DYSPHAGIA

Swallowing is a complex neuromuscular process by which food from the mouth pass through the pharynx and esophagus into the stomach.

Dysphagia is defined by the presence of difficulty swallowing. Data normally is a sign of underlying disease of the esophagus or esophageal neighboring organs, which may be due to gastro-oesophageal reflux, cancer, thytoid disease, stroke and various neurodegenerative diseases such as Alzheimer's, Guillain Barre, Syndrome or Amyotrophic Lateral Sclerosis.
Dysphagia, besides be a risk factor for malnutrition of the patient, in this case, the elderly, can cause complications, some so severe and frequent as aspiration (passage of food into the airwai), where the performance nursing staff and medical practitioners should be fast and efficient, because in a few minutes you can produce the death of the patient.

The nurse assessment at admission and during the stay in the institution it is essential, in addition to being a disease with a high incidence in the elderly.
It´s important the education directed toward these people, or their caregivers which not only has to compose for advice on dietary care but also must be of postural care and training, which can improve the patient's situation in the areas of nutritional, functional, relational, welfare and autonomy.

TREATMENT

The best performing treatment offers these patients, treatment is multidisciplinary, therefore, we treat the pathology from viewpoints of nursing, nutrition, medicine, with the following objetives:

• Getting a good nutritional status
• Reduce aspiration with oral diet
• Reduce other complications associated
• Rate supplements
• Power evaluate other channels, in the case where the oral feeding is contraindicated.

NURSING MEASURES IN PATIENS WITH NUTRITION DYSPHAGIA

• Avoid distractions during feeding
• Upright posture with slight flexion of the neck
• Perform proper cleaning pre and post oral intake
• Start with small amounts. Smell and taste food as it should be adapted to the tastes of the patient
• Give enough time and did not suppress the cough
• Select foods with texture, consistency, flavor and temperatures
• Instruct family and caregives

There are two types of patients for whom these measures are not fully developed:

• Patients with stroke.
• Patients with advanced dementia.

BIBLIOGRAPHY

Ferrero López M. I., Castellano Vela E., Navarro Sanz R.. Usefulness of implementing dysphagia care programme at an intermediate and long stay hospital, Nutr. Hosp. [serial on the Internet]. 2009 Oct [cited 2012 May 23]; 24(5): 588-595. Available from: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112009000500011&lng=en

Irles Rocamora J. A., Sánchez-Duque M. J., Valle Galindo P. B. de, Bernal López E., Fernández Palacín A., Almedia González C. et al . A prevalence study of dysphagia and intervention with dietary counselling in nursing home from Seville. Nutr. Hosp. [serial on the Internet]. 2009 Aug [cited 2012 May 23]; 24(4): 498-503. Available from: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112009000400016&lng=en