between anecdotal information, evidence, and conventional wisdom. Our assessment process is designed to effectively identify aspiration, but not to evaluate that aspiration in the context of individual risk factors and preferences.
This course will use a case-discussion format to assist clinicians in assessment of risk to each client’s respiratory status, nutrition and hydration, and quality of life. We will also discuss risks and benefits of frequently used treatment modalities, including diet modifications, exercise, and compensatory strategies, with a goal of assisting clinicians in developing effective, targeted interventions. Dysphagia clinicians working in acute, subacute, home health, and ambulatory settings will leave this course armed with the skills and knowledge to develop treatment plans that take into account individual risk factors, target specific impairments, and improve client adherence and participation.
Meet your instructor
Angela Mansolillo
Angela Mansolillo is a speech-language pathologist and board-certified specialist in swallowing disorders with more than 25 years of experience. She is currently a senior speech-language pathologist at Cooley Dickinson Hospital in Northampton, Massachusetts, where she provides evaluation and treatment services for adults and…
Chapters & learning objectives
1. If You’ve Seen One Swallow, You’ve Seen One Swallow
We can’t expect to identify abnormalities in swallowing until we understand what normal swallowing looks like. This chapter will review the evidence describing normal swallow variability and the impact of normal aging on swallow function.
2. Aspiration Pneumonia Isn’t Just About Aspiration
Every aspiration event does not inevitably lead to aspiration pneumonia, so who does get sick? This chapter will discuss risk factors for pneumonia in a variety of patient populations to allow the clinician to evaluate aspiration in the context of each patient’s health, respiratory, nutritional, and hydration status.
3. Assessment of Aspiration and Aspiration Pneumonia
Now that we have identified risk factors for aspiration pneumonia, how can we incorporate that knowledge into our assessment process? This chapter will discuss the assessment process, with a focus on putting the aspiration in the context of everything that is known about our client.
4. NPO: Friend or Foe?
NPO, or nil per os, is an all too frequent recommendation for clients at risk of aspiration. This chapter will discuss rationales for an NPO recommendation as well as the risks inherent in restricting oral intake.
5. Texture Modification: More Than Meets the Eye
Dysphagia clinicians often reduce the texture of foods to compensate for oral motor dysfunction and reduce choking risk. These modifications are not without risk, however. This chapter will discuss the impact of texture modification on oral intake and nutrition.
6. To Thicken or Not to Thicken?
Thickened liquids are often the first line of defense in dysphagia intervention. This chapter will evaluate the benefits and risks of thickening and will provide strategies to mitigate those risks.
7. Therapy Only Works If You Do It
Clinicians are often frustrated by clients who can’t or won’t adhere to their exercise program or use their strategies. This chapter will provide strategies for assessment of health literacy and potential for adherence in dysphagic clients.
8. When It Comes to Therapy, Sometimes Less Is More
Dysphagia clinicians often take a “more is better” approach to therapy, providing clients with long lists of strategies and interventions. This chapter will train clinicians to choose compensations and sensory interventions that are based on specific underlying impairments.
9. Making Exercise Work
Exercise should be prescribed—specific to the individual client and to the specific underlying impairment. This chapter will assist clinicians in improving outcomes by matching exercise to impairment.
10. Question and Answer Session
This section is a viewer-submitted question and answer session facilitated by Angela Mansolillo.