It is well documented that people with learning disabilities are more likely to have issues with swallowing. This might include problems with initiating the swallowing process or a feeling that liquids and foods are being blocked when they pass through the esophagus.
Dysphagia is linked to many neurological conditions and can cause a host of health problems. Not only can dysphagia disrupt normal eating and drinking activities, which can lead to malnutrition and a poor quality of life, but it can also raise the risk of aspiration. Appropriate management of dysphagia in people with learning disabilities is important.
Different Types of Dysphagia
There are two main types of dysphagia:
- Oropharyngeal dysphagia affects the mouth and throat. Patients with this type of dysphagia struggle to swallow liquids or some food textures.
- Esophageal dysphagia is when the patient can swallow food and liquids, but it feels as if there is a blockage in the throat and esophagus.
Management of the condition will depend on which type of dysphagia the person has.
Oropharyngeal Dysphagia
People with oropharyngeal dysphagia will need to have the consistency of their food modified. This helps the food pass through the oral cavity with fewer difficulties. Food can be mashed or eaten as a thick puree. Thickeners such as Simply Thick honey consistency can be added to liquids to reduce the risk of accidental aspiration. This will help the person have better control over the swallowing mechanism and slow down transit time as food passes through the pharynx.
It is important not to push a person with oropharyngeal dysphagia to eat their food or drink faster than is comfortable. Adult supervision will ensure safety during mealtimes but where possible, you should encourage the person to eat independently.
If the dysphagia is severe and eating and drinking independently or with supervision are not possible, a feeding tube might be necessary to ensure the person receives enough nutrition. This is something to discuss with the medical practitioner in charge of the patient.
Esophageal Dysphagia
People with esophageal dysphagia are managed differently. Drugs to relax the esophagus are often administered, which can provide relief from symptoms. Surgery may also be recommended, depending on the underlying cause of the patient’s esophageal dysphagia.
Medication Management
Ensuring the person with learning disabilities receives sufficient nutrition and hydration is not the only problem. Medications are often administered orally, which can present an issue when the person suffers from dysphagia.
Tablets may become unpalatable when crushed or chewed, which makes them harder to swallow. Sometimes changing the shape of a table from round to torpedo can help make it easier to swallow whole, but if a tablet is crushed or chewed, check with the patient whether this is acceptable. If communication is a problem, bear this in mind – you may need to consider alternative methods of administering medication, such as liquids, patches, or suppositories.
People with learning disabilities and dysphagia need careful management, but there are often workarounds when problems do arise.
