[Dysphagia] Re: new list on Medicare holiday coverage

[pressmah at sjhmc.org (pressmah@sjhmc.org)]

Dehydration secondary to refusal or inadequate intake of thickened liquids
is a significant problem.  The current newsletter from Division 13
Swallowing and Swallowing Disorders addresses this issue.  If you are not a
member of Division 13 I suggest that you join so that you can access this
excellent publication, which you can also use to get CEUs  Hilda Pressman

-----Original Message-----
From: smilinggirl336@comcast.net [mailto:smilinggirl336@comcast.net]
Sent: Wednesday, March 02, 2005 2:38 PM
To: dysphagia@b9.com
Subject: RE: [Dysphagia] Re: new list on Medicare holiday coverage


I am new to this dysphagia list and I am questioning why SLP's would be
opposed to using thickened liquids.  
  
I am a proponent of using thickened liquids to reduce the risk of aspiration
of thin liquids.  I refrain from using the term "prevent" when it comes to
aspiration, as I feel it is impossible to "prevent" aspiration, especially
with saliva. I find that poor positioning in hospital beds and poor feeding
techniques can increase the risk of aspiration with almost consistency.   I
feel my job is useful to reduce the risk of aspiration and  to reduce the
frequency of aspiration and I may do this by altering the consistency of
foods and liquids.  I think it is also important to look at the nature of
the aspirate.   I find that some patients find it uncomfortable to have
coughing episodes while drinking and find swallowing thickened liquids to be
more comfortable.  Are not these reasons to use thickened liquids?  Whenever
possible, I want people to be on a "normal" diet; it is equally important
that patient's will accept the consistencies and be able to meet their
nutrtional and hyd!
 ration needs.  If these are not met, they will develop other problems (i.e.
dehyrdation, malnutrition, cognitive changes, UTI).  There is so much more
to look at when we treat a patient than just aspiration risk.  

I also get upset when I see physician's (or others) document that they
inserted a PEG tube to prevent aspiration.  With the PEG tube, they have
just opened up another can of worms, and we can't prevent aspiration!

Anyway, as I am new to the list, I hope I am not just restating what has
already been said - just trying to add my reasoning for using thickened
liquids.

Thanks,
Jean
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